Most immunosuppressed patients don't have higher risk of severe COVID outcomes, US study finds

Cancer patients and other people taking immune-suppressing medications do not have an overall higher risk of dying from COVID-19, according to a study involving more than 200,000 hospitalized COVID-19 patients. 

Researchers from Johns Hopkins University in Baltimore evaluated the EHRs of 222,575 U.S. adults hospitalized for COVID-19 across 42 health systems from January 1, 2020, to June 11, 2021. Of those, 16,494 were taking immunosuppressive medications for rheumatologic disease, solid organ transplant and cancer. 

Of the 303 immunosuppressive medications involved in the study, just one — rituximab — was associated with a significant increase in the risk of death among hospitalized COVID-19 patients, according to the findings published Nov. 15 in The Lancet Rheumatology. Rituximab is a monoclonal antibody preparation used for cancer or autoimmune disorders that haven't responded to other treatments. 

Overall, researchers did not find hospitalized COVID-19 patients on immunosuppressants have a higher death risk or a higher risk of requiring ventilation compared to non-immunosuppressed patients hospitalized with the illness. 

"In general, people taking immunosuppressive medications may be reassured that they can safely continue to do so during this pandemic," said Kayte Anderson, lead study author and a doctoral candidate at Johns Hopkins Bloomberg School of Public Health. 

Still, people taking rituximab "should discuss their options with their doctor," said G. Caleb Alexander, MD, study author and epidemiology professor at the Bloomberg School. "At a minimum, people who take rituximab should continue to protect themselves from developing COVID-19. It also makes it all the more important that people around those taking rituximab get vaccinated."


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