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Patients on B Cell Therapy at Higher Risk From COVID-19 Infection
Patients with immune mediated inflammatory diseases (IMIDs) receiving B cell depleting therapy (BCDT) were found to be among the most vulnerable to infections resulting from COVID-19 regardless of their vaccine status, researchers stated in a retrospective cohort study.
The researchers used data from the pharmacy records and COVID-19 registry at Cleveland Clinic to identify patients with IMIDS who met the following 3 criteria: patients who were treated with BCDT, patients who were vaccinated against SARS-CoV-2, and patients who experienced breakthrough infections. Upon using univariate and multivariable logistic/proportional-odds regression models, researchers reviewed clinical data and severe outcomes from each electronic medical record.
The final study included 1696 patients with IMIDs on BCDT; 74 patients developed breakthrough COVID-19 prior to December 16, 2021. Of these patients, 29 (39.2%) were hospitalized, 11 (14.9%) required critical care, and 6 (8.1%) died. Using a comparator analysis on 1437 unvaccinated patients with IMIDs on BCDT over the same period revealed 57 (3.9%) COVID-19 cases with 28 (49.1%) requiring hospitalization, including 7 (12.3%) deaths.
Additionally, outpatient anti-SARS-CoV-2 monoclonal antibodies were used to treat 21 patients, with 1 hospitalization and no deaths.
Although data on the frequency and the severity of breakthrough infection of COVID-19 are still lacking, “IMIDs patients on BCDT regardless of vaccine status appear vulnerable to infection with SARS-CoV-2 and are associated with severe outcomes,” the study concluded. “Outpatient use of anti-SARS-CoV-2 monoclonal antibody therapy appeared to be associated with enhanced clinical outcomes.”
—Priyam Vora
Reference:
Calabrese CM, Kirchner E, Husni EM, et al. Breakthrough SARS-CoV-2 infections in immune mediated disease patients undergoing B cell depleting therapy: A retrospective cohort analysis.
Arthritis Rheumatol. First published online July 6, 2022 https://doi.org/10.1002/art.42287
