Post-COVID-19 syndrome in patients with primary Sjögren's syndrome after acute SARS-CoV-2 infection

Abstract

Objective. To analyse the frequency and characteristics of post-COVID-19 syndrome in patients with primary Sjögren's syndrome (pSS) affected by acute SARS-CoV-2 infection. Methods. By the first week of April 2021, all centres included in the Big Data Sjögren Consortium were contacted asking for patients included in the Registry diagnosed with SARS-CoV-2 infection according to the ECDC guidelines. According to the NICE definitions, symptoms related to COVID-19 were classified as acute COVID-19 (signs and symptoms for up to 4 weeks), ongoing symptomatic COVID-19 (presence of signs and symptoms from 4 to 12 weeks) and post-COVID-19 syndrome (signs and symptoms that continue for >12 weeks not explained by an alternative diagnosis after a protocolised study). Results. We identified 132 patients who were followed a mean follow-up of 137.8 days (ranging from 5 days to 388 days) after being diagnosed with COVID-19. In the last visit, 75 (57%) patients remained symptomatic: 68 (52%) remained symptomatic for more than 4 weeks fulfilling the NICE definition for ongoing symptomatic post-COVID-19, and 38 (29%) remained symptomatic for more than 12 weeks fulfilling the definition of post-COV-ID-19 syndrome. More than 40% of pSS patients reported the persistence of four symptoms or more, including anxiety/ depression (59%), arthralgias (56%), sleep disorder (44%), fatigue (40%), anosmia (34%) and myalgias (32%). Age-sex adjusted multivariate analysis identified raised LDH levels (OR 10.36), raised CRP levels (OR 7.33), use of hydroxychloroquine (OR 3.51) and antiviral agents (OR 3.38), hospital admission (OR 8.29), mean length of hospital admission (OR 1.1) and requirement of supplemental oxygen (OR 6.94) as factors associated with a higher risk of developing post-COVID-19 syndrome. A sensitivity analysis including hospital admission in the adjusted model confirmed raised CRP levels (OR 8.6,) and use of hydroxychloroquine (OR 2.52, as the key independent factors associated with an enhanced risk of developing post-COVID-19 syndrome. Conclusion. This is the first study that analyses the frequency and characteristics of post-COVID-19 syndrome in patients affected by a systemic autoimmune disease. We found that 57% of patients with pSS affected by COVID-19 remain symptomatic after a mean follow-up of 5 months. The risk of developing post-COVID-19 syndrome in patients who required hospitalisation was 8-times higher than in non-hospitalised patients, with baseline raised CRP levels and the use of hydroxychloroquine being independent risk factors for post-COVID-19.

New onset and flare of rheumatic diseases following COVID-19 vaccination are mild and respond well to treatment: 9-month follow-up data from a single centre cohort

“…Likewise, anti-COVID-19 vaccines, although having so far proved an excellent tolerability and safety profile, boost the immune response via different biologic technologies and adjuvant combinations. Based on this, great interest is now arising from rheumatologists to define the impact of infection and SARS-CoV2 immunisation among rheumatic patients (3)(4)(5). Here, a descriptive analysis of a monocentric cohort evaluated at Padova University Hospital for a new onset/flare of RD after receiving any anti-COVID-19 vaccine is reported.…”

The role of virus infections in Sjögren’s syndrome

“…At present, no broader conclusions can be drawn about the risk of developing pSS after a SARS-CoV-2 infection, although it is known that xerostomia may also be a prodromal symptom of COVID-19. This clinical observation applies to patients with acute infection of a limited duration time ( 148 ). In the coming years, it will probably be possible to assess to what extent the SARS-CoV-2 virus may affect the development of pSS or cause symptoms similar to this autoimmune disease.…”

“…It was estimated that the risk of post-COVID-19 syndrome in hospitalized pSS patients is eight times higher than in non-hospitalized patients. The increased CRP levels and the use of hydroxychloroquine in the treatment of pSS were considered as risk factors for post-COVID-19 syndrome in this group ( 148 ).…”

What a Publication Tells You -- Benefits of Narrative Information Access in Digital Libraries

“…[...] More than 40% of pSS patients reported the persistence of four symptoms or more, including anxiety/depression (59%), arthralgias (56%), sleep disorder (44%), fatigue (40%), anosmia (34%) and myalgias (32%)." [3] Here the implicit context ensured that both statements must be matched against a single abstract. But the number of found results were decreased: Fatigue (15), Dyspnea (8), Cognitive Dysfunction (4) and Headache (3).…”