Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19

Phyo K Myint; Ben Carter; Fenella Barlow-Pay; Roxanna Short; Alice Einarsson; Eilidh Bruce; Kathryn McCarthy; Alessia  Verduri; Jemima T  Collins; James Hesford; Frances Rickard; Emma Mitchell; Mark Holloway; Aine McGovern; Arturo Vilches-Moraga; Philip Braude; Lyndsay Pearce; Michael J Stechman; Angeline Price; Terence J Quinn; Enrico Clini; Susan J Moug; Jonathan Hewitt; COPE Study Collaborators

doi:10.1177/2042098620985690

Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19

Phyo K Myint, Ben Carter, Fenella Barlow-Pay, Roxanna Short, Alice Einarsson, Eilidh Bruce^* (Corresponding Author), Kathryn McCarthy, Alessia Verduri, Jemima T Collins, James Hesford, Frances Rickard, Emma Mitchell, Mark Holloway, Aine McGovern, Arturo Vilches-Moraga, Philip Braude, Lyndsay Pearce, Michael J Stechman, Angeline Price, Terence J QuinnEnrico Clini, Susan J Moug, Jonathan Hewitt^*, COPE Study Collaborators

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

We do not have much information on how the COVID-19 virus affects patients who use immunosuppressants, drugs which inhibit or reduce the activity of the immune system. There are various conflicting views on whether immune-suppressing drugs are beneficial or detrimental in patients with the disease. Methods: This study collected data from 10 hospitals in the UK and one in Italy between February and April 2020 in order to identify any association between the regular use of immunosuppressant medicines and survival in patients who were admitted to hospital with COVID-19. Results: 1184 patients were included in the study, and 10% of them were using immunosuppressants. Any immunosuppressant use was associated with increased risk of death, and the risk appeared to increase if the dose of the medicine was higher. Conclusion: We therefore recommend that patients who take immunosuppressant medicines routinely should carefully adhere to social distancing measures, and seek medical attention early during the COVID-19 pandemic.

Original language	English
Article number	2042098620985690
Pages (from-to)	1-17
Number of pages	17
Journal	Therapeutic Advances in Drug Safety
Volume	12
Early online date	18 Feb 2021
DOIs	https://doi.org/10.1177/2042098620985690
Publication status	Published - 2021

Keywords

Coronavirus
Covid-19
immunosuppressant
immunosuppression
immunosuppressants

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Myint, P. K., Carter, B., Barlow-Pay, F., Short, R., Einarsson, A., Bruce, E., McCarthy, K., Verduri, A., Collins, J. T., Hesford, J., Rickard, F., Mitchell, E., Holloway, M., McGovern, A., Vilches-Moraga, A., Braude, P., Pearce, L., Stechman, M. J., Price, A., ... COPE Study Collaborators (2021). Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19. Therapeutic Advances in Drug Safety, 12, 1-17. [2042098620985690]. https://doi.org/10.1177/2042098620985690

Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19. / Myint, Phyo K; Carter, Ben; Barlow-Pay, Fenella; Short, Roxanna; Einarsson, Alice; Bruce, Eilidh (Corresponding Author); McCarthy, Kathryn; Verduri, Alessia ; Collins, Jemima T ; Hesford, James; Rickard, Frances; Mitchell, Emma; Holloway, Mark; McGovern, Aine; Vilches-Moraga, Arturo; Braude, Philip; Pearce, Lyndsay; Stechman, Michael J; Price, Angeline; Quinn, Terence J; Clini, Enrico; Moug, Susan J; Hewitt, Jonathan (Corresponding Author); COPE Study Collaborators.

In: Therapeutic Advances in Drug Safety, Vol. 12, 2042098620985690, 2021, p. 1-17.

Research output: Contribution to journal › Article › peer-review

Myint, PK, Carter, B, Barlow-Pay, F, Short, R, Einarsson, A, Bruce, E, McCarthy, K, Verduri, A, Collins, JT, Hesford, J, Rickard, F, Mitchell, E, Holloway, M, McGovern, A, Vilches-Moraga, A, Braude, P, Pearce, L, Stechman, MJ, Price, A, Quinn, TJ, Clini, E, Moug, SJ, Hewitt, J & COPE Study Collaborators 2021, 'Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19', Therapeutic Advances in Drug Safety, vol. 12, 2042098620985690, pp. 1-17. https://doi.org/10.1177/2042098620985690

Myint, Phyo K ; Carter, Ben ; Barlow-Pay, Fenella ; Short, Roxanna ; Einarsson, Alice ; Bruce, Eilidh ; McCarthy, Kathryn ; Verduri, Alessia ; Collins, Jemima T ; Hesford, James ; Rickard, Frances ; Mitchell, Emma ; Holloway, Mark ; McGovern, Aine ; Vilches-Moraga, Arturo ; Braude, Philip ; Pearce, Lyndsay ; Stechman, Michael J ; Price, Angeline ; Quinn, Terence J ; Clini, Enrico ; Moug, Susan J ; Hewitt, Jonathan ; COPE Study Collaborators. / Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19. In: Therapeutic Advances in Drug Safety. 2021 ; Vol. 12. pp. 1-17.

