Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases
Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases
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DOI：
10.1136/annrheumdis-2020-217763
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发表时间：
2020-09-01
影响因子：
27.4
通讯作者：
Seijas-Lopez, Alvaro
中科院分区：
文献类型：
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作者：
Pablos, Jose L.;Abasolo, Lydia;Seijas-Lopez, Alvaro
背景 风湿病患者的易感性以及免疫抑制治疗对 COVID-19 的风险或益处尚不清楚。 方法 我们对西班牙 7 家医院风湿病科的随访患者进行了回顾性研究。我们将在医院进行的严重急性呼吸综合征冠状病毒 2 阳性 PCR 检测的风湿病患者的最新数据库与相同的参考人群进行了匹配。比较各组之间 PCR+ 确诊的 COVID-19 率。结果 慢性炎症性疾病患者的医院 PCR+ COVID-19 患病率是参考人群的 1.32 倍（0.76% vs 0.58%）。患有系统性自身免疫性疾病或免疫介导疾病（AI/IMID）的患者表现出显着增加，而患有炎性关节炎（IA）或系统性红斑狼疮的患者则没有。一些（但并非所有）诊断组中的 COVID-19 病例的年龄比参考人群中的病例大。尽管年龄分布相似，但服用靶向合成或生物疾病缓解抗风湿药物 (DMARD) 的 IA 患者（而非服用传统合成 DMARD 的患者）的患病率较高。结论 AI/IMID 患者患医院诊断的 COVID-19 的风险存在差异。衰老、治疗和疾病特异性因素的相互作用似乎有所贡献。这些数据为改善风湿病患者的预防建议和分析与 COVID-19 易感性相关的具体因素提供了基础。
Background The susceptibility of patients with rheumatic diseases and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown.Methods We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with severe acute respiratory syndrome coronavirus 2-positive PCR tests performed in the hospital to the same reference populations. Rates of PCR+ confirmed COVID-19 were compared among groups.Results Patients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Patients with systemic autoimmune or immune-mediated disease (AI/IMID) showed a significant increase, whereas patients with inflammatory arthritis (IA) or systemic lupus erythematosus did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. Patients with IA on targeted-synthetic or biological disease-modifying antirheumatic drugs (DMARDs), but not those on conventional-synthetic DMARDs, had a greater prevalence despite a similar age distribution.Conclusion Patients with AI/IMID show a variable risk of hospital-diagnosed COVID-19. Interplay of ageing, therapies and disease-specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyse the specific factors involved in COVID-19 susceptibility.