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意大利东北部自身免疫性风湿病患者的 SARS-CoV-2 感染:对 916 例患者的横断面研究。

SARS-CoV-2 infection in patients with autoimmune rheumatic diseases in northeast Italy: A cross-sectional study on 916 patients.

机构信息

Division of Rheumatology, Department of Medicine DIMED, University of Padua, Italy.

Division of Rheumatology, Department of Medicine DIMED, University of Padua, Italy.

出版信息

J Autoimmun. 2020 Aug;112:102502. doi: 10.1016/j.jaut.2020.102502. Epub 2020 Jun 8.

Abstract

BACKGROUND

Whether patients with autoimmune rheumatic diseases (ARD) have a higher risk for SARS-CoV-2 infection (COVID-19) and how SARS-CoV-2 pandemic impacts on adherence to therapy has not been fully elucidated. We assessed the rate and clinical presentation of COVID-19, and adherence to therapy in a large cohort of patients with ARD followed-up in a tertiary University-Hospital in Northeast Italy.

METHODS

Between April 9th and April 25th 2020, after SARS-CoV-2 infection peak, a telephone survey investigating the impact of COVID-19 on patients with systemic lupus erythematosus (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA), ANCA-associated vasculitis (AAV), and idiopathic inflammatory myopathies (IIM) was administered. Demographics, disease activity status, therapy, occupational exposure, and adherence to social distancing advise were also collected.

RESULTS

916 patients (397 SLE, 182 AAV, 176 SSc, 111 RA, 50 IIM) completed the survey. 148 patients developed at least one symptom compatible with COVID-19 (cough 96, sore throat 64, fever 64, arthromyalgias 59, diarrhea 26, conjunctivitis 18, ageusia/hyposmia, 18). Among the 916 patients, 65 (7.1%) underwent SARS-CoV-2 nasopharyngeal swab (18 symptomatic and 47 asymptomatic), 2 (0.21%) tested positive, a proportion similar to that observed in the general population of the Veneto region. No deaths occurred. 31 patients (3.4%) withdrew ≥1 medication, mainly immunosuppressants or biologics. Adoption of social distancing was observed by 860 patients (93.9%), including 335 (36.6%) who adopted it before official lockdown.

CONCLUSIONS

COVID-19 incidence seems to be similar in our cohort compared to the general population. Adherence to therapy and to social distancing advise was high.

摘要

背景

自身免疫性风湿病(ARD)患者是否有更高的 SARS-CoV-2 感染风险(COVID-19),以及 SARS-CoV-2 大流行如何影响治疗依从性尚未完全阐明。我们评估了在意大利东北部一家三级大学医院接受治疗的大量 ARD 患者的 COVID-19 发生率和临床表现,以及治疗依从性。

方法

在 2020 年 4 月 9 日至 4 月 25 日 SARS-CoV-2 感染高峰后,对系统性红斑狼疮(SLE)、系统性硬皮病(SSc)、类风湿关节炎(RA)、抗中性粒细胞胞浆抗体相关性血管炎(AAV)和特发性炎性肌病(IIM)患者进行了一项电话调查,调查 COVID-19 对患者的影响。还收集了人口统计学、疾病活动状态、治疗、职业暴露和对社交距离建议的依从性。

结果

916 名患者(397 名 SLE、182 名 AAV、176 名 SSc、111 名 RA、50 名 IIM)完成了调查。148 名患者出现至少一种与 COVID-19 相符的症状(咳嗽 96 例、咽痛 64 例、发热 64 例、肌痛 59 例、腹泻 26 例、结膜炎 18 例、味觉丧失/嗅觉减退 18 例)。在 916 名患者中,有 65 名(7.1%)接受了 SARS-CoV-2 鼻咽拭子检测(18 例症状性和 47 例无症状性),2 名(0.21%)检测呈阳性,这一比例与威尼托地区的一般人群相似。没有死亡病例。31 名(3.4%)患者停止使用≥1 种药物,主要是免疫抑制剂或生物制剂。860 名患者(93.9%)采取了社会隔离措施,包括 335 名(36.6%)在官方封锁前就采取了这一措施。

结论

COVID-19 的发病率似乎与我们的队列与普通人群相似。治疗依从性和社会隔离建议的依从性很高。

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