This relatively favorable prognosis in this cohort may be attributed to two factors: first, a “survivor bias”, as the enrolled anti-MDA5+ DM patients had survived the initial high-risk phase of RP-ILD and exhibited stable pulmonary function; second, the potential protective effect of pre-exposure to Janus kinase (JAK) inhibitors, a commonly used regimen for anti-MDA5+ DM, which has been independently associated with a reduced risk of severe COVID-19 among hospitalized IIM patients (48). This evidence concerns the gene IFIH1 and COVID-19.