Older age, comorbidity, glucocorticoid use and disease activity are risk factors for COVID-19 hospitalisation in patients with inflammatory rheumatic and musculoskeletal diseases.
Older age, comorbidity, glucocorticoid use and disease activity are risk factors for COVID-19 hospitalisation in patients with inflammatory rheumatic and musculoskeletal diseases.
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DOI：
10.1136/rmdopen-2020-001464
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发表时间：
2021-01
期刊：
影响因子：
6.2
通讯作者：
Regierer AC
中科院分区：
文献类型：
--
作者：
Hasseli R;Mueller-Ladner U;Hoyer BF;Krause A;Lorenz HM;Pfeil A;Richter J;Schäfer M;Schmeiser T;Strangfeld A;Schulze-Koops H;Voll RE;Specker C;Regierer AC
炎症性风湿和肌肉骨骼疾病(RMD)患者是否有更高的风险发展为严重的新冠肺炎病程尚未完全阐明。这项分析的目的是根据新冠肺炎的严重程度描述RMD患者，并确定住院的危险因素。对2020年3月30日至11月1日德国新冠肺炎注册中心报告的确诊为SARS-CoV-2感染的RMD患者进行了评估。使用多变量Logistic回归估计因新冠肺炎而住院的OR。本文报告468例RMD合并SARS-CoV-2感染患者的临床资料。最常见的诊断是类风湿性关节炎(RA)(48%)。29%的患者住院治疗，5.5%的患者需要呼吸机。死亡19例。多因素分析显示年龄65岁(OR2.24；95% CI 1.12~4.47)，但更多的是75岁(OR3.94；95% CI 1.86~8.32)、心血管疾病(OR 3.36；95% CI 1.5~7.55)、间质性肺疾病/慢性阻塞性肺疾病(OR2.79；95% CI 1.2~6.49)、慢性肾脏疾病(OR2.96；95% 可信区间1.16~7.5)、中度/高度RMD疾病活动度(OR1.96；95% 可信区间1.02~3.76)和糖皮质激素(GCs)治疗剂量<5 mg/天(OR 3.67；95% 可信区间1.49~9.05)与较高的住院风险相关。与类风湿性关节炎相比，脊柱性关节炎患者的住院风险较小(OR0.46；95% 可信区间0.23至0.91)。年龄是住院的主要危险因素，以及心血管疾病、ILD/COPD、慢性肾脏疾病和目前或以前接受GCs治疗的共病。中度至高度的RMD疾病活动也是住院的独立风险因素，强调了在大流行期间继续进行适当的RMD治疗的重要性。
Whether patients with inflammatory rheumatic and musculoskeletal diseases (RMD) are at higher risk to develop severe courses of COVID-19 has not been fully elucidated. Aim of this analysis was to describe patients with RMD according to their COVID-19 severity and to identify risk factors for hospitalisation. Patients with RMD with PCR confirmed SARS-CoV-2 infection reported to the German COVID-19 registry from 30 March to 1 November 2020 were evaluated. Multivariable logistic regression was used to estimate ORs for hospitalisation due to COVID-19. Data from 468 patients with RMD with SARS-CoV-2 infection were reported. Most frequent diagnosis was rheumatoid arthritis, RA (48%). 29% of the patients were hospitalised, 5.5% needed ventilation. 19 patients died. Multivariable analysis showed that age >65 years (OR 2.24; 95% CI 1.12 to 4.47), but even more>75 years (OR 3.94; 95% CI 1.86 to 8.32), cardiovascular disease (CVD; OR 3.36; 95% CI 1.5 to 7.55), interstitial lung disease/chronic obstructive pulmonary disease (ILD/COPD) (OR 2.79; 95% CI 1.2 to 6.49), chronic kidney disease (OR 2.96; 95% CI 1.16 to 7.5), moderate/high RMD disease activity (OR 1.96; 95% CI 1.02 to 3.76) and treatment with glucocorticoids (GCs) in dosages >5 mg/day (OR 3.67; 95% CI 1.49 to 9.05) were associated with higher odds of hospitalisation. Spondyloarthritis patients showed a smaller risk of hospitalisation compared with RA (OR 0.46; 95% CI 0.23 to 0.91). Age was a major risk factor for hospitalisation as well as comorbidities such as CVD, ILD/COPD, chronic kidney disease and current or prior treatment with GCs. Moderate to high RMD disease activity was also an independent risk factor for hospitalisation, underlining the importance of continuing adequate RMD treatment during the pandemic.
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影响因子：
56.3
作者：
Boehmer, Merle M.;Buchholz, Udo;Zapf, Andreas
通讯作者：
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影响因子：
4
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影响因子：
6.2
作者：
Hasseli R;Mueller-Ladner U;Schmeiser T;Hoyer BF;Krause A;Lorenz HM;Regierer AC;Richter JG;Strangfeld A;Voll RE;Pfeil A;Schulze-Koops H;Specker C
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Specker C
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Seijas-Lopez, Alvaro