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title = "Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19",

abstract = "We do not have much information on how the COVID-19 virus affects patients who use immunosuppressants, drugs which inhibit or reduce the activity of the immune system. There are various conflicting views on whether immune-suppressing drugs are beneficial or detrimental in patients with the disease. Methods: This study collected data from 10 hospitals in the UK and one in Italy between February and April 2020 in order to identify any association between the regular use of immunosuppressant medicines and survival in patients who were admitted to hospital with COVID-19. Results: 1184 patients were included in the study, and 10% of them were using immunosuppressants. Any immunosuppressant use was associated with increased risk of death, and the risk appeared to increase if the dose of the medicine was higher. Conclusion: We therefore recommend that patients who take immunosuppressant medicines routinely should carefully adhere to social distancing measures, and seek medical attention early during the COVID-19 pandemic.",

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author = "Myint, {Phyo K} and Ben Carter and Fenella Barlow-Pay and Roxanna Short and Alice Einarsson and Eilidh Bruce and Kathryn McCarthy and Alessia Verduri and Collins, {Jemima T} and James Hesford and Frances Rickard and Emma Mitchell and Mark Holloway and Aine McGovern and Arturo Vilches-Moraga and Philip Braude and Lyndsay Pearce and Stechman, {Michael J} and Angeline Price and Quinn, {Terence J} and Enrico Clini and Moug, {Susan J} and Jonathan Hewitt and {COPE Study Collaborators}",

note = "Acknowledgement We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two among the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR), Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions{\textquoteright} Research and Development Offices and Caldicott Guardians for their assistance and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.",

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AU - Carter, Ben

AU - Barlow-Pay, Fenella

AU - Short, Roxanna

AU - Einarsson, Alice

AU - Bruce, Eilidh

AU - McCarthy, Kathryn

AU - Verduri, Alessia

AU - Collins, Jemima T

AU - Hesford, James

AU - Rickard, Frances

AU - Mitchell, Emma

AU - Holloway, Mark

AU - McGovern, Aine

AU - Vilches-Moraga, Arturo

AU - Braude, Philip

AU - Pearce, Lyndsay

AU - Stechman, Michael J

AU - Price, Angeline

AU - Quinn, Terence J

AU - Clini, Enrico

AU - Moug, Susan J

AU - Hewitt, Jonathan

AU - COPE Study Collaborators

N1 - Acknowledgement We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two among the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR), Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions’ Research and Development Offices and Caldicott Guardians for their assistance and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.

PY - 2021

Y1 - 2021

N2 - We do not have much information on how the COVID-19 virus affects patients who use immunosuppressants, drugs which inhibit or reduce the activity of the immune system. There are various conflicting views on whether immune-suppressing drugs are beneficial or detrimental in patients with the disease. Methods: This study collected data from 10 hospitals in the UK and one in Italy between February and April 2020 in order to identify any association between the regular use of immunosuppressant medicines and survival in patients who were admitted to hospital with COVID-19. Results: 1184 patients were included in the study, and 10% of them were using immunosuppressants. Any immunosuppressant use was associated with increased risk of death, and the risk appeared to increase if the dose of the medicine was higher. Conclusion: We therefore recommend that patients who take immunosuppressant medicines routinely should carefully adhere to social distancing measures, and seek medical attention early during the COVID-19 pandemic.

AB - We do not have much information on how the COVID-19 virus affects patients who use immunosuppressants, drugs which inhibit or reduce the activity of the immune system. There are various conflicting views on whether immune-suppressing drugs are beneficial or detrimental in patients with the disease. Methods: This study collected data from 10 hospitals in the UK and one in Italy between February and April 2020 in order to identify any association between the regular use of immunosuppressant medicines and survival in patients who were admitted to hospital with COVID-19. Results: 1184 patients were included in the study, and 10% of them were using immunosuppressants. Any immunosuppressant use was associated with increased risk of death, and the risk appeared to increase if the dose of the medicine was higher. Conclusion: We therefore recommend that patients who take immunosuppressant medicines routinely should carefully adhere to social distancing measures, and seek medical attention early during the COVID-19 pandemic.

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Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19

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