Gracia Borja Del Carmelo, Sáez Luis, Pallarés Lucio, Velilla Jose, Marín Adela, Martinez-Lostao Luis, Simeón Carmen Pilar, Fanlo Patricia
Sytemic Autoimmune Diseases Unit, Internal Medicine Department, Lozano Blesa University Clinical Hospital, Zaragoza, Spain.
Sytemic Autoimmune Diseases Unit, Internal Medicine Department, Miguel Servet University Clinical Hospital, Zaragoza, Spain.
Front Med (Lausanne). 2022 Jan 27;8:808608. doi: 10.3389/fmed.2021.808608. eCollection 2021.
COVID-19 outcomes in population with systemic autoimmune diseases (SAD) remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 infection in people with rheumatic disease.
Two phases cross-sectional survey of individuals with rheumatic disease in April 2020 and October 2020. COVID infection, severity of disease, age, sex, smoking status, underlying rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analyzed.
A total of 1,529 individuals with autoimmunity disease diagnosis were included. Out of 50 positive patients, 21 required telephone medical assistance, 16 received assessment by primary care physician, 9 were evaluated in Emergency Department and 4 patient required hospitalization. Multivariate analysis was performed without obtaining differences in any of the systemic autoimmune diseases. Regarding the treatments, significant differences were found ( 0.011) in the treatment with anti-TNF-alpha agents with OR 3.422 (1.322-8.858) and a trend to significance ( 0.094) was observed in patients receiving mycophenolate treatment [OR 2.016 (0.996-4-081)].
Anti-TNF-alpha treatment was associated with more than 3-fold risk of suffering from SARS-CoV-2 infection, although in all cases infection was mild. Cumulative incidence in patients with SAD was up to 5 times higher than general population but with great differences between autoimmune diseases.
对患有系统性自身免疫性疾病（SAD）人群的新冠病毒病（COVID-19）结局仍知之甚少。本研究旨在探讨与风湿性疾病患者感染COVID-19相关的人口统计学和临床因素。
于2020年4月和2020年10月对风湿性疾病患者进行两阶段横断面调查。分析了新冠病毒感染情况、疾病严重程度、年龄、性别、吸烟状况、潜在的风湿性疾病诊断、合并症以及感染前立即服用的风湿性疾病药物。
共纳入1529例诊断为自身免疫性疾病的患者。在50例阳性患者中，21例需要电话医疗协助，16例接受初级保健医生评估，9例在急诊科接受评估，4例患者需要住院治疗。在任何一种系统性自身免疫性疾病中进行多变量分析均未发现差异。关于治疗，在使用抗TNF-α药物治疗的患者中发现有显著差异（P = 0.011），比值比（OR）为3.422（1.322 - 8.858），在接受霉酚酸酯治疗的患者中观察到有显著趋势（P = 0.094）[OR为2.016（0.996 - 4.081）]。
抗TNF-α治疗与感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险增加3倍以上相关，尽管在所有病例中感染均为轻症。SAD患者的累积发病率比普通人群高5倍，但在自身免疫性疾病之间存在很大差异。
