A retrospective cohort study was conducted using a de-identified healthcare claims database to analyze the association of non-infectious uveitis and COVID-19. A total of 5,806,227 patient data were analysed of which 29,869 had non-infectious uveitis (NIU). Approximately 20% of patients with NIU had another autoimmune disease. There were 1,708 cases of COVID-19 infection in patients with NIU and 363 NIU patients hospitalized with COVID-19.
On unadjusted analysis, it was found that 5.7% and 1.2% of the patients with NIU had COVID-19 infection and COVID-19 associated hospitalization respectively, whereas 4.2 % and 0.6% had of patients without NIU had COVID-19 infection and COVID-19 associated hospitalization respectively. Thus, patients with NIU had a higher rate of COVID-19 infection and COVID-19-related hospitalization. Similarly, COVID-19-related death was higher among patients with NIU ( 0.3%) in comparison to patients without NIU (0.1%). Systemic corticosteroids were commonly prescribed immunosuppressive treatments, with 18.0% of NIU patients and 10.7% of patients without NIU taking these drugs. Additionally, the use of systemic corticosteroids is significantly associated with COVID-19 infection. TNF-α inhibitors are significantly associated with COVID-19 infection, while DMARDs and other immunosuppressive drugs were associated with decreased hazard of infection.
The use of systemic corticosteroids, DMARDs, and other immunosuppressive drugs by NIU patients are also associated with COVID-19 related hospitalization and in-hospital death due to COVID-19. In conclusion, patients with NIU were significantly more likely to be infected with COVID-19 and have a higher risk of COVID-19 hospitalization and high COVID-19 associated mortality rate. Furthermore, NIU patients undergoing systemic corticosteroid therapy increased risk of infection and severe COVID-19 outcomes. But, further studies are needed for a thorough evaluation of the impact of the level of corticosteroid exposure on COVID-19 risk.
Ref Link: Europe PMC
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