OBJECTIVES: To investigate the incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases receiving targeted biologic and synthetic disease modifying anti-rheumatic drugs (tDMARDs) and to explore the possible effect of these treatments in the clinical expression of COVID-19. METHODS: A cross-sectional study comprising of a telephone survey and electronic health records review was performed including all adult and paediatric patients with rheumatic diseases treated with tDMARDs in a large rheumatology tertiary centre in Barcelona, Spain. Demographics, disease activity, COVID-19 related symptoms and contact history data were obtained from the start of the 2020 pandemic. Cumulative incidence of confirmed cases (SARS-CoV-2 positive PCR test) was compared to the population estimates for the same city districts from a governmental COVID-19 health database. Suspected cases were defined following WHO criteria and compared to those without compatible symptoms. RESULTS: 959 patients with rheumatic diseases treated with tDMARDs were included. We identified 11 confirmed SARS-CoV-2 positive cases in the adult cohort and no confirmed positive cases in the paediatric cohort. All patients had a successful recovery and only one patient required admission in the intensive care unit. When using the same classification criteria (only COVID-19 positive cases with pneumonia), COVID-19 incidence rates of the rheumatic patient cohort were very similar to that of the general population [(0.48% (95% CI 0.09 to 8.65%)] and [0.58% (95% CI 5.62 to 5.99%)], respectively. We found significant differences in tDMARDs proportions between the suspected and non-suspected cases (p=0.002). CONCLUSION: Adult and paediatric patients with rheumatic diseases on tDMARDs do not seem to present a higher risk of COVID-19 or a more severe disease outcome when compared to general population. Our exploratory analysis suggests that the proportion of COVID-19 suspected cases differs between tDMARDs.

中文翻译：

---

用靶向生物和合成疾病改良抗风湿药治疗的成年和小儿风湿病患者队列中COVID-19的发生率

目的：调查在接受靶向生物和合成疾病修饰抗风湿药（tDMARDs）治疗的风湿性疾病的成年和儿科患者队列中COVID-19的发生率，并探讨这些治疗对COVID临床表达的可能影响-19。方法：在西班牙巴塞罗那的一家大型风湿病专科中心，进行了一项包括电话调查和电子健康记录审查的横断面研究，包括所有接受tDMARD治疗的风湿性疾病的成人和儿童患者。从2020年大流行开始就获得了人口统计学，疾病活动，COVID-19相关症状和接触史数据。将确诊病例的累积发生率（SARS-CoV-2阳性PCR试验）与来自政府COVID-19健康数据库的同一城区的人口估计值进行比较。根据WHO标准定义可疑病例，并将其与无相适应症状的病例进行比较。结果：纳入959例tDMARDs治疗的风湿病患者。我们在成年队列中确定了11例确诊的SARS-CoV-2阳性病例，在儿科队列中没有确诊的阳性病例。所有患者均成功康复，只有一名患者需要重症监护病房。当使用相同的分类标准时（仅COVID-19阳性的肺炎病例），风湿性患者队列的COVID-19发生率与普通人群非常相似[（0.48％（95％CI 0.09至8.65％）]和[0。58％（95％CI 5.62至5.99％）]。我们发现疑似病例与非疑似病例在tDMARDs比例上存在显着差异（p = 0.002）。结论：与普通人群相比，患有tDMARD的风湿性疾病的成年和儿科患者似乎未表现出更高的COVID-19风险或更严重的疾病结果。我们的探索性分析表明，tDMARD之间COVID-19疑似病例的比例有所不同。