Clinical features of patients with rheumatic diseases and COVID-19 infection in Sarawak, Malaysia

Wan, Sharifah Aishah; Teh, Cheng Lay; Singh, Benjamin; Cheong, Yaw Kiet; Chuah, Seow Lin; Jobli, Ahmad Tirmizi

doi:10.1136/annrheumdis-2020-218425

Cited by 8 publications

(6 citation statements)

References 6 publications

(5 reference statements)

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“… First author Country Continent Study design No. of patients Age (years) mean + −sd,/ median(range) Sex Male Female Sharmeen et al [ 37 ] America North America case series 4 Male (78,49) Female (76,27) 2 2 Cheng et al [ 36 ] China Asia cross-sectional 5 66 (61–72) 1 4 Ye et al [ 18 ] China Asia case series 21 – Lin et al [ 40 ] China Asia cohort 11 55 (25,71) 1 10 Zhao et al [ 62 ] China Asia cross-sectional 29 Median 61 4 25 Huang et al [ 41 ] China Asia cross-sectional 17 64.0 (60.5–71.5) 3 14 Benucci et al [ 63 ] Italy Europe cross-sectional 4 60 ± 9.5 1 3 Teh et al [ 39 ] Malaysia Asia cross-sectional 5 42.8 ± 18.3 0 5 Wan et al [ 42 ] Malaysia Asia ...…”

Section: Resultsmentioning

confidence: 99%

“…The fatality rate was higher (0.113, 95% CI 0.098 to 0.13) than our study (0.07, 95% CI 0.03–0.11) and the COVID-19 GRA data (0.067). There were total 16 publications included in our meta-analysis but not in the study by Akiyama et al Three publications were missed [ [33] , [34] , [35] ], eight were excluded because only hospitalized patients were recruited [ 18 , [36] , [37] , [38] , [39] , [40] , [41] , [42] ], four published after 31st July 2020 when is the updated time of literature search by Akiyama et al [ 19 , 20 , 43 , 44 ]. Furthermore, we were not certain whether the cases were duplicated in published data and the COVID-19 GRA data.…”

Section: Discussionmentioning

confidence: 99%

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Clinical outcomes of COVID-19 in patients with rheumatic diseases: A systematic review and meta-analysis of global data

Cai

et al. 2021

Autoimmunity Reviews

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Objectives The impact of rheumatic diseases on COVID-19 infection remains poorly investigated. Here we performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 in patients with rheumatic diseases. Methods We systematically searched PubMed, Embase, Cochrane Library, Scopus and preprint database up to 29th August 2020, for publications with confirmed COVID-19 infection in patients with rheumatic diseases. The primary outcomes were the rates of hospitalization, oxygen support, intensive care unit (ICU) admission and death. A meta-analysis of effect sizes using the random-effects models was performed, and meta-regression analyses were performed to explore heterogeneity. The data from the COVID-19 Global Rheumatology Alliance physician registry (the COVID-19 GRA) was used as a reference. Results A total of 31 articles involving 1138 patients were included in this systematic review and meta-analysis. The publications were from Europe, Asia and North America, but none from other continents. The overall rates of hospitalization, oxygen support, ICU admission and fatality among COVID-19 infected patients with rheumatic diseases were 0.58 (95% confidence interval (CI) 0.48–0.67), 0.33 (95% CI 0.21–0.47), 0.09 (95% CI 0.05–0.15) and 0.07 (95% CI 0.03–0.11), respectively. The rate of oxygen support in Europe (0.48, 95% CI 0.4–0.57) was higher than that in other continents. Among all hospitalized patients, the rates of oxygen support, ICU admission and fatality were 0.61 (95% CI 0.48–0.73), 0.13 (95% CI 0.07–0.21) and 0.13 (95% CI 0.09–0.18), respectively. The fatality rate was highest in Europe (0.19, 95% CI 0.15–0.24). The fatality rate was higher both in this meta-analysis and the COVID-19 GRA (7.0% and 6.7%, respectively) than that (3.4%) in WHO database, although the age, gender and comorbidity were not matched. Conclusion Patients with rheumatic diseases remain vulnerable with substantial rates of severe outcomes and a geographic variation. More studies were urgently needed to elucidate the risk factors of severe outcomes in this population.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of COVID-19 in patients with rheumatic diseases: A systematic review and meta-analysis of global data

