Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: data from the French RMD COVID-19 cohort of 694 patients.
Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: data from the French RMD COVID-19 cohort of 694 patients.
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DOI：
10.1136/annrheumdis-2020-218310
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发表时间：
2021-04
影响因子：
27.4
通讯作者：
FAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors
中科院分区：
文献类型：
--
作者：
FAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors
关于SARS-CoV-2对炎症性风湿性和肌肉骨骼疾病（iRMD）患者的影响知之甚少。我们研究了与严重疾病相关的流行病学特征，然后与死亡相关。我们还比较了患有和不患有iRMD的COVID-19住院患者的死亡率。疑似iRMD-COVID-19的个体被纳入该法国队列。使用经年龄和性别校正的Logistic回归模型估计重度COVID-19的校正OR和95% CI。最重要的临床相关因素进行了分析，多变量惩罚逻辑回归模型，使用向前选择方法。将iRMD-COVID-19（中重度）住院患者的死亡率与来自法国医院的年龄、性别和合并症匹配的非iRMD-COVID-19患者亚组进行比较。在694名成人中，438名（63%）发生轻度（未住院），169名（24%）中度（从重症监护室（ICU）住院）和87名（13%）重度（ICU患者/死亡）疾病。在多变量插补分析中，与严重感染相关的变量为年龄（OR=1.08，95%CI：1.05-1.10），女性（OR=0.45，95%CI：0.25-0.80），体重指数（OR=1.07，95%CI：1.02-1.12），高血压（OR=1.86，95%CI：1.01-3.42），和使用皮质类固醇（OR=1.97，95% CI：1.09-3.54）、吗替麦考酚酯（OR=6.6，95% CI：1.47-29.62）和利妥昔单抗（OR=4.21，95% CI：1.61-10.98）。58例患者死亡（8%（总计）和23%（住院））。与175例匹配的非iRMD-COVID-19住院患者相比，与iRMD-COVID-19住院患者相关的死亡率OR为1.45（95%CI：0.87-2.42）（每组n=175）。在法国RMD COVID-19队列中，正如在一般人群中已经确定的那样，发现年龄较大、男性、肥胖和高血压与重度COVID-19相关。iRMD患者使用皮质类固醇，而不是甲氨蝶呤，或肿瘤坏死因子α和白细胞介素-6抑制剂，应被认为更有可能发展为严重的COVID-19。与常见的合并症如肥胖、心血管或肺部疾病不同，iRMD患者的死亡风险并未显著增加。ClinicalTrials.gov注册表（NCT 04353609）。
There is little known about the impact of SARS-CoV-2 on patients with inflammatory rheumatic and musculoskeletal diseases (iRMD). We examined epidemiological characteristics associated with severe disease, then with death. We also compared mortality between patients hospitalised for COVID-19 with and without iRMD. Individuals with suspected iRMD-COVID-19 were included in this French cohort. Logistic regression models adjusted for age and sex were used to estimate adjusted ORs and 95% CIs of severe COVID-19. The most significant clinically relevant factors were analysed by multivariable penalised logistic regression models, using a forward selection method. The death rate of hospitalised patients with iRMD-COVID-19 (moderate–severe) was compared with a subset of patients with non-iRMD-COVID-19 from a French hospital matched for age, sex, and comorbidities. Of 694 adults, 438 (63%) developed mild (not hospitalised), 169 (24%) moderate (hospitalised out of the intensive care unit (ICU) and 87 (13%) severe (patients in ICU/deceased) disease. In multivariable imputed analyses, the variables associated with severe infection were age (OR=1.08, 95% CI: 1.05–1.10), female gender (OR=0.45, 95% CI: 0.25–0.80), body mass index (OR=1.07, 95% CI: 1.02–1.12), hypertension (OR=1.86, 95% CI: 1.01–3.42), and use of corticosteroids (OR=1.97, 95% CI: 1.09–3.54), mycophenolate mofetil (OR=6.6, 95% CI: 1.47–29.62) and rituximab (OR=4.21, 95% CI: 1.61–10.98). Fifty-eight patients died (8% (total) and 23% (hospitalised)). Compared with 175 matched hospitalised patients with non-iRMD-COVID-19, the OR of mortality associated with hospitalised patients with iRMD-COVID-19 was 1.45 (95% CI: 0.87–2.42) (n=175 each group). In the French RMD COVID-19 cohort, as already identified in the general population, older age, male gender, obesity, and hypertension were found to be associated with severe COVID-19. Patients with iRMD on corticosteroids, but not methotrexate, or tumour necrosis factor alpha and interleukin-6 inhibitors, should be considered as more likely to develop severe COVID-19. Unlike common comorbidities such as obesity, and cardiovascular or lung diseases, the risk of death is not significantly increased in patients with iRMD. ClinicalTrials.gov Registry (NCT04353609).
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影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.
影响因子：
27.4
作者：
Ramiro, Sofia;Mostard, Remy L. M.;Landewe, Robert B. M.
通讯作者：
Landewe, Robert B. M.
DOI：
10.1016/s1473-3099(20)30243-7
发表时间：
2020-06-01
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Verity, Robert;Okell, Lucy C;Ferguson, Neil M
通讯作者：
Ferguson, Neil M
DOI：
10.1056/nejmp2026913
发表时间：
2020-10-29
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gandhi M;Rutherford GW
通讯作者：
Rutherford GW
影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.