ASST Gaetano Pini-CTO Institute, Milan, Italy.
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Arthritis Rheumatol. 2020 Oct;72(10):1600-1606. doi: 10.1002/art.41388. Epub 2020 Sep 6.
To describe the incidence and severity of coronavirus disease 2019 (COVID-19) in patients with rheumatic diseases treated with targeted synthetic or biologic disease-modifying antirheumatic drugs (DMARDs) compared with that in the general population living in the same Italian region.
Patients followed up at 2 rheumatology referral centers in Lombardy from February 25, 2020 to April 10, 2020 were invited to participate in a survey designed to identify patients who had confirmed COVID-19, close contact with others with confirmed COVID-19, or symptoms of the infection, and to detect changes in work, behavior, and disease management made in an attempt to prevent infection. The incidence of COVID-19 in the Lombardy population was obtained from the National Institute of Statistics. COVID-19 cases were confirmed by nasopharyngeal swab.
The survey was given to 955 patients (531 patients with rheumatoid arthritis, 203 patients with psoriatic arthritis, 181 patients with spondyloarthritis, and 40 patients with connective tissue diseases, vasculitides, or autoinflammatory diseases). These patients had a mean age of 53.7 years, and 67.4% were women. The rate of response to the survey was 98.05%, and the incidence of confirmed COVID-19 cases was consistent with that in the general population (0.62% versus 0.66%; P = 0.92). None of the patients had severe complications or required intensive care treatment, and all of the patients who tested positive for COVID-19 temporarily discontinued ongoing targeted synthetic drug or biologic DMARD therapy. Almost all patients took precautions to prevent the COVID-19 infection (90.6%), and almost all continued treatment with targeted synthetic drugs or biologic DMARDs (93.2%). Disease activity remained stable in 89.5% of patients.
Our results reflected the attitude of patients with rheumatic diseases regarding the prevention of the infection while maintaining their long-term treatment regimens. The incidence and severity of COVID-19 in patients treated with targeted synthetic drugs or biologic DMARDs was not significantly different from that in the general population in the same region.
描述与居住在同一意大利地区的普通人群相比，接受靶向合成或生物疾病修正抗风湿药物（DMARDs）治疗的风湿性疾病患者中 COVID-19 的发生率和严重程度。
2020 年 2 月 25 日至 4 月 10 日，邀请在伦巴第 2 家风湿病转诊中心接受随访的患者参加一项调查，旨在识别出已确诊 COVID-19 的患者、与其他已确诊 COVID-19 的患者有密切接触的患者、出现感染症状的患者，并发现为预防感染而做出的工作、行为和疾病管理的变化。从国家统计局获得伦巴第地区的 COVID-19 发病率。通过鼻咽拭子确认 COVID-19 病例。
该调查共向 955 名患者（531 名类风湿关节炎患者、203 名银屑病关节炎患者、181 名强直性脊柱炎患者和 40 名结缔组织疾病、血管炎或自身炎症性疾病患者）发放问卷。这些患者的平均年龄为 53.7 岁，67.4%为女性。对调查的回复率为 98.05%，确诊 COVID-19 病例的发生率与普通人群一致（0.62%对 0.66%；P=0.92）。没有患者出现严重并发症或需要重症监护治疗，所有 COVID-19 检测呈阳性的患者均暂时停止正在进行的靶向合成药物或生物 DMARD 治疗。几乎所有患者都采取了预防 COVID-19 感染的措施（90.6%），几乎所有患者都继续接受靶向合成药物或生物 DMARD 治疗（93.2%）。89.5%的患者疾病活动保持稳定。
我们的结果反映了风湿性疾病患者在保持长期治疗方案的同时，对预防感染的态度。接受靶向合成药物或生物 DMARD 治疗的患者 COVID-19 的发生率和严重程度与同一地区的普通人群无显著差异。
