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We read with great interest the article by Salvarani et al comparing the COVID-19 infection susceptibility and severity between the patients treated with biologic or targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs) and all residents in the Reggio Emilia area.1 In their cohort of 1195 patients treated with b/tsDMARDs, there were nine confirmed COVID-19 cases. None of these COVID-19 cases were ≤45 years of age while only two out of 25 patients who were tested for COVID-19 were ≤45 years. They did not observe a different susceptibility or severity of COVID-19 in patients treated with these drugs.1
Biologic/targeted synthetic DMARDs often target pathways of the immune system and this may result in a tendency for infections.2 Serious infections have been reported in both children and adults treated with these drugs.3 However, the data about infection rate and severity in children on b/ts DMARDs are limited. Consistent …
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