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The paper by Akiyama et al 1 on the prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases was an interesting read. This systematic review and meta-analysis indicates that glucocorticoid usage increases the risk of developing COVID-19, while monotherapy with biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs, particularly antitumour necrosis factor (TNF) monotherapy, has been associated with a decreased risk of developing severe COVID-19 and related mortality.1 However, certain methodological issues in this meta-analysis study need to be addressed. First, the efficacy and safety of glucocorticoid usage in patients …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.