The association between immunosuppressants use and COVID-19 adverse outcomes: national COVID-19 cohort in South Korea

  1. Hyun Joon Shin
  2. Ronald Chow
  3. Hyerim Noh
  4. Jongseong Lee
  5. Jihui Lee
  6. Charles B. Simone II
  7. Young-Geun Choi

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Abstract

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  1. Version published to 10.21037/apm-21-3465
  2. Version published to 10.1101/2021.08.17.21262183v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.08.17.21262183: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: This study was approved by the Human Investigation Review Board of Public Institutional Bioethics Committee designated by the MOHW, which waived the requirement of informed consent due to retrospective study design and anonymity of the HIRA database (IRB # P01-2020-1262-001. Study Design and Participants: The HIRA data consisted of 234,427 individuals who were tested for SARS-CoV-2 between January 1, 2020 and May 15, 2020. 7,590 were identified positive for COVID-19, as designated by the coding in the #OpenData4COVID19 project (Supplementary Material 2). 4,610 individuals were aged 40 years or older.
    Consent: This study was approved by the Human Investigation Review Board of Public Institutional Bioethics Committee designated by the MOHW, which waived the requirement of informed consent due to retrospective study design and anonymity of the HIRA database (IRB # P01-2020-1262-001. Study Design and Participants: The HIRA data consisted of 234,427 individuals who were tested for SARS-CoV-2 between January 1, 2020 and May 15, 2020. 7,590 were identified positive for COVID-19, as designated by the coding in the #OpenData4COVID19 project (Supplementary Material 2). 4,610 individuals were aged 40 years or older.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Immunosuppressants were identified by the anatomical therapeutic chemical (ATC) codes (Supplementary Material 2).
    ATC
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study was also not without limitations. We do not have data regarding the severity of COVID-19 at the time of COVID-19 diagnosis, which is a limitation of using claims data. In addition, there may still exist residual confounding by confounders that are typically not captured in a claims database (e.g., body mass index, baseline blood pressure, laboratory test values). Also, our result is limited by the observational nature of our study design. In conclusion, our study of a large nationwide cohort of hospitalized COVID-19 patients in South Korea finds that use of immunosuppressants or corticosteroids increases the odds of all-cause mortality, mechanical ventilation and ICU admissions. We support the latest guidelines from the CDC, that people on immunosuppressants are at high risk of severe COVID-19 and immunocompromised people need booster COVID-19 vaccinations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.08.17.21262183v1 on medRxiv