Acute and postacute COVID-19 outcomes for patients with rheumatoid arthritis: lessons learned and emerging directions 3 years into the pandemic

Zaccardelli, Alessandra; Wallace, Zachary S; Sparks, Jeffrey A.

doi:10.1097/bor.0000000000000930

Cited by 11 publications

(7 citation statements)

References 73 publications

(104 reference statements)

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“…Different from this, an increase of ischemic events in giant cell arteritis (GCA) has been reported during pandemic in Italy, which was largely due to failure to receive timely medical care ( 23 ). Some other studies have also reported risks of developing serious outcomes in people with rheumatic diseases after COVID-19 infection ( 24 – 26 ). Moreover, the COVID-19 Global Rheumatology Alliance Vaccine Survey found that about 25% of patients with ARDs had PASC ( 27 ), which was similar to our study (26.38%).…”

Section: Discussionmentioning

confidence: 97%

COVID-19 infection characteristics, risk factors and its potential impacts on Takayasu arteritis: a web-based survey in a large cohort

Kong,

Wang,

Fan

et al. 2024

Front. Immunol.

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ObjectivesTo investigate the characteristics of COVID-19 and its impact on patients with Takayasu’s arteritis (TAK).MethodsA web-based survey was administered to a TAK cohort and their co-residents in China during January 2023. Infection symptoms, post-acute sequelae of COVID-19 (PASC), potential impacts of COVID-19 on patients’ disease condition, treatment and immune-related parameters were analyzed. In addition, risk factors for COVID-19 and disease relapse after infection were explored.ResultsThe infection rate was significantly lower in patients with TAK than in co-residents (79.13% vs 90.67%, p=0.025). TAK patients were more prone to gastrointestinal symptoms (17.78% vs 5.88%, p=0.024), sleep problems (25.15% vs 10.29%, p=0.011), and symptoms involving more than 2 organs (58.90% vs 35.29%, p=0.001) after infection. Although only 2.45% of TAK patients were hospitalized and none progressed to life-threatening conditions, they were more likely to suffer from PASC (26.38% vs 13.24%, p=0.029), especially active patients. Active disease after the pandemic was significantly lower in infected patients than uninfected patients (21/163, 12.88% vs. 11/43, 25.58%, p=0.041). The presence of multiple system symptoms was a risk factor for active TAK after infection [OR: 3.62 (95% CI 1.06-12.31), p=0.040]. Moreover, csDMARDs treatment was a risk factor for COVID-19 infection [OR: 3.68 (95% CI 1.56-8.66), p=0.002].ConclusionAlthough TAK patients with COVID-19 have more acute and post-acute symptoms, there is no adverse outcome and the risk of disease relapse does not increase. Patients treated with csDMARDs may be at higher risk of infection and deserve more clinical attention.

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Section: Discussionmentioning

confidence: 97%

COVID-19 infection characteristics, risk factors and its potential impacts on Takayasu arteritis: a web-based survey in a large cohort

Kong,

Wang,

Fan

et al. 2024

Front. Immunol.

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“…Others have found that lower serum butyrylcholinesterase activity is associated with severe COVID-19 [17]. Patients with rheumatoid arthritis have also been shown to have an increased risk of suffering from severe COVID-19, even though this association may be affected by factors such as immunosuppressive medications and concomitant interstitial lung disease [18]. Collectively, these genetic associations may contribute to the understanding of ADAM17 and its potential implications in relation to severe COVID-19.…”

Section: Discussionmentioning

confidence: 98%

Genetic Predisposition to Elevated Levels of Circulating ADAM17 Is Associated with the Risk of Severe COVID-19

