St. James's Hospital and Trinity College, Dublin, Ireland.
Yale University, New Haven, Connecticut.
Arthritis Rheumatol. 2022 May;74(5):766-775. doi: 10.1002/art.42030. Epub 2022 Mar 28.
The relative risk of SARS-CoV-2 infection and COVID-19 disease severity among people with rheumatic and musculoskeletal diseases (RMDs) compared to those without RMDs is unclear. This study was undertaken to quantify the risk of SARS-CoV-2 infection in those with RMDs and describe clinical outcomes of COVID-19 in these patients.
We conducted a systematic literature review using 14 databases from January 1, 2019 to February 13, 2021. We included observational studies and experimental trials in RMD patients that described comparative rates of SARS-CoV-2 infection, hospitalization, oxygen supplementation/intensive care unit (ICU) admission/mechanical ventilation, or death attributed to COVID-19. Methodologic quality was evaluated using the Joanna Briggs Institute critical appraisal tools or the Newcastle-Ottawa scale. Risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated, as applicable for each outcome, using the Mantel-Haenszel formula with random effects models.
Of the 5,799 abstracts screened, 100 studies met the criteria for inclusion in the systematic review, and 54 of 100 had a low risk of bias. Among the studies included in the meta-analyses, we identified an increased prevalence of SARS-CoV-2 infection in patients with an RMD (RR 1.53 [95% CI 1.16-2.01]) compared to the general population. The odds of hospitalization, ICU admission, and mechanical ventilation were similar in patients with and those without an RMD, whereas the mortality rate was increased in patients with RMDs (OR 1.74 [95% CI 1.08-2.80]). In a smaller number of studies, the adjusted risk of outcomes related to COVID-19 was assessed, and the results varied; some studies demonstrated an increased risk while other studies showed no difference in risk in patients with an RMD compared to those without an RMD.
Patients with RMDs have higher rates of SARS-CoV-2 infection and an increased mortality rate.
与无风湿性和肌肉骨骼疾病（RMD）的人相比，患有 RMD 的人感染 SARS-CoV-2 的相对风险以及 COVID-19 疾病严重程度尚不清楚。本研究旨在量化 RMD 患者感染 SARS-CoV-2 的风险，并描述这些患者 COVID-19 的临床结局。
我们使用 14 个数据库从 2019 年 1 月 1 日至 2021 年 2 月 13 日进行了系统文献综述。我们纳入了描述 RMD 患者 SARS-CoV-2 感染、住院、氧疗/重症监护病房（ICU）入院/机械通气或 COVID-19 相关死亡的比较率的观察性研究和实验性试验。使用 Joanna Briggs 研究所的批判性评估工具或纽卡斯尔-渥太华量表评估方法学质量。对于每个结局，使用 Mantel-Haenszel 公式和随机效应模型计算风险比（RR）和比值比（OR）及 95%置信区间（95%CI）。
在筛选出的 5799 篇摘要中，有 100 项研究符合系统综述的纳入标准，其中有 54 项研究的偏倚风险较低。在纳入的荟萃分析研究中，我们发现 RMD 患者 SARS-CoV-2 感染的患病率高于普通人群（RR 1.53 [95%CI 1.16-2.01]）。患有 RMD 和无 RMD 的患者住院、ICU 入院和机械通气的几率相似，而 RMD 患者的死亡率增加（OR 1.74 [95%CI 1.08-2.80]）。在少数研究中，评估了与 COVID-19 相关结局的调整风险，结果有所不同；一些研究表明风险增加，而其他研究则表明 RMD 患者与无 RMD 患者的风险无差异。
患有 RMD 的患者 SARS-CoV-2 感染率较高，死亡率增加。
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