COVID-19 in Italian patients with rheumatic autoimmune systemic diseases

Ferri, Clodoveo; Giuggioli, Dilia; Raimondo, Vincenzo; Fallahi, Poupak; Antonelli, Alessandro; Spinella, Amelia; Brittelli, Raffaele; Aiello, Vincenzo; Caminiti, Rodolfo; L’Andolina, Massimo; Tavoni, Antonio; Bilia, Silvia; Giannini, Daiana; Mariano, Giuseppa Pagano; Cecchetti, Riccardo; Guiducci, Serena; Bellando-Randone, Silvia; Ursini, F.; Brusi, Veronica; Melicòni, Riccardo; Caminiti, Maurizio; Varcasia, Giuseppe; Ferrari, Tommaso Micelli; Gigliotti, Pietro; Pellegrini, Roberta; Olivo, Domenico; Colaci, Michele; Murdaca, Giuseppe

doi:10.1136/annrheumdis-2020-219113

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…Surveillance bias due to increased awareness and testing of our patients because of their rheumatic diseases and immunosuppression could have led to increased identification of COVID‐19 in our cohort. An Italian study indicated a similar increase in the prevalence of COVID‐19 in patients with systemic autoimmune diseases (9). Smoking may be a confounder and was not assessed in this study.…”

Section: Discussionmentioning

confidence: 82%

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Risk Factors for COVID‐19 and Rheumatic Disease Flare in a US Cohort of Latino Patients

Fike

Hartman

Redmond

et al. 2021

Arthritis & Rheumatology

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Objectives Latino patients are overrepresented among cases of coronavirus disease 2019 (COVID‐19) and are at an increased risk for severe disease. Prevalence of COVID‐19 in Latinos with rheumatic diseases are poorly reported. The purpose of this study was to characterize COVID‐19 clinical features and outcomes in Latino patients with rheumatic diseases. Methods This is a retrospective study of Latino patients with rheumatic diseases from an existing observational cohort in the Washington, DC area. Patients seen between April 1 to October 15, 2020 were analyzed in this study. We reviewed demographics, body mass index (BMI), comorbidities, and immunomodulatory therapies. An exploratory Classification and Regression Tree (CART) analysis along with logistic regression (LR) analyses were performed to identify risk factors for COVID‐19 and rheumatic disease flare. Results Out of 178 patients, 32 (18%) were identified with COVID‐19 and the incidence rate of infection was found to be three‐fold higher than the general Latino population. No patients required ICU level care. CART analysis and multivariable LR analysis identified BMI>30.35 as a risk factor for COVID‐19 [ P =0.004, OR=3.37, 95%CI (1.5‐7.7)]. COVID‐19 positivity was a risk factor for rheumatic disease flare [ P =0.02, OR=4.57, 95%CI (1.2‐17.4)]. Conclusion Latino patients with rheumatic diseases had a higher rate of COVID‐19 compared with the general Latino population. Obesity was identified as a risk factor for COVID‐19 and COVID‐19 itself was found to be a risk factor for rheumatic disease flare. Latino patients with risk factors should be followed closely, especially post‐COVID‐19 in anticipation of disease flare.

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Section: Discussionmentioning

confidence: 82%

“…Initial reports (8) revealed no unique or outstanding risk factors, apart from what has already been noted in the general population. An Italian study indicated a possible increased incidence of COVID‐19 in patients with rheumatic diseases (9).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for COVID‐19 and Rheumatic Disease Flare in a US Cohort of Latino Patients

Fike

Hartman

Redmond

et al. 2021

Arthritis & Rheumatology

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“…They both showed an incidence of 2.5%, although in patients affected by systemic lupus erythematosus and large-vessel vasculitis, respectively [ 9 , 10 ]. It has been hypothesized by others that patients suffering from connective tissue diseases could run a higher risk of COVID-19 than those with inflammatory arthritis [ 11 ]. Thus, considering the demographic data of the different cohorts, the relevant element seems to be the belonging geographical area of the patients.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and systemic sclerosis: analysis of lifestyle changes during the SARS-CoV-2 pandemic in an Italian single-center cohort

et al. 2020

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The outbreak of SARS-CoV-2 has changed the habits and lives of people worldwide. Patients affected by systemic sclerosis (SSc) experienced constant fear because of their immunocompromised status. The aim of this study was to investigate the prevalence of SARS-CoV-2 infection and to analyze the lifestyle changes in a single-center cohort of SSc patients and if these changes were more severe than in the general population. During the Italian lockdown, we supplied two surveys to our 184 SSc patients. In the first one, filled by 110 patients, we asked if SARS-CoV-2 had infected them or if they experienced signs and symptoms consistent with COVID-19. The second survey, performed by 79 SSc patients and 63 healthy subjects, included questions about the lifestyle adopted during this specific period. Among our patients, COVID-19 was diagnosed only in one case, while three other subjects reported signs and symptoms suggestive for the disease. Regarding the second survey, our patients greatly changed their lifestyle during the pandemic, adopting more restrictive isolation measures, because of their awareness of frailty. To date, we do not dispose of enough data to speculate about the risk of COVID-19 among immunocompromised patients, although in our SSc patients their frailty seems to have been their shelter. Pending more accurate epidemiological studies, it is essential to share as much data as possible to better understand the impact of COVID-19 on SSc patients’ health. Key points • The lifestyle adopted by SSc patients during the first months of COVID-19 pandemic was characterized by more stringent isolation rules than general population. • The prudential behavior of patients with SSc during Italian lockdown should be considered as a possible bias when analyzing the risk of SARS-CoV-2 disease in these subjects, as well as a protective factor against infection.

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“…Akiyama et al also evaluated the results from six case-control studies that demonstrated that the risk of COVID-19 in patients with RA was significantly higher than in the control groups (OR: 1.6; 95% CI: 1.1-2.3; p = 0.008) [104]. When interpreting results, it is important to consider that observational data may underestimate infection risk, as patients will often be aware of the risks inherent to their disease and may have adapted their lifestyle to reduce the probability of contracting COVID-19 [105].…”

Section: Infections Inmentioning

confidence: 99%

The Key Comorbidities in Patients with Rheumatoid Arthritis: A Narrative Review

Taylor

Atzeni

Balsa

et al. 2021

JCM

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Comorbidities in patients with rheumatoid arthritis (RA) are often associated with poor health outcomes and increased mortality. Treatment decisions should take into account these comorbidities due to known or suspected associations with certain drug classes. In clinical practice, it is critical to balance potential treatment benefit against the possible risks for comorbidities as well as the articular manifestations of RA. This review summarises the current literature relating to prevalence and risk factors for the important comorbidities of cardiovascular disease, infections, lymphomas and nonmelanoma skin cancers in patients with RA. The impact on patient outcomes and the interplay between these comorbidities and the therapeutic options currently available, including tumour necrosis factor inhibitors and newer biological therapies, are also explored. As newer RA therapies are developed, and patients gain wider and earlier access to advanced therapies, in part due to the emergence of biosimilars, it is important to consider the prevention or treatment of comorbidities as part of the overall management of RA.

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COVID-19 in Italian patients with rheumatic autoimmune systemic diseases

Cited by 8 publications

References 18 publications

Risk Factors for COVID‐19 and Rheumatic Disease Flare in a US Cohort of Latino Patients

Risk Factors for COVID‐19 and Rheumatic Disease Flare in a US Cohort of Latino Patients

COVID-19 and systemic sclerosis: analysis of lifestyle changes during the SARS-CoV-2 pandemic in an Italian single-center cohort

The Key Comorbidities in Patients with Rheumatoid Arthritis: A Narrative Review

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