Incidence and course of COVID-19 hospitalizations among patients with familial Mediterranean fever

Abstract

Objectives To evaluate the incidence of hospitalization for COVID-19 in patients with familial Mediterranean fever (FMF), as compared with the general population, and to compare the disease course between FMF inpatients, and age, sex, ethnicity, and comorbidity-matched non-FMF COVID-19 inpatients. Methods We used electronic medical records (EMR) to obtain data about the total number of the insured population and the number of FMF patients in the two largest health management organizations (HMOs) in Jerusalem, Clalit and Meuhedet. The total number of COVID-19 inpatients at the Hadassah Medical Center, including those with FMF, for the period between the 1 February 2020, and the 10 March 2021 was retrieved from the EMR of Hadassah. COVID-19 course was compared between the FMF inpatient group and age, sex, ethnicity, and comorbidity-matched non-FMF COVID-19 inpatients. Each FMF inpatient was matched with 2 non-FMF controls. Results We found no statistically significant difference in the odds of hospitalization for COVID-19 between FMF patients and the non-FMF population (0.46% vs 0.41%; p= 0.73). Furthermore, we found similar disease severity and therapeutic approach in FMF COVID-19 inpatients and matched non-FMF COVID-19 inpatients. Conclusions Neither FMF, nor baseline colchicine therapy appear to affect the incidence of hospitalization for COVID-19 or the disease course, in terms of severity and therapeutic approach.

Immune dysfunction in COVID-19 and judicious use of antirheumatic drugs for the treatment of hyperinflammation

“…Metaanalyzes of observational and RCTs showed an advantage of colchicine use; however, subgroup analysis with randomized controlled trials showed no statistically significant difference in the mortality (OR: 0.80, 95%CI, 0.44-1.46) [101]. Moreover, colchicine neither prevented COVID-19-related hospital admissions nor disease course among rheumatic patients who were receiving it for their underlying diseases [102,103]. Colchicine has potential toxicities, particularly in those with kidney and liver impairment and elders, myelosuppression, elevation in transaminases, and myopathy, which are commonly observed during the course of COVID-19 [97,104].…”

Conventional and novel therapeutic options in children with familial Mediterranean fever: A rare autoinflammatory disease

“…In addition, both colchicine and IL‐1 inhibitors treatments have recently been proposed for off‐label use in COVID‐19 patients 134,135 . However, another study did not observe any significant difference in the severity and outcome of COVID‐19 between FMF and non‐FMF patients 136 …”

“…134,135 However, another study did not observe any significant difference in the severity and outcome of COVID-19 between FMF and non-FMF patients. 136 Finally, it is important to emphasize that evidence to precisely guide the treatment in children with FMF is still limited and large multicentre clinical trials are definitely needed to improve the therapeutic management of paediatric FMF.…”

Immunologic Dysregulation and Hypercoagulability as a Pathophysiologic Background in COVID-19 Infection and the Immunomodulating Role of Colchicine

“…Finally, a small ( n = 36) retrospective case-control study from Jerusalem revealed that neither FMF history nor colchicine administration at baseline affected COVID-19-related length of hospitalization, mortality, oxygen support needs and mechanical ventilation [ 79 ].…”