DISCUSSION
Our study discusses the role of immunosuppressant drugs and
susceptibility to SARS nCoV-2 virus along with its associated risk
factors, adverse reactions, drug-drug interactions and
contraindications. The study conducted by Brownstone ND, Thibodeaux QG,
Reddy VD et. al., 2020 and Zhang C, Wu Z, Li JW et. al., 2020 shows
Etanercept can cause serious COVID-19 infection risk for patients
undergoing treatment for psoriasis leading to upper respiratory
infection, influenza and serious infections. Moreover, patients who are
older with comorbid conditions like lung disease, hypertension,
diabetes, cancer or taking immunosuppressive drugs, etc. are also at
serious risk of developing infection [35-36]. Another study by Del
Papa N, Sambataro G, Minniti A, Pignataro F et. al., 2020 shows the role
of mycophenolate mofetil’s in suppression of immune system of systemic
sclerosis (SSc) leading to heightened vulnerability to develop COVID-19
with worse clinical outcomes. Chronic immunosuppressive therapies with
SSc need to maintain precautions amid COVID-19 pandemic. It is
associated with increased morbidity and mortality specially with
underlying medical conditions like primary cardiomyopathy and secondary
to pulmonary hypertension [37]. Zhou Y, Hou Y, Shen J, Huang Y et.
al., 2020 shows that clinical application of Sirolimus reduces MERS
(Middle East Respiratory Syndrome) CoV infection. It is also used to
manage patients with acute respiratory failure and severe H1N1
pneumonia. The study also discusses the role of Sirolimus in autoimmune
diseases including systemic lupus erythematosus, Crohn’s disease,
rheumatoid arthritis, etc. [38]. de Wilde AH, Zevenhoven-Dobbe JC,
van der Meer Y et. al., shows Cyclosporin’s effect on the replication of
severe acute respiratory syndrome coronavirus (SARS-CoV). The study
states that the mechanism of inhibition remains to be established. It
reports that it is associated with one or multiple members of the
cyclophilin family and it interferes with the functional interactions of
viral proteins [39]. Another study by Willis MD, Robertson NP et.
al., 2020 shows increased risk of infection among vulnerable cohort
study populations suffering from multiple sclerosis. It also shows a
serious risk of infection with Rituximab amid COVID-19 pandemic
[40]. Overall, patients are advised to continue with their
immunosuppressant medications unless they are asked by their respective
healthcare provider to reduce the dosage or halt medication temporarily
based upon the patient’s current condition and risk of contracting
COVID-19.