Incidence of COVID-19 in Patients With Rheumatic Diseases Treated With Targeted Immunosuppressive Drugs: What Can We Learn From Observational Data?
Incidence of COVID-19 in Patients With Rheumatic Diseases Treated With Targeted Immunosuppressive Drugs: What Can We Learn From Observational Data?
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DOI：
10.1002/art.41388
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发表时间：
2020-09-06
影响因子：
13.3
通讯作者：
Montecucco, Carlomaurizio
中科院分区：
文献类型：
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作者：
Favalli, Ennio Giulio;Monti, Sara;Montecucco, Carlomaurizio
目的描述与生活在同一意大利地区的普通人群相比，接受靶向合成或生物疾病缓解抗风湿药物（DMARDs）治疗的风湿性疾病患者中2019冠状病毒病（COVID-19）的发病率和严重程度。方法邀请2020年2月25日至2020年4月10日在伦巴第大区2个风湿病转诊中心随访的患者参加一项调查，旨在确定确诊COVID-19的患者、与确诊COVID-19的其他人密切接触的患者或感染症状，并检测工作、行为、和疾病管理，以防止感染。伦巴第大区人口的COVID-19发病率来自国家统计研究所。COVID-19病例经鼻咽拭子确诊。结果共调查955例患者，其中类风湿关节炎531例，银屑病关节炎203例，脊柱关节炎181例，结缔组织病、血管炎、自身炎性疾病40例。这些患者的平均年龄为53.7岁，67.4%为女性。调查应答率为98.05%，确诊COVID-19病例发生率与一般人群一致（0.62%对0.66%;P= 0.92）。没有患者出现严重并发症或需要重症监护治疗，所有COVID-19检测呈阳性的患者都暂时停止了正在进行的靶向合成药物或生物DMARD治疗。几乎所有患者都采取了预防措施来预防COVID-19感染（90.6%），几乎所有患者都继续使用靶向合成药物或生物DMARD（93.2%）进行治疗。89.5%的患者病情稳定。结论本研究结果反映了风湿性疾病患者在长期坚持治疗方案的同时，对预防感染的态度。接受靶向合成药物或生物DMARD治疗的患者中，COVID-19的发病率和严重程度与同一地区的一般人群无显著差异。
Objective To describe the incidence and severity of coronavirus disease 2019 (COVID-19) in patients with rheumatic diseases treated with targeted synthetic or biologic disease-modifying antirheumatic drugs (DMARDs) compared with that in the general population living in the same Italian region. Methods Patients followed up at 2 rheumatology referral centers in Lombardy from February 25, 2020 to April 10, 2020 were invited to participate in a survey designed to identify patients who had confirmed COVID-19, close contact with others with confirmed COVID-19, or symptoms of the infection, and to detect changes in work, behavior, and disease management made in an attempt to prevent infection. The incidence of COVID-19 in the Lombardy population was obtained from the National Institute of Statistics. COVID-19 cases were confirmed by nasopharyngeal swab. Results The survey was given to 955 patients (531 patients with rheumatoid arthritis, 203 patients with psoriatic arthritis, 181 patients with spondyloarthritis, and 40 patients with connective tissue diseases, vasculitides, or autoinflammatory diseases). These patients had a mean age of 53.7 years, and 67.4% were women. The rate of response to the survey was 98.05%, and the incidence of confirmed COVID-19 cases was consistent with that in the general population (0.62% versus 0.66%;P= 0.92). None of the patients had severe complications or required intensive care treatment, and all of the patients who tested positive for COVID-19 temporarily discontinued ongoing targeted synthetic drug or biologic DMARD therapy. Almost all patients took precautions to prevent the COVID-19 infection (90.6%), and almost all continued treatment with targeted synthetic drugs or biologic DMARDs (93.2%). Disease activity remained stable in 89.5% of patients. Conclusion Our results reflected the attitude of patients with rheumatic diseases regarding the prevention of the infection while maintaining their long-term treatment regimens. The incidence and severity of COVID-19 in patients treated with targeted synthetic drugs or biologic DMARDs was not significantly different from that in the general population in the same region.