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09 June 2022

Higher rate of COVID-19 death before vaccination linked to certain common inflammatory immune conditions

People with inflammatory immune conditions that affect their skin, bowel, and joints have been linked to a greater risk of being hospitalised and death from COVID-19.

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The research was based on 17 million patient GP records in England from March to September 2020, the first phase of the pandemic before any vaccines or antiviral treatments were approved.

The study encompassed more than one million patients with immune mediated inflammatory diseases (IMIDs), including inflammatory bowel diseases (Crohn's disease, ulcerative colitis), skin conditions (psoriasis) or joint conditions (rheumatoid arthritis).

Dr James Galloway, Senior Clinical Lecturer in the School of Immunology & Microbial Sciences, is co-primary author of the study led by the London School of Hygiene & Tropical Medicine (LSHTM) with colleagues from multiple institutions, including King’s College London and the St John’s Institute of Dermatology at Guy’s and St Thomas’ NHS Foundation Trust.

The research, published in The Lancet Rheumatology, revealed that people with IMIDs had a 23% increased risk for both COVID-19-related hospitalisation and COVID-19-related death when compared to people without IMIDs. The authors note that, among people with IMID conditions, people with inflammatory join conditions were especially vulnerable towards COVID-19.

Until now we did not know whether severe COVID-19 risk increases with ongoing health conditions related to problems with the immune system such as arthritis, Crohn’s disease and psoriasis.

Catherine Smith, Professor of Dermatology & Therapeutics, St John’s Institute of Dermatology

Alongside these findings, the authors analysed people with IMIDs taking medication as a therapy for their condition. Specifically, they compared the impact of targeted immune modifiers (biologics) to standard systemics which are less targeted against the wider immune system.

Results show there wasn’t an increase in COVID-19 hospitalisation or death from people taking targeted modifiers (such as TNF blockers) when compared to standard, (non-targeted) therapies like methotrexate. These results highlight how important it is for people with IMIDs to continue taking COVID-19 related medication and ensure that vaccinations can work with their IMID medication.

Our study provides important information that will help guide policymakers to ensure prevention strategies such as vaccination, and early intervention treatments such as anti-virals are targeted towards those most at risk.

Professor Catherine Smith

In this story

James Galloway

Professor of Rheumatology

Catherine  Smith

Professor of Dermatology & Therapeutics