Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.
Ann Rheum Dis. 2020 Sep;79(9):1163-1169. doi: 10.1136/annrheumdis-2020-217425. Epub 2020 Jun 16.
Increasing data about COVID-19 have been acquired from the general population. We aim to further evaluate the clinical characteristics of COVID-19 in patients with systemic autoimmune diseases (AIDs).
We included all confirmed inpatients with COVID-19 and systemic AIDs in Wuhan Tongji Hospital from 29 January to 8 March 2020. We retrospectively collected and analysed information on epidemiology of 1255 inpatients and additional clinical characteristics of patients with systemic AIDs. Outcomes were followed up until 16 April 2020.
Of the 1255 patients with COVID-19, the median age was 64.0 years and 53.1% were male. More than half (63.0%) had chronic comorbidities. The proportions of elderly, male and patients with comorbidities were significantly higher in intensive care unit (ICU) than in the general ward (p<0.001). 17 (0.61%) patients with systemic AIDs were further screened and analysed from 2804 inpatients. The median age was 64.0 years and 82.4% were female. All patients were living in Wuhan and two family clusters were found. 1 (5.9%) patient was admitted to ICU and one died. 10 (62.5%) of 16 patients changed or stopped their anti-AIDs treatments during hospitalisation, and 5 of them felt that the disease had worsened after the quarantine.
Older males with chronic comorbidities are more vulnerable to severe COVID-19. The lower proportion of COVID-19 in patients with systemic AIDs needs more high-quality human clinical trials and in-depth mechanism researches. Of note, the withdrawal of anti-AIDs treatments during hospitalisation can lead to flares of diseases.
从普通人群中获取了越来越多关于 COVID-19 的数据。我们旨在进一步评估患有系统性自身免疫性疾病（AIDs）的 COVID-19 患者的临床特征。
我们纳入了 2020 年 1 月 29 日至 3 月 8 日期间武汉同济医院所有确诊的 COVID-19 和系统性 AIDs 住院患者。我们回顾性收集并分析了 1255 例住院患者的流行病学信息以及系统性 AIDs 患者的其他临床特征。研究结果随访至 2020 年 4 月 16 日。
在 1255 例 COVID-19 患者中，中位年龄为 64.0 岁，53.1%为男性。超过一半（63.0%）有慢性合并症。与普通病房相比，重症监护病房（ICU）中老年人、男性和合并症患者的比例明显更高（p<0.001）。从 2804 例住院患者中进一步筛选并分析了 17（0.61%）例系统性 AIDs 患者。中位年龄为 64.0 岁，82.4%为女性。所有患者均居住在武汉，发现了 2 个家庭聚集病例。1（5.9%）例患者入住 ICU，1 例死亡。16 例患者中有 10（62.5%）例在住院期间改变或停止了抗 AIDs 治疗，其中 5 例患者在隔离后感到病情恶化。
患有慢性合并症的老年男性更容易患严重 COVID-19。系统性 AIDs 患者 COVID-19 的比例较低，需要更多高质量的人类临床试验和深入的机制研究。值得注意的是，住院期间停止抗 AIDs 治疗可能导致疾病发作。
