Influence of Confinement on Patients with Autoimmune and Immune-Mediated Inflammatory Disease Receiving Biological Treatment for COVID-19 Infection. The BIOCOVID Study

Objectives: To assess the rates and severity of SARS-CoV-2 infection in patients with autoimmune and immune-mediated inflammatory disease (AI/IMID) treated with anticytokine biologics (AB) or Janus Kinase inhibitors (JAKi), and to compare the types of confinement observed by AI/IMID patients and the general population. Methodology: A case-control study nested within a retrospective observational study.  Subjects: AI/IMID patients followed by rheumatology, dermatology and digestology specialists and who were receiving treatment with AB/JAKi. Controls were selected from our Primary Care Centers.  The main outcome was SARS-CoV-2 infection and severity. The secondary outcome was the type of confinement (strict, standard, lax, and no confinement). Results: Three hundred and sixty-seven patients (54·8% men, mean age 52 years) and 193 controls (53·4% men, mean age 52 years). In patients’ group, 95·6% were receiving AB treatment, and 43·3% had at least one risk factor for COVID compared to 37·8% of controls. Cumulative rates of COVID infection were 10·1% in the AI/IMID group and 13·5% in controls (p=0·228). Strict confinement was the most frequent form in both groups; lax confinement was more common in the control group (p=0·013, OR=0·62). There were no differences in the incidence of COVID-19 according to type of confinement. Conclusions: The incidence of COVID-19 infection in our cohort is similar to that reported in other series. None of our patients developed severe COVID-19 infection. We observed that strict confinement was predominant in both groups and was higher in the AI/IMID patients. Lax confinement was more frequent in the control group. Funding: This project has obtained a research grant from the Catalan Society of Rheumatology which has allowed the project to be carried out. Declaration of Interest: None to declare. Ethical Approval: The protocol was approved by an independent Clinical Research Ethics Committee (Comite d'Etica d'Investigacio Clinica de la Fundacio Unio Catalana d'Hospitals, protocol number CEIC 20/45).