Clinical characteristics of moderate or severe COVID‐19 infection in patients with rheumatic diseases and analysis of risk factors leading to severe disease

Abstract

ObjectiveTo explore the clinical characteristics of rheumatic disease (RD) patients who suffered from moderate or severe coronavirus disease 2019 (COVID‐19) infection and to evaluate risk factors of COVID‐19 infection in RD patients.MethodsA retrospective analysis was conducted on 148 moderate or severe COVID‐19 patients admitted to the First People's Hospital of Suqian Affiliated to Nanjing Medical University, including 74 RD patients and 74 non‐RD patients. Clinical data were collected including clinical characteristics and laboratory tests.ResultsThe RD group showed a higher proportion of females with a higher incidence of interstitial lung disease and kidney disease than the non‐RD group. Also, the incidence of fatigue, olfactory dysfunction and musculoskeletal pain was higher in the RD group, but the incidence of cough, wheezing, and fever was lower compared with non‐RD patients. The hospitalized course of the RD group (12.7 days ± 6.55) was significantly longer than that in the non‐RD group (8.07 days ± 3.40). Also, patients in the RD group had higher levels of erythrocyte sedimentation rate, interleukin (IL)‐2, and IL‐4 than the non‐RD group. The logistic regression analysis showed that dizziness and headache, C‐reactive protein (CRP) > 8 mg/L and lactate dehydrogenase (LDH) > 248 μ/L were independent risk factors for severe COVID‐19 infections of RD patients.ConclusionRD patients who suffered from moderate or severe COVID‐19 infections have a higher risk of comorbidities, higher levels of inflammation, and longer hospitalized course. Dizziness and headache, CRP > 8 mg/L and LDH > 248 μ/L are risk factors for severe COVID‐19 infections in RD patients.

Comment on Shao et al.'s “Risk factors associated with COVID‐19 pneumonia in Chinese patients with pre‐existing interstitial lung disease during the SARS‐CoV‐2 pandemic”

“…However, it is essential to note that certain risk factors, such as smoking, diabetes mellitus, autoimmune diseases, and recurrent COVID-19 infections, maintain a strong association with pneumonia, but were not considered in the analysis. [7][8][9] Therefore, the authors should consider…”