评估抗 TNF-α 药物治疗的 COVID-19 患者的发病频率及临床病程的影响因素。
Evaluation of factors affecting the frequency and clinical course of COVID-19 in patients using anti-TNF-alpha agents.
机构信息
Umraniye Training and Research Hospital, Department of Pulmonology - Istanbul, Turkey.
Umraniye Training and Research Hospital, Department of Rheumatology - Istanbul, Turkey.
出版信息
Rev Assoc Med Bras (1992). 2021 Sep;67(9):1286-1292. doi: 10.1590/1806-9282.20210568.
OBJECTIVES
Patients being treated with anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents were reported to have better prognosis related to COVID-19. We evaluated the factors affecting the frequency, clinical course, and outcome of COVID-19 in patients treated with anti-TNF-alpha agents.
METHODS
Patients with rheumatoid diseases and chronic inflammatory bowel diseases treated with anti-TNF-alpha agents were evaluated retrospectively. The laboratory data in routine visits, frequency of COVID-19, pneumonia, hospitalization and/or intensive care unit (ICU) follow-up and, mortality were recorded. The factors related to COVID-19 frequency and clinical outcome were evaluated.
RESULTS
A total of 324 patients (177 males [54.6%] and 147 females [45.4%], mean age: 45.3±12.16 years) was included in the study. In all, 44 (13.6%) patients had COVID-19; of these, 11 (25%) developed pneumonia, 7 (15.9%) were hospitalized, and 1 (2.3%) was followed up in ICU. There was no mortality. The patients with COVID-19 pneumonia were older (mean age: 52±11 years versus 41±12 years, p=0.01), had hypertension and coronary artery disease more frequently (5 cases [55.6%] versus 4 cases [44.4], p=0.02 and 2 cases [100%] versus 0 cases [0%], p=0.014, respectively), and lower eosinophil % (1.35±1.79% versus 2.3±1.45%, p=0.016). The diabetes mellitus was more frequent (66.7 versus 33.3%, p=0.013), and mean eosinophil % was lower among inpatients compared with outpatients (1.29±2.22% versus 2.19±1.37%, p=0.02).
CONCLUSIONS
We concluded that the patients treated with anti-TNF-alpha agents having COVID-19 might have mild clinical course and better prognosis.
目的
有报道称，接受肿瘤坏死因子-α（anti-TNF-α）治疗的患者 COVID-19 预后较好。我们评估了影响接受 anti-TNF-α 治疗的患者 COVID-19 频率、临床病程和结局的因素。
方法
回顾性评估接受 anti-TNF-α 治疗的类风湿性疾病和慢性炎症性肠病患者。记录常规就诊时的实验室数据、COVID-19 频率、肺炎、住院和/或重症监护病房（ICU）随访以及死亡率。评估与 COVID-19 频率和临床结局相关的因素。
结果
共纳入 324 例患者（177 例男性[54.6%]和 147 例女性[45.4%]，平均年龄：45.3±12.16 岁）。共有 44 例（13.6%）患者患有 COVID-19；其中，11 例（25%）发生肺炎，7 例（15.9%）住院，1 例（2.3%）入住 ICU。无死亡病例。COVID-19 肺炎患者年龄更大（平均年龄：52±11 岁 vs 41±12 岁，p=0.01），更频繁地患有高血压和冠心病（5 例[55.6%] vs 4 例[44.4%]，p=0.02 和 2 例[100%] vs 0 例[0%]，p=0.014），且嗜酸性粒细胞%更低（1.35±1.79% vs 2.3±1.45%，p=0.016）。糖尿病更常见（66.7% vs 33.3%，p=0.013），住院患者的平均嗜酸性粒细胞%低于门诊患者（1.29±2.22% vs 2.19±1.37%，p=0.02）。
结论
我们的结论是，接受 anti-TNF-α 治疗的 COVID-19 患者可能具有较轻的临床病程和较好的预后。
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