Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases

Nuñez, Dalifer Dayanira Freites; León, Leticia; Mucientes, Arkaitz; Rodríguez‐Rodríguez, Luis; Font, J.; Madrid, Alfredo; Colomer, José Ignacio; Jover, Juan A.; Fernández‐Gutiérrez, Benjamín; Abásolo, Lydia

doi:10.1136/annrheumdis-2020-217984

Cited by 120 publications

(109 citation statements)

References 22 publications

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“…10,28 The same report indicated that 32% of social media users were female, whereas the published cohorts of patients with CRD reported a female prevalence of 72%. 10,30 Around 60% of our population were from 3 countries: Iraq, KSA, and Egypt. This high contribution reflects the large populations in these countries.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on patients with chronic rheumatic diseases: A study in 15 Arab countries

et al. 2020

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Aim: To evaluate the impact of the coronavirus disease 2019 pandemic (COVID-19) on the access to rheumatology care for patients with chronic rheumatic diseases (CRD) in the Arab countries. Method: A web-based cross-sectional survey was designed by the Arab Adult Arthritis Awareness group (AAAA) consisting of 16 rheumatologists representing countries from the Arab League of Associations for Rheumatology (ArLAR) and was validated by the ArLAR scientific committee. The survey was disseminated online through social media and patients' association channels between May 8 and May 22, 2020. The steering committee developed recommendations to improve the care of patients with CRD during the COVID-19 pandemic. Results: A total of 2163 patients were included in the analysis; 72% were female; mean age was 40 years (SD 11.9). The Levant, the Gulf, and North Africa contributed almost equally to the sample. The pandemic had a significant negative impact on rheumatology visits in 82% of cases, access to hydroxychloroquine (47%), and chronic medication persistency (28%). The negative impact on rheumatology visits was associated with female gender, country, medication non-persistency, isolation due to COVID-19, and impact on mental health. Sixty-one patients (2.8%) stated that they had COVID-19, 5% said that a close contact was infected, and 47% were in isolation because of COVID-19. Conclusion: The current study highlights the deleterious consequences of the COVID-19 pandemic on the continuity of rheumatology care. Therefore, an action plan, including establishing a telemedicine platform, securing drug availability, and promoting medication persistence through the appropriate communication channels, is strongly recommended.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on patients with chronic rheumatic diseases: A study in 15 Arab countries

et al. 2020

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“…This finding that indicates the increased need for rheumatologists during the COVID-19 pandemic may be attributable to two factors: (a) patients with a rheumatic disease and/or receiving immunosuppressive treatments wanted to consult rheumatologists on their disease/treatments [30]; (b) patients consult rheumatologists on properties of several anti-inflammatory and immunomodulatory drugs that are being used in the treatment of COVID-19 because rheumatologists are experts in the use of these drugs [1,7]. Rheumatic patients may be at a higher risk of receiving COVID infection with worse outcomes, as many of them tend to be susceptible from their underlying rheumatic disease or immunocompromised due to their treatment [9][10][11][12][13][14][15][16]. Thus, this pandemic has put great responsibility on the shoulders of the rheumatologists for caring for this vulnerable patient group.…”

Section: Discussionmentioning

confidence: 99%

“…Since rheumatologists have substantial knowledge in the benefits and adverse effects of these drugs as well, rheumatologists are playing a significant role in this pandemic. Besides fighting COVID-19, the rheumatologists also have an essential role in caring for their rheumatic patients who may express concerns about their potential increased risk of acquiring COVID-19 infection due to their underlying disease itself and any immunosuppressive treatments they may be on [9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Public interest in rheumatic diseases and rheumatologist in the United States during the COVID-19 pandemic: evidence from Google Trends

