Risk of severe COVID-19 in adults with immune-mediated inflammatory diseases and those on immune-modifying therapies

A total of 17,672,065 subjects, of which 1,163,438 subjects (55% females and 45% males, and 71% Whites) had inflammatory disorders, and 16,508,627 subjects (49.8% females and 50.2% males, and 64% of Whites) were included from the general public. Out of 1,163,438 subjects with immunological inflammatory disorders, 1.6% (n=19,119) were administered immunomodulatory therapeutic agents, whereas 15.6% (n=181,694) were administered standard systemic therapies. Compared to the general public, individuals with inflammatory disorders showed a higher risk of SARS-CoV-2 infection-associated mortality after data adjustments for confounding variables (HR 1.2) and mediators (HR = 1.2). In addition, individuals with inflammatory disorders showed a higher risk of SARS-CoV-2 infection-associated admissions in critical care settings or mortality (confounder-adjusted HR and mediator-adjusted HRs were 1.2 and 1.2, respectively) and hospitalization (confounder-adjusted HR 1.3, and mediator-adjusted HR 1.2).