COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries.
COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries.
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DOI：
10.1093/rheumatology/keab250
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发表时间：
2021-10-09
期刊：
影响因子：
--
通讯作者：
Prieto-Alhambra D
中科院分区：
文献类型：
--
作者：
Tan EH;Sena AG;Prats-Uribe A;You SC;Ahmed WU;Kostka K;Reich C;Duvall SL;Lynch KE;Matheny ME;Duarte-Salles T;Bertolin SF;Hripcsak G;Natarajan K;Falconer T;Spotnitz M;Ostropolets A;Blacketer C;Alshammari TM;Alghoul H;Alser O;Lane JCE;Dawoud DM;Shah K;Yang Y;Zhang L;Areia C;Golozar A;Recalde M;Casajust P;Jonnagaddala J;Subbian V;Vizcaya D;Lai LYH;Nyberg F;Morales DR;Posada JD;Shah NH;Gong M;Vivekanantham A;Abend A;Minty EP;Suchard M;Rijnbeek P;Ryan PB;Prieto-Alhambra D
建议患有自身免疫性疾病的患者屏蔽以避免2019冠状病毒病（COVID-19），但缺乏有关其预后的信息。我们描述了流行性自身免疫性疾病患者因COVID-19住院后30天的结局和死亡率，并比较了类似季节性流感患者住院后的结局。使用来自哥伦比亚大学欧文医学中心[美国]、Optum（美国）、退伍军人事务部（美国）、初级保健-住院关联数据研究信息系统（西班牙）的电子健康记录数据以及来自IQVIA Open Claims（美国）和Health Insurance and Review Assessment（韩国）的索赔数据进行了一项多国网络队列研究。纳入了2020年1月至6月期间诊断和/或住院治疗COVID-19的所有流行性自身免疫性疾病患者，以及2017-18年因流感住院的类似患者。结局为住院后30天内死亡和并发症。我们研究了133589名确诊为COVID-19并住院治疗的患者，其中48418人患有流行性自身免疫性疾病。大多数患者为女性，年龄≥50岁，既往有合并症。高血压（45.5-93.2%）、慢性肾脏疾病（14.0-52.7%）和心脏病（29.0-83.8%）的患病率在住院的COVID-19患者中高于确诊患者。与70 660名因流感住院的患者相比，因COVID-19住院的患者有更多的呼吸系统并发症，包括肺炎和急性呼吸窘迫综合征，30天死亡率也更高（2.2-4.3% vs 6.32-24.6%）。与流感相比，COVID-19是一种更严重的疾病，导致更多并发症和更高的死亡率。
Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization with COVID-19 among patients with prevalent autoimmune diseases, and compared outcomes after hospital admissions among similar patients with seasonal influenza. A multinational network cohort study was conducted using electronic health records data from Columbia University Irving Medical Center [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017–18 were included. Outcomes were death and complications within 30 days of hospitalization. We studied 133 589 patients diagnosed and 48 418 hospitalized with COVID-19 with prevalent autoimmune diseases. Most patients were female, aged ≥50 years with previous comorbidities. The prevalence of hypertension (45.5–93.2%), chronic kidney disease (14.0–52.7%) and heart disease (29.0–83.8%) was higher in hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2–4.3% vs 6.32–24.6%). Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.
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