et al. 2020

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To evaluate the public interest in rheumatic diseases during the coronavirus disease 2019 (COVID-19) pandemic. Google Trends was queried to analyze search trends in the United States for numerous rheumatic diseases and also the interest in a rheumatologist. Three 8-week periods in 2020 ((March 15-May 9), (May 10-July 4), and (July 5-August 29)) were compared to similar periods of the prior 4 years (2016-2019). Compared to a similar time period between 2016 and 2019, a significant decrease was found in the relative search volume for more than half of the search terms during the initial March 15-May 9, 2020 period. However, this trend appeared to reverse during the July 5-August 29, 2020 period where the relative volume for nearly half of the search terms were not statistically significant compared to similar periods of the prior 4 years. In addition, this period showed a significant increase in relative volume for the terms: Axial spondyloarthritis, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, Sjögren's syndrome, antiphospholipid syndrome, scleroderma, Kawasaki disease, Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis, and rheumatologist. There was a significant decrease in relative search volume for many rheumatic diseases between March 15 and May 9, 2020 when compared to similar periods during the prior 4 years. However, the trends reversed after the initial period ended. There was an increase in relative search for the term "rheumatologist" between July and August 2020 suggesting the need for rheumatologists during the COVID-19 pandemic. Policymakers and healthcare providers should address the informational demands on rheumatic diseases and needs for rheumatologists by the general public during pandemics like COVID-19.

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“…Since excessive in ammatory response is known to be associated with severe COVID-19, it is of particular interest to nd out whether a speci c IRD diagnosis in uences COVID-19 outcome. Two studies with a relatively small number of patients found no association between IRD diagnoses and a worse outcome [11,12] and two other studies showed a higher risk for severe COVID-19 among patients with diagnoses other than in ammatory arthritis such as connective tissue diseases, vasculitis and sarcoidosis [13,14].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Among Patients With Inflammatory Rheumatic Diseases

Esatoğlu¹,

Taşçılar

Babaoğlu

et al. 2020

Preprint

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Background: There are few data on disease characteristics and outcome of coronavirus 2019 (COVID-19) among patients with inflammatory rheumatic diseases (IRDs). In this cohort study, we aimed to report the disease characteristics and variables associated with COVID-19 outcome among patients with IRDs.Methods: Between April and June, 2020, 167 adult IRD patients with COVID-19 were registered from 31 centers in 14 cities in Turkey. Disease outcome was classified in 4 categories; (i) outpatient management, (ii) hospitalization without oxygen requirement, (iii) hospitalization with oxygen requirement, and (iv) intensive care unit (ICU) admission or death. Multivariable ordinal logistic regression analysis was conducted to determine variables associated with a worse outcome.Results: 165 patients (mean age: 50 ± 15.6 years, 58.2% female) were included. Twenty-four patients (14.5%) recovered under outpatient management, 141 (85.5%) were hospitalized, 49 (30%) required inpatient oxygen support, 22 (13%) were treated in the ICU (17 received invasive mechanic ventilation) and 16 (10%) died. Glucocorticoid use (OR: 4.53, 95%CI 1.65-12.76), chronic kidney disease (OR: 12.8, 95%CI 2.25-103.5), pulmonary disease (OR: 2.66, 95%CI 1.08-6.61) and obesity (OR: 3.7, 95%CI 1.01-13.87) were associated with a worse outcome. Biologic disease-modifying antirheumatic drugs (DMARDs) do not seem to affect COVID-19 outcome while conventional synthetic DMARDs may have a protective effect (OR: 0.36, 95%CI 0.17-0.75). Estimates for the associations between IRD diagnoses and outcome were inconclusive.Conclusions: Among IRD patients with COVID-19, comorbidities and glucocorticoid use were associated with a worse outcome, while biologic DMARDs do not seem to be associated with a worse outcome.

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Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases

Cited by 120 publications

References 22 publications

Impact of the COVID‐19 pandemic on patients with chronic rheumatic diseases: A study in 15 Arab countries

Impact of the COVID‐19 pandemic on patients with chronic rheumatic diseases: A study in 15 Arab countries

Public interest in rheumatic diseases and rheumatologist in the United States during the COVID-19 pandemic: evidence from Google Trends

COVID-19 Among Patients With Inflammatory Rheumatic Diseases

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