The Course of COVID-19 in Patients with Systemic Autoimmune Rheumatic Diseases

Abstract

Patients with systemic autoimmune rheumatic disease (SARD) have increased susceptibility to viral infections, including SARS-CoV-2. The aim of this study was to analyse the SARD patient population with COVID-19 (coronavirus disease 2019) in terms of baseline characteristics, severity, course and outcomes of the disease compared with the non-SARD group, and to identify factors associated with prognosis, including remdesivir therapy efficacy. Retrospective study comprised 8220 COVID-19 cases from the SARSTer database, including 185 with SARD. Length of hospitalisation, duration of oxygen therapy, mortality and the need for HFNO (high-flow nasal oxygen) and/or NIV (noninvasive ventilation) were significantly higher in the SARD versus non-SARD group. There was no difference in clinical features on admission to hospital. Patients with SARD were older and more likely to have cardiovascular, pulmonary and chronic kidney diseases. Age, the presence of cardiovascular disease, more severe conditions on admission and higher inflammatory marker values were found to be risk factors for death in the SARD group. In patients with SARD treated with remdesivir, there was a trend towards improved mortality but without statistical significance. Length of hospitalisation, 28-day mortality and the need for HFNO and/or NIV were higher in the SARD group. These patients often had other chronic diseases and were older.

Disparities in COVID-19 mortality amongst the immunosuppressed: A systematic review and meta-analysis for enhanced disease surveillance

“…99 unique studies 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , ...…”

COVID‐19 Hospitalization Outcomes Among Patients With Autoimmune Rheumatic Diseases in the United States

“…Several studies have challenged the idea that the presence of ARDs does not impact COVID‐19‐related inpatient outcomes. For instance, a national database analysis conducted in 30 Polish centers by Rorat et al found that patients with ARDs hospitalized with COVID‐19 had longer LOS and higher mortality rates compared with patients without ARDs ( 11 ). Supporting these results, a multicenter study carried out in Oman by Al‐Adhoubi et al also found increased mortality in COVID‐19 hospitalizations among those with ARDs ( 13 ).…”

“…Despite these plausible mechanisms for more severe disease presentation and the noted increases in incidence and hospitalization, the impact of ARD presence on inpatient outcomes in those with COVID‐19 is still debated. Some studies have shown ARDs to have no significant impact on inpatient COVID‐19 outcomes ( 5 , 6 , 7 , 8 , 9 ), whereas others have shown significant increases in many clinical factors, including mortality and rates of mechanical ventilation ( 10 , 11 , 12 , 13 , 14 ). To address this important clinical question, we conducted a retrospective cohort study to evaluate outcomes in individuals with ARDs hospitalized with COVID‐19 in 2020 using the largest national inpatient database in the United States.…”

The outcome of COVID‐19 in patients with autoimmune rheumatic diseases: Comparable to the general population or worse?

“…In the Global Rheumatology Alliance Physician Reported Registry, Strangfeld et al 4 showed that COVID‐19‐related mortality was associated with rheumatic disease‐specific factors such as moderate‐high disease activity and specific drugs such as sulfasalazine and rituximab, along with known risk factors (male gender, older age, classical comorbidities). Rorat et al 15 have recently compared the COVID‐19 disease course between 185 patients with AIRDs and 8035 patients without AIRDs. The disease course was more severe in AIRD patients.…”