The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study.
<h4>Background</h4>Protective effects of Bacillus Calmette-Guérin (BCG) vaccination and clofazimine and dapsone treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. Patients at risk for leprosy represent an interesting model for ass...
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doaj-1973dd3437e44308a981ac2a1559e6ee2021-08-13T04:32:02ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352021-07-01157e000963510.1371/journal.pntd.0009635The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study.Selma Regina Penha Silva CerqueiraPatrícia Duarte DepsDébora Vilela CunhaNatanael Victor Furtunato BezerraDaniel Holanda BarrosoAna Bárbara Sapienza PinheiroGecilmara Salviato PillegiTaynah Alves Rocha RepsoldPatrícia Shu KurizkySimon M CollinCiro Martins Gomes<h4>Background</h4>Protective effects of Bacillus Calmette-Guérin (BCG) vaccination and clofazimine and dapsone treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. Patients at risk for leprosy represent an interesting model for assessing the effects of these therapies on the occurrence and severity of coronavirus disease 2019 (COVID-19). We assessed the influence of leprosy-related variables in the occurrence and severity of COVID-19.<h4>Methodology/principal findings</h4>We performed a 14-month prospective real-world cohort study in which the main risk factor was 2 previous vaccinations with BCG and the main outcome was COVID-19 detection by reverse transcription polymerase chain reaction (RT-PCR). A Cox proportional hazards model was used. Among the 406 included patients, 113 were diagnosed with leprosy. During follow-up, 69 (16.99%) patients contracted COVID-19. Survival analysis showed that leprosy was associated with COVID-19 (p<0.001), but multivariate analysis showed that only COVID-19-positive household contacts (hazard ratio (HR) = 8.04; 95% CI = 4.93-13.11) and diabetes mellitus (HR = 2.06; 95% CI = 1.04-4.06) were significant risk factors for COVID-19.<h4>Conclusions/significance</h4>Leprosy patients are vulnerable to COVID-19 because they have more frequent contact with SARS-CoV-2-infected patients, possibly due to social and economic limitations. Our model showed that the use of corticosteroids, thalidomide, pentoxifylline, clofazimine, or dapsone or BCG vaccination did not affect the occurrence or severity of COVID-19.https://doi.org/10.1371/journal.pntd.0009635 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Selma Regina Penha Silva Cerqueira Patrícia Duarte Deps Débora Vilela Cunha Natanael Victor Furtunato Bezerra Daniel Holanda Barroso Ana Bárbara Sapienza Pinheiro Gecilmara Salviato Pillegi Taynah Alves Rocha Repsold Patrícia Shu Kurizky Simon M Collin Ciro Martins Gomes |
spellingShingle |
Selma Regina Penha Silva Cerqueira Patrícia Duarte Deps Débora Vilela Cunha Natanael Victor Furtunato Bezerra Daniel Holanda Barroso Ana Bárbara Sapienza Pinheiro Gecilmara Salviato Pillegi Taynah Alves Rocha Repsold Patrícia Shu Kurizky Simon M Collin Ciro Martins Gomes The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study. PLoS Neglected Tropical Diseases |
author_facet |
Selma Regina Penha Silva Cerqueira Patrícia Duarte Deps Débora Vilela Cunha Natanael Victor Furtunato Bezerra Daniel Holanda Barroso Ana Bárbara Sapienza Pinheiro Gecilmara Salviato Pillegi Taynah Alves Rocha Repsold Patrícia Shu Kurizky Simon M Collin Ciro Martins Gomes |
author_sort |
Selma Regina Penha Silva Cerqueira |
title |
The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study. |
title_short |
The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study. |
title_full |
The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study. |
title_fullStr |
The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study. |
title_full_unstemmed |
The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study. |
title_sort |
influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of covid-19: a prospective real-world cohort study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS Neglected Tropical Diseases |
issn |
1935-2727 1935-2735 |
publishDate |
2021-07-01 |
description |
<h4>Background</h4>Protective effects of Bacillus Calmette-Guérin (BCG) vaccination and clofazimine and dapsone treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. Patients at risk for leprosy represent an interesting model for assessing the effects of these therapies on the occurrence and severity of coronavirus disease 2019 (COVID-19). We assessed the influence of leprosy-related variables in the occurrence and severity of COVID-19.<h4>Methodology/principal findings</h4>We performed a 14-month prospective real-world cohort study in which the main risk factor was 2 previous vaccinations with BCG and the main outcome was COVID-19 detection by reverse transcription polymerase chain reaction (RT-PCR). A Cox proportional hazards model was used. Among the 406 included patients, 113 were diagnosed with leprosy. During follow-up, 69 (16.99%) patients contracted COVID-19. Survival analysis showed that leprosy was associated with COVID-19 (p<0.001), but multivariate analysis showed that only COVID-19-positive household contacts (hazard ratio (HR) = 8.04; 95% CI = 4.93-13.11) and diabetes mellitus (HR = 2.06; 95% CI = 1.04-4.06) were significant risk factors for COVID-19.<h4>Conclusions/significance</h4>Leprosy patients are vulnerable to COVID-19 because they have more frequent contact with SARS-CoV-2-infected patients, possibly due to social and economic limitations. Our model showed that the use of corticosteroids, thalidomide, pentoxifylline, clofazimine, or dapsone or BCG vaccination did not affect the occurrence or severity of COVID-19. |
url |
https://doi.org/10.1371/journal.pntd.0009635 |
work_keys_str_mv |
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