Methotrexate As a Safe Immunosuppressive Agent During the COVID-19 Pandemic
Overview
Pharmacology
Authors
Affiliations
Background: During the ongoing COVID-19 pandemic, immunocompromised patients are at a higher risk of severe infection, since the immune system has an important role in defeating this disease. This study compares the severity of COVID-19 in patients taking methotrexate with the severity of their family members' illness as patients with normal immune system function.
Methods: A total of 35 participants, including 14 patients taking methotrexate and 21 patients with normal immune function, entered this study, and the indicators of COVID-19 severity were compared between these two groups.
Results: The case group, who were on methotrexate therapy, had significantly less severe COVID-19 based on their symptoms, including fever (p = 0.000) and cough and dyspnea (p = 0.01) as well as in terms of COVID-19 severity indicators such as pulmonary involvement (p = 0.001), ferritin level (p = 0.001), white blood cell count (p = 0.008) and CRP level (p = 0.006), compared to the control group. There was a significant correlation between taking methotrexate and lower severity in COVID-19 disease.
Conclusion: The present findings demonstrated that methotrexate does not predispose patients to severe COVID-19; on the contrary, patients taking methotrexate may experience a milder disease, possibly due to their reduced severe inflammatory reactions as a result of inhibited TNFα, lowered IL6, and increased T regulatory cells. According to these findings, methotrexate appears to be a suitable treatment option for patients who need immunosuppressive medications during the COVID-19 pandemic.
Wang K, Li J, Guo K, Zhang X BMC Ophthalmol. 2024; 24(1):196.
PMID: 38671401 PMC: 11046742. DOI: 10.1186/s12886-024-03458-x.
Zhang Z, Jin H, Zhang X, Bai M, Zheng K, Tian J Front Immunol. 2024; 15:1369311.
PMID: 38601162 PMC: 11004287. DOI: 10.3389/fimmu.2024.1369311.
Chebbi P, Shobha V, Rao V, Haridas V, Janardana R, Pinto B BMC Rheumatol. 2023; 7(1):22.
PMID: 37496101 PMC: 10369741. DOI: 10.1186/s41927-023-00345-8.
Maynard N, Armstrong A Curr Dermatol Rep. 2023; 12(2):45-55.
PMID: 37304177 PMC: 10068706. DOI: 10.1007/s13671-023-00385-w.
Iaconis D, Caccuri F, Manelfi C, Talarico C, Bugatti A, Filippini F Viruses. 2023; 15(5).
PMID: 37243214 PMC: 10221469. DOI: 10.3390/v15051128.