COVID-19 and Rheumatic Diseases: It Is Time to Better Understand This Association

Marques, Cláudia Diniz Lopes

doi:10.3899/jrheum.201541

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…Author details 1 Hospital das Clínicas -Universidade Federal de Pernambuco, Recife, Brazil. 2 Universidade Federal do Amazonas, Manaus, Brazil.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…The COVID-19 epidemic is undoubtedly one of the greatest challenges facing humanity in the modern era. In just over 1 year, hundreds of articles on the evolution of SARS-CoV-2 infection in patients with immune-mediated rheumatic diseases (IMRD) have been published, but still there are some uncertainties regarding risk factors for unfavorable outcomes and clinical management in different types of IMRD [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…COVID-19 outcomes in Axial Spondyloarthritis (axSpA) and Psoriatic Arthritis (PsA) patients p-descriptive level of the chi-square test, Fisher's exact test (a), Student's t (b) or Mann-Whitney test (c); SD: standard deviation1 Only for cases with contact2 Only for patients with laboratory confirmed diagnosis3 Only for patients with hospital care4 Only for patients with AxSpA and PsA; 1 patient among the two with enteropathic arthritis was hospitalized…”

mentioning

confidence: 99%

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COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data

Marques

Ribeiro²,

Albuquerque³

et al. 2022

Adv Rheumatol

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Objectives To evaluate the disease activity before and after COVID-19 and risk factors associated with outcomes, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV) and death in patients with spondylarthritis (SpA). Methods ReumaCoV Brazil is a multicenter prospective cohort of immune-mediated rheumatic diseases (IMRD) patients with COVID-19 (case group), compared to a control group of IMRD patients without COVID-19. SpA patients enrolled were grouped as axial SpA (axSpA), psoriatic arthritis (PsA) and enteropathic arthritis, according to usual classification criteria. Results 353 SpA patients were included, of whom 229 (64.9%) were axSpA, 118 (33.4%) PsA and 6 enteropathic arthritis (1.7%). No significant difference was observed in disease activity before the study inclusion comparing cases and controls, as well no worsening of disease activity after COVID-19. The risk factors associated with hospitalization were age over 60 years (OR = 3.71; 95% CI 1.62–8.47, p = 0.001); one or more comorbidities (OR = 2.28; 95% CI 1.02–5.08, p = 0.001) and leflunomide treatment (OR = 4.46; 95% CI 1.33–24.9, p = 0.008). Not having comorbidities (OR = 0.11; 95% CI 0.02–0.50, p = 0.001) played a protective role for hospitalization. In multivariate analysis, leflunomide treatment (OR = 8.69; CI = 95% 1.41–53.64; p = 0.023) was associated with hospitalization; teleconsultation (OR = 0.14; CI = 95% 0.03–0.71; p = 0.01) and no comorbidities (OR = 0.14; CI = 95% 0.02–0.76; p = 0.02) remained at final model as protective factor. Conclusions Our results showed no association between pre-COVID disease activity or that SARS-CoV-2 infection could trigger disease activity in patients with SpA. Teleconsultation and no comorbidities were associated with a lower hospitalization risk. Leflunomide remained significantly associated with higher risk of hospitalization after multiple adjustments.

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“…Author details 1 Hospital das Clínicas -Universidade Federal de Pernambuco, Recife, Brazil. 2 Universidade Federal do Amazonas, Manaus, Brazil.…”

Section: Supplementary Informationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data

Marques

Ribeiro²,

Albuquerque³

et al. 2022

Adv Rheumatol

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Summarizing Evidence of Associations of COVID‐19 With a Future Diagnosis of Inflammatory Rheumatic and Musculoskeletal Diseases: A Rapid Review

Mudge,

Honey,

Tachoukaft

et al. 2023

Arthritis Care & Research

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Musculoskeletal symptoms are commonly reported following acute coronavirus disease 2019 (COVID‐19). It is unclear whether those with musculoskeletal symptoms subsequently develop inflammatory rheumatic musculoskeletal disease (iRMD). This review seeks to identify evidence for an association between acute COVID‐19 and subsequent iRMD diagnosis. A rapid review of the literature using a systematic search of Medline, EMBASE and two COVID‐19 databases was undertaken until August 2022. Case studies, case series, cross‐sectional, case‐control, and cohort studies reporting patients with an incident iRMD following COVID‐19 were included. Title and abstract screening were conducted by one reviewer, and full text screening by two reviewers. Data extraction and quality appraisal were by one reviewer, with a second verifying. Study‐type specific critical appraisal tools were used. Results were narratively synthesised. 80 studies were included (69 case reports, 10 case series and 1 cross‐sectional study). Commonly reported iRMDs were ‘reactive arthropathies’ (studies=47), ‘inflammatory arthropathies unspecified’ (studies=18), rheumatoid arthritis (studies=12) and lupus erythematosus (studies=11). The cross‐sectional study reported 37% of those with COVID‐19 developed ‘post‐covid arthritis.’ Time from diagnosis of COVID‐19 to iRMD presentation ranged from 0‐120 days. Several mechanisms were proposed to explain the association between COVID‐19 and iRMD development: auto‐immune processes, aberrant inflammatory responses, colonisation of joint spaces, direct damage from the SARS‐CoV2 virus and genetic predisposition. The level of evidence of the studies included in this review was low, and the quality generally poor. Prospective observational studies are required to confirm associations and likely impact of post COVID‐19 iRMDs at a population level.

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COVID-19 and Rheumatic Diseases: It Is Time to Better Understand This Association

Cited by 2 publications

References 26 publications

COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data

COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data

Summarizing Evidence of Associations of COVID‐19 With a Future Diagnosis of Inflammatory Rheumatic and Musculoskeletal Diseases: A Rapid Review

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