Pan,

Goncalves,

Edsfeldt

et al. 2023

IJMS

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High levels of ADAM17 activity have emerged as an important mediator in severe COVID-19. This study aims to characterize eventual causal relationships between ADAM17 and COVID-19. Using Mendelian randomization analyses, we examined the causal effects of circulating ADAM17 on COVID-19 outcomes using summary statistics from large, genome-wide association studies of ADAM17 (up to 35,559 individuals) from the Icelandic Cancer Project and deCODE genetics, as well as critically ill COVID-19 patients (cases: 13,769; controls: 1,072,442), hospitalized COVID-19 patients (cases: 32,519; controls: 2,062,805) and reported SARS-CoV-2 infections (cases: 122,616; controls: 2,475,240) from the COVID-19 Host Genetics Initiative. The Mendelian randomization (MR) analyses demonstrated that a 1 standard deviation increase in genetically determined circulating ADAM17 (extracellular domain) was associated with an increased risk of developing critical ill COVID-19 (odds ratio [OR] = 1.26, 95% confidence interval [CI]:1.03–1.55). The multivariable MR analysis suggested a direct causal role of circulating ADAM17 (extracellular domain) in the risk of developing critical COVID-19 (OR = 1.09; 95% CI:1.01–1.17) when accounting for body mass index. No causal effect for the cytoplasmic domain of ADAM17 on COVID-19 was observed. Our results suggest that an increased genetic susceptibility to elevated levels of circulating ADAM17 (extracellular domain) is associated with a higher risk of suffering from severe COVID-19, strengthening the idea that the timely selective inhibition of ADAM17 could be a potential therapeutic target worthy of investigation.

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“…Coronaviruses use membrane ACE2 receptors to enter human cells. At the same time, ACE2 is also highly expressed in lung cells of patients with RA-related interstitial lung disease (ILD), and patients with RA and ILD are more susceptible to high inflammation and acute lung injury than the general population 17 , 18 . In addition, RA-ILD and COVID-19-infected lung lesions have remarkable similarities in epidemiological, clinical, and immunological characteristics.…”

Section: Discussionmentioning

confidence: 99%

Analysis of related factors for RA flares after SARS-CoV-2 infection: a retrospective study from patient survey

Li,

Zhao,

et al. 2024

Sci Rep

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SARS-CoV-2 and its variants are widely prevalent worldwide. With frequent secondary and breakthrough infections, immune dysfunction in RA patients, and long-term use of immune preparations, SARS-CoV-2 infection poses a significant challenge to patients and rheumatologists. Whether SARS-CoV-2 infection causes RA flares and what factors aggravate RA flares are poorly studied. A questionnaire survey was conducted on RA patients infected with SARS-CoV-2 after December 7, 2022, in China through a multicenter and inter-network platform regarding general personal condition, primary disease, comorbidity, SARS-CoV-2 vaccination, viral infection, and impact on the primary disease. A total of 306 RA patients were included in this study, and the patient data were analyzed, in which the general condition of RA patients, medication use before SARS-CoV-2 infection and post-infection typing and manifestations, and medication adjustment did not affect the Flare of RA patients after SARS-CoV-2 infection. The control of disease before SARS-CoV-2 infection (OR = 2.10), RA involving pulmonary lesions (OR = 2.28), and the recovery time of COVID-19 (OR = 2.50) were risk factors for RA flare. RA involving pulmonary lesions, control status of disease before infection, and recovery time of COVID-19 disease are risk factors for RA flare after SARS-CoV-2 infection.

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Acute and postacute COVID-19 outcomes for patients with rheumatoid arthritis: lessons learned and emerging directions 3 years into the pandemic

Cited by 11 publications

References 73 publications

COVID-19 infection characteristics, risk factors and its potential impacts on Takayasu arteritis: a web-based survey in a large cohort

COVID-19 infection characteristics, risk factors and its potential impacts on Takayasu arteritis: a web-based survey in a large cohort

Genetic Predisposition to Elevated Levels of Circulating ADAM17 Is Associated with the Risk of Severe COVID-19

Analysis of related factors for RA flares after SARS-CoV-2 infection: a retrospective study from patient survey

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