Cai

et al. 2021

Autoimmunity Reviews

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“…Furthermore, in comparison to the general population, patients with rheumatoid arthritis treated with biological DMARDs or targeted synthetic DMARDs did not appear to have an elevated risk of life-threatening complications from SARS-CoV-2. An 80-year-old woman with PM on azathioprine was described with a benign COVID-19 prognosis in a case series of four patients with rheumatologic diseases [ 25 ]. Immunosuppressive medications were not substantially related with an increased risk of ICU hospitalization, mechanical ventilation or death in COVID-19, according to preliminary research from the Italian Registry of the Italian Society of Rheumatology [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Course of Idiopathic Inflammatory Myopathies in the COVID-19 Pandemic: A single-center Experience

et al. 2022

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Aim: To evaluate the clinical course of idiopathic inflammatory myopathy (IIM) patients in COVID-19 pandemic, and to assess the COVID-19 outcomes in infected IIM patients. Materials & methods: In this study, 39 patients were evaluated retrospectively. Myositis disease activity, myositis damage index, depression, fatigue, active medical treatment, drug compliance and SARS-CoV-2 PCR test results in COVID-19 pandemic were collected. Results: Fourteen of these patients (35%) were detected to have a positive SARS-CoV-2 PCR test. The demographic and clinical characteristics, active medical treatment, disease activity, depression and fatigue of the patients who had undergone or not SARS-CoV-2 were similar. Conclusion: Our results have shown that although prevalence of COVID-19 seems to be increased in IIM patients under immunosuppressive treatment, hospitalization rates were lower and no intensive care unit admissions or deaths were observed.

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“…It has been described that polymyositis could be observed during infection with viruses, especially retroviruses [ 4 ] and more recently COVID-19 [ 9 ]. Comorbidities such as diabetes mellitus, heart disease, obesity, impaired renal function are risk factors for mortality [ 10 , 11 ], and when associated with an age greater than 59 years, are predictive factors for the development of rapidly progressive severe or fatal COVID-19 infection [ [10] , [11] , [12] , [13] ].…”

Section: Discussionmentioning

confidence: 99%

Polymyositis and covid-19: A morbide association (a case report)

Musoni

Ezzouine

Ettouki

et al. 2021

Annals of Medicine &Amp; Surgery

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The COVID-19 pandemic and its impact on health systems had a significant effect on the management of inflammatory diseases in the long term and myopathies could be signs of COVID-19, making it difficult to diagnose the cause and effect relationship. An unvaccinated 62-year-old female patient followed for polymyositis was tested positive for COVID-19 on polymerase chain reaction (PCR) of nasopharyngeal swab revealed by dyspnea and rhinorrhea with fever and pulmonary involvement of 75%. She had an enlarged left ventricle with complete left branch block, inaugural diabetes mellitus with ketosis, kidney dysfunction, and inflammatory syndrome. Despite the early initiation of invasive ventilation in combination with the national protocol against covid-19, the patient died on day 4 of care. The best management should anticipate comorbidities and the evolutionary profile would guide the continuation of the treatment. Polymyositis like other rheumatic diseases was associated with a very high risk of developing a severe form of COVID-19. The combination of elder age and comorbidities led to a severe form of COVID-19 and therefore to a poor prognosis. The article aimed to show the severity of the association of covid-19 with polymyositis at the comorbid stage.

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Clinical features of patients with rheumatic diseases and COVID-19 infection in Sarawak, Malaysia

Cited by 8 publications

References 6 publications

Clinical outcomes of COVID-19 in patients with rheumatic diseases: A systematic review and meta-analysis of global data

Clinical outcomes of COVID-19 in patients with rheumatic diseases: A systematic review and meta-analysis of global data

Clinical Course of Idiopathic Inflammatory Myopathies in the COVID-19 Pandemic: A single-center Experience

Polymyositis and covid-19: A morbide association (a case report)

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