Comparison of Respiratory Complications of COVID-19 among Patients with Rheumatological Conditions Taking Biological Disease-Modifying Anti-Rheumatic Drugs and Conventional Synthetic Disease-Modifying Antirheumatic Drugs

Abstract

Objective: To compare the respiratory complications of COVID-19 among patients with rheumatological conditions taking bDMARDs and csDMARDs at Pak Emirates Military Hospital Rawalpindi.

Study Design: Comparative prospective study.

Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan from Mar to May 2020.

Methodology: Patients diagnosed with COVID-19 on polymerase chain reaction having previously rheumatological conditions managed either with bDMARD or cs DMARD were included in the study. They were followed up for three weeks after the positive polymerase chain reaction. Complications leading to the use of oxygen or ICU support or death were compared in both groups of patients.

Results: A total of 82 patients with any rheumatological condition managed either with bDMARD or csDMARD tested positive for covid-19 on polymerase chain reaction and were included in the final analysis. 30 (36.6%) patients were taking bDMARDs while 52 (63.4%) were taking csDMARD. In addition, 4 (4.8%) low dose oxygen therapy, 5 (6.1%) required moderate dose oxygen therapy, while 5 (6.1%) required severe dose oxygen therapy or intensive care unit support. 2 (2.4%) patients died within the three weeks. The requirement of moderate or severe dose oxygen and intensive care unit support was found statistically significantly more in the group taking csDMARDS.

Conclusion: The presence of complications of COVID -19 and the requirement of oxygen and intensive care unit support were present in some of the patients taking DMARDs. Among the DMARDs, bDMARDs were less linked with complications, but large studies with better design required better results.