Sarcoidosis Does Not Increase Risk of Worse COVID-19 Outcomes, Early Survey Data Show

Sarcoidosis, and the medications prescribed to patients with the disease, do not lead to worse outcomes from COVID-19 infection, according to preliminary results of a survey conducted by the Foundation for Sarcoidosis Research (FSR).

Though more participants are needed to confirm the results, the data are noteworthy for what they do not show: a strong association between sarcoidosis and poor COVID-19 outcomes.

“Although more sarcoidosis patients need to participate in this survey to reach definite conclusions, these preliminary results are reassuring,” Marc Judson, MD, a co-investigator of the study, said in a press release. “These data show no obvious signal of a particularly poor outcome from COVID-19 infection in sarcoidosis patients.”

The Centers for Disease Control and Prevention has stated that people with compromised immune systems may be at an increased risk of severe COVID-19 symptoms.

As sarcoidosis is a disorder that affects the immune system, the FSR and researchers at the University of Cincinnati launched a survey in mid-April. Their goal was to investigate whether having sarcoidosis increased the risk of COVID-19 infection and of having more severe symptoms.

The survey also evaluated whether certain medications prescribed for sarcoidosis, some of which also affect immune system activity, had any impact on COVID-19 outcomes.

More than 1,600 people with sarcoidosis have taken the survey, which is available on the FSR website.

Results showed that among survey responders, less than 2% (31 patients) reported having COVID-19, a slight increase from the national average.

“When COVID-19 began, there was controversy about the additional risks of sarcoidosis and treatments,” said Bob Baughman, MD, of the University of Cincinnati and the principal investigator of the study. “This information, although only preliminary, found the rate of infection only slightly higher than the national average. Sarcoidosis patients with COVID-19 mostly did well, which is what we are seeing for many other patients.”

The survey found that most of the sarcoidosis patients with COVID-19 were able to be treated at home, and none required the use of a ventilator.

Many sarcoidosis treatments, including the corticosteroid prednisone and the monoclonal antibody Remicade (infliximab), are designed to modulate immune system activity. Researchers are, therefore, also investigating whether this immune system modulation can impact COVID-19 outcomes.

Initial survey results indicate that the use of these medications is not associated with an increased risk of COVID-19 infection or poor outcomes.

“These preliminary results do not suggest steroids or other immunosuppressive medications are placing sarcoidosis patients at greater risk of poor outcome,” said Judson. “This has been an important undertaking by the FSR.”

Another treatment sometimes prescribed for sarcoidosis, called hydroxychloroquine, has shown some evidence in relieving COVID-19 symptoms in severe cases. The U.S. Food and Drug Administration has approved it for emergency use in COVID-19 patients, but has cautioned against its unsupervised use outside of hospital or clinical trial settings.

The survey found that hydroxychloroquine treatment was not protective against infection, nor was it a risk factor.

The data also revealed that the race of participants was not associated with an increased risk of COVID-19 infection.

Overall, the data are still preliminary but thus far the results indicate that sarcoidosis and prescribed treatments are not associated with an increased risk of COVID-19 infection or severe symptoms.

The survey is still ongoing, and all participants will be asked to take a follow-up questionnaire in July.