Risk of Severe COVID-19 Infection in Patients With Inflammatory Rheumatic Diseases
Risk of Severe COVID-19 Infection in Patients With Inflammatory Rheumatic Diseases
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DOI：
10.3899/jrheum.200755
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发表时间：
2021-07-01
影响因子：
3.9
通讯作者：
Vazquez-Diaz, Monica
中科院分区：
文献类型：
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作者：
Bachiller-Corral, Javier;Boteanu, Alina;Vazquez-Diaz, Monica
目标。描述Ramon y Cajal医院因SARS- CoV-2感染而住院的炎症性风湿病（IRD）患者队列，并确定无IRD的患者发生2019年严重冠状病毒病（COVID-19）的风险增加。这是一项回顾性单中心观察性研究，研究对象是因covid -19住院的风湿科积极监测的IRD患者。2315名SARS-CoV-2重症肺炎患者中有41名（1.8%）出现了IRD。与一般人群相比，IRD患者的入院OR为1.91，而干燥综合征、血管炎和系统性红斑狼疮患者的入院OR要高得多。27例患者接受皮质类固醇治疗，23例接受常规dmard治疗，12例接受生物制剂治疗（7例利妥昔单抗[RTX]， 4例抗肿瘤坏死因子[anti-TNF]， 1例阿巴接受），1例接受Janus激酶抑制剂治疗。在IRD患者中登记有10例死亡。RTX治疗组的住院率和死亡人数较高（OR为12.9），而抗tnf治疗组的住院率和死亡人数较高（OR为0.9）。与普通人群相比，IRD患者，特别是自身免疫性疾病和接受RTX治疗的患者，患SARS-CoV-2严重肺炎的风险可能更高。需要更多的研究来进一步分析这种关联，以便在大流行期间帮助管理这些患者。
Objective. To describe the cohort of patients with inflammatory rheumatic diseases (IRD) hospitalized due to SARS- CoV-2 infection in the Ramon y Cajal Hospital, and to determine the increased risk of severe coronavirus disease 2019 (COVID-19) in patients with no IRD.Methods. This is a retrospective single-center observational study of patients with IRD actively monitored in the Department of Rheumatology who were hospitalized due to COVID-19.Results. Forty-one (1.8%) out of 2315 patients admitted due to severe SARS-CoV-2 pneumonia suffered from an IRD. The admission OR for patients with IRD was 1.91 against the general population, and it was considerably higher in patients with Sjogren syndrome, vasculitis, and systemic lupus erythematosus. Twenty-seven patients were receiving treatment for IRD with corticosteroids, 23 with conventional DMARDs, 12 with biologics (7 rituximab [RTX], 4 anti-tumor necrosis factor [anti-TNF], and 1 abatacept), and 1 with Janus kinase inhibitors. Ten deaths were registered among patients with IRD. A higher hospitalization rate and a higher number of deaths were observed in patients treated with RTX (OR 12.9) but not in patients treated with anti-TNF (OR 0.9).Conclusion. Patients with IRD, especially autoimmune diseases and patients treated with RTX, may be at higher risk of severe pneumonia due to SARS-CoV-2 compared to the general population. More studies are needed to analyze this association further in order to help manage these patients during the pandemic.