Affiliation:
1. Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan
2. Department of Molecular Biology, Ariel University, Ariel 40700, Israel
Abstract
Background: Viral infections, including coronavirus disease 2019 (COVID-19), in patients with autoimmune rheumatic diseases (AIRDs) tend to present more severe disease. This study aims to investigate the clinical characteristics and risk factors for severe infection in rheumatologic patients. Methods: We included patients with a diagnosis of AIRD and COVID-19 infection between January 2022 and July 2023. Patients with AIRDs infected with SARS-CoV-2 were matched with control patients of the general population according to age (±5 years) and sex in a 1:1 ratio. Confirmed infection was defined if a patient had a positive polymerase chain reaction (PCR) test. The severity was divided into mild, moderate, severe, and critical according to the guidelines of the United States National Institutes of Health (NIH). Results: A total of 140 individuals (37 males, 103 females; mean age 56.1 ± 11.3 years) with rheumatic disease diagnosed with COVID-19 infection were enrolled in the study. AIRDs included rheumatoid arthritis (RA) (n = 63, 45%), ankylosing spondylitis (AS) (n = 35, 25%), systemic lupus erythematosus (SLE) (n = 26, 8.6%), and systemic sclerosis (SSc) (n = 16, 11.4%). The AIRDs group had more SARS-CoV-2-related dyspnea (38.6%), arthralgia (45.7%), and depression (27.1%) than the control group (p = 0.004). The rate of lung infiltration on radiographic examination was higher in 58 (41.4%, p = 0.005) patients with rheumatic diseases than in those without them. Severe SARS-CoV-2 infection was more common in the AIRDs group than in the control group (22% vs. 12%; p = 0.043). Conclusions: Patients with AIRDs experienced more symptoms of arthralgia, depression, and dyspnea. There was a trend towards an increased severity of the disease in patients with AIRDs. Patients with arterial hypertension, diabetes, chronic lung, and kidney disease, treated with corticosteroids, had a longer duration, and high activity of autoimmune disease had an increased risk of severe COVID-19.
Reference60 articles.
1. (2024, June 29). COVID-19 Cases|WHO COVID-19 Dashboard. Available online: https://data.who.int/dashboards/covid19/cases.
2. Maddur, M.S., Vani, J., Lacroix-Desmazes, S., Kaveri, S., and Bayry, J. (2010). Autoimmunity as a Predisposition for Infectious Diseases. PLoS Pathog., 6.
3. Incidence and Severeness of COVID-19 Hospitalisation in Patients with Inflammatory Rheumatic Disease: A Nationwide Cohort Study from Denmark;Cordtz;Rheumatology,2020
4. Coronavirus Disease 2019: Investigational Therapies in the Prevention and Treatment of Hyperinflammation;Amigues;Expert. Rev. Clin. Immunol.,2020
5. Factors Associated with COVID-19-Related Death Using OpenSAFELY;Williamson;Nature,2020