COVID-19: What Do Rheumatologists Need to Know?

Fitzgerald, Gillian; Maguire, Sinead; Haroon, Nigil

doi:10.1007/s11926-020-00971-y

Cited by 9 publications

(6 citation statements)

References 80 publications

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“…Collagen disease and moderate to severe renal dysfunction/dialysis were major risks for severe disease in older patients. Former robust data of clinical outcomes in COVID-19 patients with collagen diseases are insufficient [ 31 ]. Some reports suggested that rheumatic diseases did not change the mortality in COVID-19 but tended to increase the risk of respiratory failure [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Comorbidities as Risk Factors for Severe Disease in Hospitalized Elderly COVID-19 Patients by Different Age-Groups in Japan

et al. 2022

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Introduction: Old age is an independent risk factor (RF) for severe COVID-19; evidence for clinico-epidemiological characteristics among elderly COVID-19 patients is scarce. We aimed to analyze clinical and epidemiological characteristics and comorbidities associated with COVID-19 inpatients in age-stratified populations of an elderly COVID-19 cohort. Methods: We conducted a retrospective cohort study, using nationwide registry data of COVID-19 patients hospitalized before October 31, 2020 (major information entered in the registry as of December 28, 2020). Participants were divided by age according to the Japan Geriatrics Society and the Japan Gerontological Society: pre-old (65–74 years), old (75–89 years), and super-old (≥90 years). Multivariable logistic regression (MLR) analyses were conducted to identify stratified risk and relationships with comorbidities associated with worse outcomes in different age-groups of elderly patients. Demographics and supportive care were evaluated by category. Results: Data of 4,701 patients from 444 hospitals were included. Most patients (79.3%) had at least one comorbidity; the proportion of patients with hypertension was high in all categories. The proportion of patients with dementia, cardiovascular disease, and cerebrovascular disease increased with age. The percentage of patients who underwent invasive mechanical ventilation/extracorporeal membrane oxygenation was lower in the super-old group. In total, 11.5% of patients died (5.3%, pre-old; 15.2%, old; and 22.4%, super-old). MLR showed that the risk of critical illness differed among age-groups. Male sex was a significant RF in all ages. Collagen disease, moderate to severe renal disorder, and dialysis were significant RFs in older patients, while hematological malignancies and metastatic tumors were more important RFs for severe disease in relatively younger patients. Most of the RFs for critical illnesses were associated with death. Conclusion: Differences in the epidemiological and clinical characteristics among the different age-groups were found.

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Section: Discussionmentioning

confidence: 99%

Comorbidities as Risk Factors for Severe Disease in Hospitalized Elderly COVID-19 Patients by Different Age-Groups in Japan

et al. 2022

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“…As far as rheumatology scientific societies are concerned, current European League Against Rheumatism recommendations suggest not stopping previous treatment with synthetic DMARDs or biologic DMARDs[ 19 ]. There is no evidence that these therapies could increase the risk of infection or adverse outcomes in COVID-19[ 20 ]. Nevertheless, in individuals with current or suspected COVID-19, the American College of Radiology recommends stopping immunosuppressants and biologics, except non-IL-6 inhibitors and Janus kinase inhibitors[ 21 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19: Considerations about immune suppression and biologicals at the time of SARS-CoV-2 pandemic

Costanzo¹,

Cordeddu²,

Chessa³

et al. 2021

WJCC

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The extent of the profound immunological and nonimmunological responses linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is currently being investigated worldwide due to the large burden associated with death due to SARS-CoV-2 and the short-term consequences of coronavirus disease 2019 (COVID-19). It has been hypothesized that patients on immunosuppressive treatments, including biologics, may have an augmented risk of being infected by SARS-CoV-2; however, there are currently no definitive data about biological drugs and COVID-19 in immune-mediated inflammatory diseases. Current epidemiological models developed to understand how long the COVID-19 epidemic may last are not conclusive and range from sustained epidemics to complete elimination. Nevertheless, even in the best-case scenario of apparent elimination, there is concordance about a possible contagion resurgence as late as 2024. Therefore, knowledge of the impact of SARS-CoV-2 on immune-mediated diseases and among patients treated with biologicals, together with the results of novel and promising COVID-19 treatment strategies targeting the virus and the host immune response (or both), will help us to best manage our patients during this pandemic over the next few years.

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“…Despite the numerous variations between SARS-CoV-2 infection and RA in terms of origin, epidemiology, clinical characteristics, organ involvement and prognosis, the pathophysiology and risk factors linked with these diseases appear to be somewhat comparable [60].…”

Section: Rheumatoid Arthritis and Sars-cov-2mentioning

confidence: 99%

COVID-19—A Trigger Factor for Severe Immune-Mediated Thrombocytopenia in Active Rheumatoid Arthritis

Bobircă

Ancuta

et al. 2022

Life

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Thrombocytopenia is defined as a platelet count below 150,000/mm3 for adults. There is still controversy about whether individuals with platelet counts of 100,000/mm3 to 150,000/mm3 should be classified as having genuine thrombocytopenia or borderline thrombocytopenia. Thrombocytopenia is considered mild when the platelet count is between 70,000 and 150,000/mm3 and severe if the count is less than 20,000/mm3. Thrombocytopenia in rheumatoid arthritis is a rare complication, with an incidence estimated between 3 and 10%. The main etiological aspects include drug-induced thrombocytopenia and immune thrombocytopenic purpura. The most common hematological abnormalities in SARS-CoV-2 infection are lymphopenia and thrombocytopenia. It has been observed that the severity of thrombocytopenia correlates with the severity of the infection, being a poor prognosis indicator and a risk factor for mortality. COVID-19 can stimulate the immune system to destroy platelets by increasing the production of autoantibodies and immune complexes. Autoimmunity induced by viral infections can be related to molecular mimicry, cryptic antigen expression and also spreading of the epitope. During the COVID-19 pandemic, it is of great importance to include the SARS-CoV-2 infection in differential diagnoses, due to the increased variability in forms of presentation of this pathology. In this review, our aim is to present one of the most recently discovered causes of thrombocytopenia, which is the SARS-CoV-2 infection and the therapeutic challenges it poses in association with an autoimmune disease such as rheumatoid arthritis.

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COVID-19: What Do Rheumatologists Need to Know?

Cited by 9 publications

References 80 publications

Comorbidities as Risk Factors for Severe Disease in Hospitalized Elderly COVID-19 Patients by Different Age-Groups in Japan

Comorbidities as Risk Factors for Severe Disease in Hospitalized Elderly COVID-19 Patients by Different Age-Groups in Japan

COVID-19: Considerations about immune suppression and biologicals at the time of SARS-CoV-2 pandemic

COVID-19—A Trigger Factor for Severe Immune-Mediated Thrombocytopenia in Active Rheumatoid Arthritis

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