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COVID-19 infection among autoimmune rheumatic disease patients: Data from an observational study and literature review
Journal of Autoimmunity ( IF 7.9 ) Pub Date : 2021-07-16 , DOI: 10.1016/j.jaut.2021.102687
Athanasios-Dimitrios Bakasis 1 , Clio P Mavragani 2 , Kyriaki A Boki 3 , Athanasios G Tzioufas 4 , Panayiotis G Vlachoyiannopoulos 4 , Ioanna E Stergiou 1 , Fotini N Skopouli 5 , Haralampos M Moutsopoulos 6
Affiliation  

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.



中文翻译:

自身免疫性风湿病患者的 COVID-19 感染:一项观察性研究和文献综述的数据

在 COVID-19 大流行期间,SARS-CoV-2 感染对接受免疫调节治疗的自身免疫/自身炎症性风湿病 (AARD) 患者的影响一直是人们关注的焦点。在这项观察性研究中,记录了 77 名感染 SARS-CoV-2 的潜在 AARD 患者的人口统计数据、疾病相关特征和合并症、COVID-19 表现和结果以及对 SARS-CoV-2 的抗体反应。使用单变量和多变量模型进行数据分析。大多数患者 (68.8%) 的 COVID-19 病程较轻。主要临床表现为乏力(58.4%)、低热(45.4%)和上呼吸道症状(68.8%)。大约四分之一的患者需要住院治疗 (23.3%),死亡率为 1.3%。关于 COVID-19 的严重程度,既往使用皮质类固醇、吗替麦考酚酯或利妥昔单抗治疗的病程更严重的患者更常见(分别为 60.0 对 29.9%,p = 0.003、40.0 对 7.5%,p = 0.003、10.0 对 0.0%,p = 0.009) ). 当在多变量模型中考虑疾病相关特征和合并症时,发现 AARD 背景下的年龄较大和肺部疾病是住院的独立预测因素(OR [95%]:1.09 [1.03–1.15] 和 6.43 [1.11– 37.19])。在 COVID-19 相关特征中,呼吸急促和高烧的患者更容易住院(OR [95%]:7.06 [1.36–36.57]、12.04 [2.96–48.86]),而嗅觉缺失独立相关住院风险较低(OR [95%]:0.09 [0.01–0.99])。尽管大多数 AARD 患者表现出轻微的 COVID-19 病程,

更新日期:2021-07-24
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