ArticleOphthalmology2022
Association between Immunosuppressive Drugs and Coronavirus Disease 2019 Outcomes in Patients with Noninfectious Uveitis in a Large US Claims Database.
Article in Ophthalmology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- Early vs Deferred Non-Messenger RNA COVID-19 Vaccination Among Chinese Patients With a History of Inactive Uveitis: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Risk of herpes zoster among adults in the United States initiating immunosuppressive therapy: A retrospective cohort study.Journal of managed care & specialty pharmacy · 2026Article
- Bidirectional Associations Between Seborrheic Dermatitis and Epithelial Barrier Diseases: A Retrospective Cohort Study.Allergy · 2026Article
- Epidemiology of herpes zoster and postherpetic neuralgia in Japan: analysis of a large-scale claims database.BMC infectious diseases · 2026Article
- Herpes Zoster Risk Among US Cancer Patients Following Initiation of Immunosuppressive Therapy.Cancer management and research · 2025Article
- Association between immunosuppressive medications and COVID-19 hospitalisation and death: a retrospective cohort study.BMJ open · 2024Article
- Questionnaire survey of risk factors for recurrence of ocular inflammation in patients with uveitis after SARS-CoV-2 infection.Frontiers in cellular and infection microbiology · 2023Article
- Risk for uveitis relapse after COVID-19 vaccination.Journal of autoimmunity · 2022Article
- Impact of the Coronavirus Disease 2019 Pandemic on Initiation Therapy for Noninfectious Uveitis.Ophthalmology scienceArticle
- Immunosuppressive Medications and COVID-19 Outcomes in Patients with Noninfectious Uveitis in the Era of COVID-19 Vaccinations.Ophthalmology scienceArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
purposeTo determine the dose-dependent risk of systemic corticosteroids (SCs) and the risk of other immunosuppressive therapies on coronavirus disease 2019 (COVID-19) infection, hospitalization, and death in patients with noninfectious uveitis (NIU).
designA retrospective cohort study from January 20, 2020, to December 31, 2020 (an era before widespread COVID-19 vaccination), using the Optum Labs Data Warehouse, a US national de-identified claims database.
participantsPatients who had at least 1 NIU diagnosis from January 1, 2017.
methodsUnadjusted and adjusted hazard ratios (HRs) were estimated for each variable and COVID-19 outcome using Cox proportional hazards models, with time-updated dichotomous indicators for outpatient immunosuppressive medication exposure. To assess the dose-dependent effect of SC exposure, the average daily dose of prednisone over the exposed interval was included in the adjusted models as a continuous variable, in addition to the dichotomous variable.
main outcome measuresIncidence rates of COVID-19 infection, COVID-19-related hospitalization, and COVID-19-related in-hospital death.
resultsThis study included 52 286 NIU patients of whom 12 000 (23.0%) were exposed to immunosuppressive medications during the risk period. In adjusted models, exposure to SCs was associated with increased risk of COVID-19 infection (HR, 2.66; 95% confidence interval [CI], 2.19-3.24; P < 0.001), hospitalization (HR, 3.26; 95% CI, 2.46-4.33; P < 0.001), and in-hospital death (HR, 1.99; 95% CI, 0.93-4.27; P = 0.08). Furthermore, incremental increases in the dosage of SCs were associated with a greater risk for these outcomes. Although tumor necrosis factor-α (TNF-α) inhibitors were associated with an increased risk of infection (HR, 1.48; 95% CI, 1.08-2.04; P = 0.02), other immunosuppressive treatments did not increase the risk of COVID-19 infection, hospitalization, or death.
conclusionsThis study from an era before widespread COVID-19 vaccination demonstrates that outpatient SC exposure is associated with greater risk of COVID-19 infection and severe outcomes in patients with NIU. Future studies should evaluate the impact of immunosuppression in vaccinated NIU patients. Limiting exposure to SCs and use of alternative therapies may be warranted.
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