Τίτλος:
COVID-19 infection among autoimmune rheumatic disease patients: Data from an observational study and literature review
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The impact of SARS-CoV-2 infection in patients with autoimmune/auto-inflammatory rheumatic diseases (AARD) under immunomodulatory treatment has been a focus of interest during the COVID-19 pandemic. In this observational study, demographic data, disease related features and comorbidities, COVID-19 manifestations and outcome as well as antibody responses to SARS-CoV-2 were recorded among 77 consecutive patients with underlying AARD infected by SARS-CoV-2. Analysis of data was performed using univariate and multivariate models. Most patients (68.8%) had a mild COVID-19 course. The predominant clinical manifestations were fatigue (58.4%), low grade fever (45.4%) and upper respiratory tract symptoms (68.8%). About a quarter of patients required hospitalization (23.3%) and the mortality rate was 1.3%. Regarding COVID-19 severity, prior treatment with corticosteroids, mycophenolate mofetil or rituximab was more common in patients who developed a more serious disease course (60.0 vs 29.9%, p = 0.003, 40.0 vs 7.5%, p = 0.003, 10.0 vs 0.0%, p = 0.009, respectively). When disease related features and comorbidities were considered in multivariate models, older age and lung disease in the context of the AARD were found to be independent predictive factors for hospitalization (OR [95%]: 1.09 [1.03–1.15] and 6.43 [1.11–37.19]). Among COVID-19 related features, patients with shortness of breath and high-grade fever were more likely to get hospitalized (OR [95%]: 7.06 [1.36–36.57], 12.04 [2.96–48.86]), while anosmia was independently associated with lower hospitalization risk (OR [95%]: 0.09 [0.01–0.99]). Though the majority of AARD patients displayed a mild COVID-19 course, certain underlying disease features and COVID-19 related manifestations should prompt alertness for the physician to identify patients with AARD at high risk for severe COVID-19 and need for hospitalization. © 2021 Elsevier Ltd
Συγγραφείς:
Bakasis, A.-D.
Mavragani, C.P.
Boki, K.A.
Tzioufas, A.G.
Vlachoyiannopoulos, P.G.
Stergiou, I.E.
Skopouli, F.N.
Moutsopoulos, H.M.
Περιοδικό:
Journal of Autoimmune Diseases
Εκδότης:
INSTAP Academic Press
Λέξεις-κλειδιά:
anakinra; azathioprine; belimumab; canakinumab; corticosteroid; cyclophosphamide; cyclosporine; hydroxychloroquine; leflunomide; methotrexate; methylprednisolone; mycophenolate mofetil; rituximab; SARS-CoV-2 antibody; thalidomide; tocilizumab; tumor necrosis factor inhibitor; immunoglobulin G; immunologic factor; immunosuppressive agent; virus antibody, adult; aged; anosmia; antibody response; Article; autoimmune disease; autoimmunity; autoinflammatory disease; clinical feature; comorbidity; controlled study; coronavirus disease 2019; demography; disease course; disease severity; dyspnea; fatigue; female; fever; hospitalization; human; immunocompromised patient; lung disease; major clinical study; male; middle aged; monotherapy; mortality rate; multicenter study; nasopharyngeal swab; observational study; odds ratio; patient coding; physician; respiratory tract disease; rheumatic disease; risk factor; Severe acute respiratory syndrome coronavirus 2; symptom; upper respiratory tract; asymptomatic infection; autoimmune disease; biosynthesis; connective tissue disease; critical illness; Greece; hypothyroidism; immunology; inflammation; literature; lung disease; rheumatic disease; severity of illness index; symptom assessment; very elderly, Adult; Aged; Aged, 80 and over; Antibodies, Viral; Asymptomatic Infections; Autoimmune Diseases; Comorbidity; Connective Tissue Diseases; COVID-19; Critical Illness; Female; Greece; Hospitalization; Humans; Hypothyroidism; Immunocompromised Host; Immunoglobulin G; Immunologic Factors; Immunosuppressive Agents; Inflammation; Lung Diseases; Male; Middle Aged; Observational Studies as Topic; Review Literature as Topic; Rheumatic Diseases; SARS-CoV-2; Severity of Illness Index; Symptom Assessment
DOI:
10.1016/j.jaut.2021.102687
