The Influence of Corticosteroids, Immunosuppressants and Biologics on Patients With Inflammatory Bowel Diseases, Psoriasis and Rheumatic Diseases in the Era of COVID-19: A Review of Current Evidence.
The Influence of Corticosteroids, Immunosuppressants and Biologics on Patients With Inflammatory Bowel Diseases, Psoriasis and Rheumatic Diseases in the Era of COVID-19: A Review of Current Evidence.
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DOI：
10.3389/fimmu.2021.677957
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发表时间：
2021
影响因子：
7.3
通讯作者：
Yang H
中科院分区：
文献类型：
--
作者：
Zhang M;Bai X;Cao W;Ji J;Wang L;Yang Y;Yang H
炎症性肠病、银屑病或其他风湿性疾病患者接受皮质类固醇、免疫调节剂和生物制剂治疗，由于其免疫功能低下状态，在COVID-19流行期间可能面临额外风险。然而，在COVID-19疫情期间，对这些疗法的使用仍然没有一致的意见。目前的研究表明，全身性皮质类固醇可能会增加免疫介导的炎症性疾病患者的住院风险，以及通气、ICU和死亡的风险。抗肿瘤坏死因子药物与较低的住院率，以及较低的通气，ICU和死亡的风险。在接受免疫调节剂或除抗TNF药物外的生物制剂治疗的患者中，未观察到住院率、通气率、ICU和死亡率的显著变化。这些结果的潜在机制可能与SARS-COV-2感染诱导的抗病毒免疫应答途径和细胞因子风暴有关。应根据个体患者权衡获益和潜在风险后，再决定是否使用皮质类固醇、免疫调节剂和生物制剂。
Patients with inflammatory bowel disease, psoriasis or other rheumatic diseases treated with corticosteroids, immunomodulators and biologics might face additional risk during COVID-19 epidemic due to their immunocompromised status. However, there was still no unanimous opinion on the use of these therapy during COVID-19 epidemic. Current studies suggested that systemic corticosteroids might increase the risk of hospitalization, as well as risks of ventilation, ICU, and death among patients with immune-mediated inflammatory diseases. Anti-TNF agent was associated with lower rate of hospitalization, as well as lower risks of ventilation, ICU, and death. No significant changes in rates of hospitalization, ventilation, ICU and mortality were observed in patients treated with immunomodulators or biologics apart from anti-TNF agents. The underlying mechanism of these results might be related to pathway of antiviral immune response and cytokine storm induced by SARS-COV-2 infection. Decision on the use of corticosteroids, immunomodulators and biologics should be made after weighing the benefits and potential risks based on individual patients.
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