DMARD disruption, rheumatic disease flare, and prolonged COVID-19 symptom duration after acute COVID-19 among patients with rheumatic disease: A prospective study.
DMARD disruption, rheumatic disease flare, and prolonged COVID-19 symptom duration after acute COVID-19 among patients with rheumatic disease: A prospective study.
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DOI：
10.1016/j.semarthrit.2022.152025
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发表时间：
2022-08
影响因子：
5
通讯作者：
Sparks, Jeffrey A.
中科院分区：
文献类型：
--
作者：
Di Iorio, Michael;Cook, Claire E.;Vanni, Kathleen M. M.;Patel, Naomi J.;D'Silva, Kristin M.;Fu, Xiaoqing;Wang, Jiaqi;Prisco, Lauren C.;Kowalski, Emily;Zaccardelli, Alessandra;Martin, Lily W.;Qian, Grace;Hsu, Tiffany Y-T;Wallace, Zachary S.;Sparks, Jeffrey A.
描述患有全身性自身免疫性风湿病（SARD）的COVID-19幸存者中的疾病缓解抗风湿药（DMARD）中断、风湿病发作/活动和COVID-19症状持续时间延长。我们调查了在马萨诸塞州布里格姆将军医院确诊COVID-19的既存SARD患者，以调查COVID-19的急性后遗症。我们获得了人口统计学、临床特征、COVID-19症状/病程和患者报告指标的数据。我们使用logistic回归分析了COVID-19症状持续时间延长（定义为持续≥28天）的基线预测因素。我们分析了2021年3月至2022年1月期间174名COVID-19幸存者（平均年龄52岁，81%为女性，80%为白色，50%为类风湿性关节炎）的调查。在接受DMARD治疗的127名受访者中，有51%的人报告称，在COVID-19发病后，他们的治疗方案受到了干扰。对于个体DMARD，56-77%有任何变化，除了羟氯喹（23%）和利妥昔单抗（46%）。COVID-19后的SARD发作报告率为41%。在调查时，全球患者报告的疾病活动度比COVID-19之前更差（平均值6.6±2.9 vs. 7.6±2.3，p<0.001）。COVID-19症状缓解的中位时间为25天（IQR 11，160）。45%的患者症状持续时间延长≥28天。因COVID-19住院（OR 3.54，95%CI 1.27-9.87）和初始COVID-19症状计数（每种症状OR 1.38，95%CI 1.17-1.63）与症状持续时间延长相关。与没有长期症状的人相比，经历长期症状持续时间的受访者有更高的RAPID 3评分（p=0.007）和更多的疼痛（p<0.001）和疲劳（p=0.03）。在这项针对COVID-19幸存者的前瞻性研究中，DMARD中断、SARD发作和COVID-19症状持续时间延长是常见的，这表明急性COVID-19后对SARD产生了重大影响。
To describe disease-modifying antirheumatic drug (DMARD) disruption, rheumatic disease flare/activity, and prolonged COVID-19 symptom duration among COVID-19 survivors with systemic autoimmune rheumatic diseases (SARDs). We surveyed people with pre-existing SARDs who had confirmed COVID-19 at Mass General Brigham to investigate post-acute sequelae of COVID-19. We obtained data on demographics, clinical characteristics, COVID-19 symptoms/course, and patient-reported measures. We examined baseline predictors of prolonged COVID-19 symptom duration (defined as lasting ≥28 days) using logistic regression. We analyzed surveys from 174 COVID-19 survivors (mean age 52 years, 81% female, 80% White, 50% rheumatoid arthritis) between March 2021 and January 2022. Fifty-one percent of 127 respondents on any DMARD reported a disruption to their regimen after COVID-19 onset. For individual DMARDs, 56-77% had any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41%. Global patient-reported disease activity was worse at the time of survey than before COVID-19 (mean 6.6±2.9 vs. 7.6±2.3, p<0.001). Median time to COVID-19 symptom resolution was 25 days (IQR 11, 160). Prolonged symptom duration of ≥28 days occurred in 45%. Hospitalization for COVID-19 (OR 3.54, 95%CI 1.27-9.87) and initial COVID-19 symptom count (OR 1.38 per symptom, 95%CI 1.17-1.63) were associated with prolonged symptom duration. Respondents experiencing prolonged symptom duration had higher RAPID3 scores (p=0.007) and more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms. DMARD disruption, SARD flare, and prolonged COVID-19 symptom duration were common in this prospective study of COVID-19 survivors, suggesting substantial impact on SARDs after acute COVID-19.
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影响因子：
4
作者：
Karaarslan F;Demircioğlu Güneri F;Kardeş S
通讯作者：
Kardeş S
影响因子：
3.1
作者：
Leon L;Perez-Sancristobal I;Madrid A;Lopez-Pedraza L;Colomer JI;Lerma S;Lois P;Mucientes A;Rodriguez-Rodriguez L;Fernandez-Gutierrez B;Abasolo L
通讯作者：
Abasolo L
影响因子：
3.5
作者：
Hann, DM;Denniston, MM;Baker, F
通讯作者：
Baker, F
影响因子：
27.4
作者：
Alunno, Alessia;Najm, Aurelie;Mariette, Xavier
通讯作者：
Mariette, Xavier
影响因子：
3.4
作者：
Karaarslan F;Güneri FD;Kardeş S
通讯作者：
Kardeş S