Correspondence on 'Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis'

The paper by Akiyama et al 1 on the prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases was an interesting read. This systematic review and meta-analysis indicates that glucocorticoid usage increases the risk of developing COVID-19, while monotherapy with biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs, particularly antitumour necrosis factor (TNF) monotherapy, has been associated with a decreased risk of developing severe COVID-19 and related mortality.1 However, certain methodological issues in this meta-analysis study need to be addressed. First, the efficacy and safety of glucocorticoid usage in patients with …