To investigate the incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases receiving targeted biologic and synthetic disease modifying anti-rheumatic drugs (tDMARDs) and to explore the possible effect of these treatments in the clinical expression of COVID-19. Methods: A cross-sectional study comprising of a telephone survey and electronic health records review was performed including all adult and paediatric patients with rheumatic diseases treated with tDMARDs in a large rheumatology tertiary centre in Barcelona, Spain. Demographics, disease activity, COVID-19 related symptoms and contact history data were obtained from the start of the 2020 pandemic. Cumulative incidence of confirmed cases (SARS-CoV-2 positive PCR test) was compared to the population estimates for the same city districts from a governmental COVID-19 health database. Suspected cases were defined following WHO criteria and compared to those without compatible symptoms. Results: 959 patients with rheumatic diseases treated with tDMARDs were included. We identified 11 confirmed SARS-CoV-2 positive cases in the adult cohort and no confirmed positive cases in the paediatric cohort. COVID-19 incidence rates of the rheumatic patient cohort were very similar to that of the general population [(0.48% (95% CI 0.09 to 0.87%)] and [0.58% (95% CI 0.56 to 0.60%)], respectively. We found significant differences in tDMARDs proportions between the suspected and non-suspected cases (p=0.002). Conclusion: Adult and paediatric patients with rheumatic diseases on tDMARDs do not seem to present a higher risk of COVID-19 or a more severe disease outcome when compared to general population.

OBJECTIVES: To investigate the incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases receiving targeted biologic and synthetic disease modifying anti-rheumatic drugs (tDMARDs) and to explore the possible effect of these treatments in the clinical expression of COVID-19. METHODS: A cross-sectional study comprising of a telephone survey and electronic health records review was performed including all adult and paediatric patients with rheumatic diseases treated with tDMARDs in a large rheumatology tertiary centre in Barcelona, Spain. Demographics, disease activity, COVID-19 related symptoms and contact history data were obtained from the start of the 2020 pandemic. Cumulative incidence of confirmed cases (SARS-CoV-2 positive PCR test) was compared to the population estimates for the same city districts from a governmental COVID-19 health database. Suspected cases were defined following WHO criteria and compared to those without compatible symptoms. RESULTS: 959 patients with rheumatic diseases treated with tDMARDs were included. We identified 11 confirmed SARS-CoV-2 positive cases in the adult cohort and no confirmed positive cases in the paediatric cohort. All patients had a successful recovery and only one patient required admission in the intensive care unit. When using the same classification criteria (only COVID-19 positive cases with pneumonia), COVID-19 incidence rates of the rheumatic patient cohort were very similar to that of the general population [(0.48% (95% CI 0.09 to 8.65%)] and [0.58% (95% CI 5.62 to 5.99%)], respectively. We found significant differences in tDMARDs proportions between the suspected and non-suspected cases (p=0.002). CONCLUSION: Adult and paediatric patients with rheumatic diseases on tDMARDs do not seem to present a higher risk of COVID-19 or a more severe disease outcome when compared to general population. Our exploratory analysis suggests that the proportion of COVID-19 suspected cases differs between tDMARDs.

Objectives: To characterize the frequency of thrombocytopenia in patients with SLE and determine its time of onset during the course of the disease, severity and impact on mortality. Methods:This was a single centre cohort analysis of 707 patients with SLE followed for up to 40 years. We reviewed the patients' clinical notes identifying the presence of thrombocytopenia, its time of onset and ascertained other clinical and serological features of the disease. Thrombocytopenia was classified as mild (100-149x10 9 /L), moderate (31-99x10 9 /L) or severe (≤30x10 9 /L platelets). It was also classified as asymptomatic, with minor bleeding or with major bleeding.Results: 22.9% of patients (n=162) had thrombocytopenia prior to or during the course of SLE. Twenty three patients (14.2%) had isolated ITP before the diagnosis of SLE. Median follow-up time was 19 years (IQR=13). Most patients (N=67, 41.4%) had mild thrombocytopenia. More than half the patients (n=98, 60.5%) developed asymptomatic thrombocytopenia and only 6 patients (3.7%) had major bleeding events in the context of thrombocytopenia. The development of severe thrombocytopenia anytime during the course of SLE was associated with an increased risk of death (HR=3.57, p=0.025). There was an increased risk of death for male patients (HR=3.41, p=0.036) who develop thrombocytopenia and for those who presented with concomitant haemolytic anaemia (HR=3.07, p=0.027). Conclusion:The presence of severe thrombocytopenia (platelets ≤30x10 9 ) in patients with SLE is associated with an increased risk of death, regardless of bleeding events. Male patients with SLE and thrombocytopenia had an increased mortality risk, as have those who develop concomitant thrombocytopenia and haemolytic anaemia.

Objectives:To study the differences in severity marker and disease activity in patients with RA and ILD and patients with RA without DILD, and to identify factors associated with ILD in RA patients.Methods:Design:Observational case-control study.Patients: consecutive RA-patients (ACR/EULAR 2010 criteria) with ILD (American Thoracic Society) selected from a prospective cohort from Regional Hospital and Virgen Victoria Hospital of Málaga were included. Controls: RA-patients without ILD. Sex-age matched controls were collected from a prospective cohort of Regional Hospital.Protocol: RA Patients are reviewed every six months in general clinic and patients with biological terapy every three months. All patients are reviewed according to a protocol with systematic data collection. The data of patients with RA and ILD are also collected in a database according to a specific protocol for these patients. The day that was reviewed the last time in consultation will be marked as inclusion date. Data will be collected on the date of inclusion and their clinical records.Outcomes: Difference in severity marker in both groups on the date of inclusion (RF, ACPA, erosive arthritis); in disease Activity Score (DAS28-ESR) and Health Assessment Questionnaire (HAQ); description of modifying antirheumatic drugs (DMARDs);Variables: Demographic, clinical-analytical variables: number of tender joints (TJ), number of swollen joints (SJ), CRP, ESR, general evaluation,DAS28-ESR, HAQ and adverse effects (description, severity and number).Statistical analysis: Descriptive and paired T-test or Chi-square test followed by binary logistic regression (RLB) (Vd:ILD in patients with RA).Results:Fifty-three patients were included, 29 RA with ILD and 24 RA controls. The differences between clinical and epidemiological characteristcs to cases and controls are shown in table 1. RA patients with ILD showed more months with RA duration (p=0.002), more number of exsmokers (p=0.003), erosive arthritis (p=0.011) and ACPA positive (P=0.008). No significant differences in the mean of DAS28 in cases and controls were observed (2.61 vs 2.68; p=0.789), but RA patients with ILD presented worse in physical function parameters by HAQ (1.12 VS 0.63; P=0.032). All patients were treated with disease modifying antirheumatic drugs (DMARDs). RA patients with ILD had: 5 (17.2%) monotherapy with bDMARDs, 17 (58.62) monotherapy with sDMARD and 7 (24.1) sDMARDs with a bDMARDs. In multivariate analysis, the independent variables that were associated with ILD in RA patients were: ACPA elevated (OR [IC95%] =5.0 [1.2–9.9]; p=0.023) and RA duration (months) (OR [IC95%]=1.1 [1.0–1,2]; p=0.037). This model would explain 28% of the variability of the ILD in RA (R2=0.28).Conclusions:The evolution time of arthritis and the presence of ACPA to high titres (>340) were the predictors of ILD in patients with RA in our study. More prospective studies with a greater number of patients are necessary to identify the possible association.Disclosure of Interest:None declared