How risky is taking immunosuppressants for COVID-19?

Taking most immunosuppressants that suppress the immune system does not actually increase the risk of severe COVID-19 or death from infection. This unexpected conclusion was reached by scientists from the United States, whose research results were published in the journal The Lancet Rheumatology.

At the onset of the pandemic, it was believed that people taking immunosuppressive drugs were at increased risk. However, experts later found out that a significant part of the damage to organ tissue in severe COVID-19 was caused not by the virus itself, but by overly strong immune responses. Therefore, some doctors have even begun to use immunosuppressants for coronavirus infection. Until recently, however, it was not known whether long-term use of these common drugs increases or decreases the risk of severe COVID-19.

A group of American scientists led by specialists from Johns Hopkins University analyzed data from electronic medical records of 222,500 patients hospitalized with COVID-19 from January 2020 to June 2021. More than 16,000 of them took immunosuppressants before hospitalization.

The researchers also categorized the 303 drugs into 17 classes. None of them were associated with an increased risk of the need for mechanical ventilation, a sign of a severe course of coronavirus infection.

The only exception was one drug - Rituximab. They are chimeric monoclonal antibodies that target B cells and are used for serious medical conditions - cancer or autoimmune diseases - when other drugs have failed.

The use of this drug has been associated with a significant increase in the risk of death. For 153 patients with cancer who took it, the risk of death was more than 2 times higher, and for 100 patients with rheumatic diseases, the risk was 72% higher.