effects of biologic therapies on the chance of covid-19 infection among rheumatoid arthritis and lupus patients during the first wave of the pandemic

Risk of severe acute respiratory syndrome coronavirus 2 (sars-cov-2) infection. despite the effectiveness of usingcombined conventional and biological disease-modifying anti-rheumatic drugs(bdmards) in managing rheumaticdiseases, there have been concerns that taking biological agents may have an additive effect on getting infected withcovid-19. this study evaluates the impact of taking biological agents on altering the chance of getting infected withsars-cov-2 in rheumatoloid and lupus patients compared to traditional dmards.methods: we carried out a cross-sectional survey study from february 2020 to january 2021 on patients diagnosedwith lupus and rheumatid arthritis. covid-19 infection was confirmed by the presence of symptoms and signs of the diseaseand para-clinical findings such as lymphopenia and elevated c-reactive protein (crp) and positive chest ct scanor polymerase chain reaction (pcr) of covid-19.results: out of 591 patients included in this study, 422 (71.4%) had rheumatoid arthritis (ra), and 169 (28.6%) hadsystemic lupus erythematosus (sle). among them, 56 (9.5%) cases were diagnosed with covid-19 infection. noassociation was found between age, gender, or type of rheumatological diseases and sars-cov-2. there was asignificant association between covid-19 infection and treatment with biological drugs (p-value<0.05) regardless ofthe type of rheumatologic disease. interestingly, the analysis revealed that the type of biologic drug also altered thechance of covid-19 infection; in fact, patients who took tnf inhibitors were significantly at a higher risk of diseasethan those taking rituximab (p-value=0.000). identical results were observed among ra patients (p-value<0.001),however, all 5 (3%) lupus cases treated with rituximab infected with covid 19.conclusion: this study develops a better understanding of the risk of immunosuppressive medications for sarscov-2 infection. patients treated with conventional and biological medicine had a higher disease risk than those takingexclusively conventional drugs. however, more studies are required to deliberate the relation of the reviewed factorswith the severity of covid-19.level of evidence: ii