Evolution of COVID-19 in patients with autoimmune rheumatic diseases

Abstract

The characteristics of COVID-19 patients with autoimmune rheumatic diseases (AIRD) have rarely been reported. Patients with AIRD have suppressed immune defense function, which may increase their susceptibility to COVID-19. However, the immunosuppressive agents AIRD patients routinely used may be beneficial for protecting the cytokine storm caused by SARS-CoV-2. In this retrospective study, we included all confirmed cases in Huoshenshan Hospital from February 4 to April 9. Data were extracted from electronic medical records and were analyzed for clinical and laboratory features using SPSS (version 25.0). Of 3059 patients, 21 had the comorbidities with systematic lupus erythematosus (SLE) and/or rheumatoid arthritis (RA), including 5 with SLE, 15 with RA, and 1 with Rhupus. The proportion was 57.1% for severe cases, 61.9% for

Pathogenic implications, incidence, and outcomes of COVID-19 in autoimmune inflammatory joint diseases and autoinflammatory disorders

“…Conversely, TNFi appeared to have a protective role being associated with a reduction of the development of a more severe COVID-19 [64]. Finally, other small case series were available furtherly confirming these findings, as described in Table 1 [65,66].…”

Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network

“…Several studies that have focused on the COVID-19 outcomes in patients with RMD have shown mixed results. While some studies have shown no difference in outcomes of COVID-19 among those with RMDs as compared to the general population [ [5] , [6] , [7] ], a few others have shown contradicting results [ 8 , 9 ]. The reasons for such diverse results may be numerous, ranging from the geographical location, the genetic make-up of the study population, prevalence of comorbidities, immunosuppressive agent usage, and, most importantly, the heterogeneity between different RMDs.…”

Epidemiology and Clinical Management of Rheumatic Autoimmune Diseases in the COVID-19 Pandemic: A Review

“…Tan C et al found that the significant increase of C-reactive protein (CRP) may be a potential early predictor for the severity of COVID-19, for CRP changes precede the imaging findings ( 65 ). And cohort studies reported a significant correlation between poor prognosis and elevated serum ferritin, IL-6 and procalcitonin ( 15 , 66 , 67 ). In their meta-analysis, Hariyanto et al ( 68 ) summarized the predictive roles of increased procalcitonin (≥0.065 ng/ml), CRP (≥33.55 mg/L), D-dimer (≥0.635 μg/L), LDH (≥263.5 U/L) and decreased albumin (≤38.85 g/L) in the clinical prognosis of COVID-19 ( 68 ).…”

“…However, studies have also shown that the diagnostic rate of SARS-CoV-2 in RADs patients does not necessarily increase, at least, they are less likely to develop into severe cases (13,14). By analyzing the 2-month electronic medical records of Huoshenshan Hospital in Wuhan, China, a study showed the admission rate of ICU, hospital stays and mortality of COVID-19 in RADs patients were similar to the non-RADs patients (15), and these points have been supported by other cohort studies (16)(17)(18). It has even been reported that the prevalence of COVID-19 in RADs patients is lower than that of randomly selected non-RADs patients (19), which is based on the explanation that RADs patients are more consciously following the rules of epidemic prevention and control.…”

“…Male and female patients behave differently in COVID-19 outbreak. The majority of RADs patients infected with COVID-19 were female (4,5,15,18,20,22,23,25,(28)(29)(30)(31)(32), generally exceeding 60%, with an average of 70.86% (Figure 2). The overall mortality during COVID-19 development was higher in female RADs patients (11), which is different from the situation in non-RAD population that male accounts for a greater proportion.…”