• RochaAline Pereira daAPD0000-0002-0863-6500MSc. Pharmacist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil., Álvaro Nagib Atallah, PintoAna Carolina Pereira NunesACPN0000-0002-1505-877XMSc. Physiotherapist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; Professor, Department of Biological and Health Sciences, U, César Ramos Rocha-Filho, Keilla Martins Milby, Vinicius Tassoni Civile, Nelson Carvas Junior, Felipe Sebastião de Assis Reis, Laura Jantsch Ferla, Gabriel Sodré Ramalho, Giulia Fernandes Moça Trevisani, Maria Eduarda Dos Santos Puga, and TrevisaniVirgínia Fernandes MoçaVFM0000-0002-7180-6285MD, PhD. Rheumatologist and Professor, Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP) Brazil; and Pr.
• MSc. Pharmacist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; and Volunteer Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
• Sao Paulo Med J. 2020 Nov 1; 138 (6): 515520515-520.

BackgroundPatients with immune-mediated inflammatory diseases (IMID) are at increased risk of infection.ObjectiveTo assess whether patients undergoing pharmacological treatment for IMID present higher risk of worse outcomes when diagnosed with COVID-19.Design And SettingRapid systematic review conducted in the medical school of the Federal University of São Paulo (SP), Brazil.MethodsWe searched CENTRAL, MEDLINE, EMBASE, LILACS, SCOPUS, Web of Science, L·OVE, ClinicalTrials.gov and WHO-ICTRP for studies evaluating patients diagnosed with COVID-19 who were undergoing pharmacological treatment for IMID. Two authors selected studies, extracted data and assessed risk of bias and certainty of evidence, following the Cochrane recommendations.ResultsWe identified 1,498 references, from which one cohort study was included. This compared patients with and without rheumatic diseases (RD) who all had been diagnosed with COVID-19. Those with RD seemed to have higher chances of hospitalization and mortality, but no statistical difference was detected between the groups: hospitalization: odds ratio (OR) 1.17; 95% confidence interval (CI) 0.6 to 2.29; mortality rate: OR 1.53; 95% CI 0.33 to 7.11 (very low certainty of evidence). Patients with RD were three times more likely to require admission to intensive care units (ICUs), with invasive mechanical ventilation (IMV), than those without RD: OR 3.72; 95% CI 1.35 to 10.26 (for both outcomes; very low certainty of evidence).ConclusionPatients undergoing pharmacological treatment for IMID seem to present higher chances of requiring admission to ICUs, with IMV. Additional high-quality studies are needed to analyze the effects of different treatments for IMID.

14 keywords...

hide…