COVID-19 感染在自身炎症性疾病患者中的情况：一项对 117 名法国患者和来自法国 RMD COVID-19 队列的 1545 名患者进行的研究：COVIMAI - 法国全身性自身炎症性疾病患者 SARS-CoV-2 感染队列研究。
COVID-19 infection among patients with autoinflammatory diseases: a study on 117 French patients compared with 1545 from the French RMD COVID-19 cohort: COVIMAI - the French cohort study of SARS-CoV-2 infection in patient with systemic autoinflammatory diseases.
机构信息
Sorbonne University, AP-HP, Tenon Hospital, Internal Medicine Department, 4 rue de la Chine, 75020, Paris, France; national Reference center for autoinflammatory diseases and AA amyloidosis (CEREMAIA), Tenon Hospital, Paris, France.
Univ. Lille, CHU Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France, CHU Lille, Département de Biostatistiques, F-59000 Lille, France, Université de Lille, Lille, France.
出版信息
RMD Open. 2022 May;8(1). doi: 10.1136/rmdopen-2021-002063.
OBJECTIVE
There is little known about SARS-CoV-2 infection in patients with systemic autoinflammatory disease (SAID). This study aimed to describe epidemiological features associated with severe disease form and death. Mortality between patients with and without SAID hospitalised for SARS-CoV-2 infection was compared.
METHODS
A national multicentric prospective cohort study was conducted from the French Rheumatic and Musculoskeletal Diseases (RMD) COVID-19 cohort. Patients with SAID were matched with patients with non-SAID on age±7 years, gender and number of comorbidities to consider important confounding factors. Impact of SAID on severity of SARS-CoV-2 infection was analysed using multinomial logistic regression for severity in three classes (mild, moderate and severe with mild status as reference). Fine-Gray regression model for length of hospital stay and binomial logistic regression model for risk of death at 30 days.
RESULTS
We identified 117 patients with SAID (sex ratio 0.84, 17 children) and compared them with 1545 patients with non-autoinflammatory immune-mediated inflammatory disorders (non-SAID). 67 patients had a monogenic SAID (64 with familial Mediterranean fever). Other SAIDs were Behçet' disease (n=21), undifferentiated SAID (n=16), adult-onset Still disease (n=9) and systemic-onset juvenile idiopathic arthritis (n=5). Ten adults developed severe form (8.6%). Six patients died. All children had a benign disease. After matching on age±7 years, sex and number of comorbidities, no significant difference between the two groups in length of stay and the severity of infection was noted.
CONCLUSION
As identified in the whole French RMD COVID-19 cohort, patients with SAID on corticosteroids and with multiple comorbidities are prone to develop more severe COVID-19 forms.
目的
关于系统性自身炎症性疾病（SAID）患者的 SARS-CoV-2 感染，知之甚少。本研究旨在描述与严重疾病形式和死亡相关的流行病学特征。比较了因 SARS-CoV-2 感染住院的 SAID 患者和非 SAID 患者的死亡率。
方法
进行了一项全国多中心前瞻性队列研究，纳入了法国风湿和肌肉骨骼疾病（RMD）COVID-19 队列。SAID 患者与非 SAID 患者按年龄±7 岁、性别和合并症数量进行匹配，以考虑重要的混杂因素。使用多分类逻辑回归分析 SAID 对 SARS-CoV-2 感染严重程度的影响，严重程度分为三级（轻度、中度和重度，轻度作为参考）。采用 Fine-Gray 回归模型分析住院时间，采用二项逻辑回归模型分析 30 天内死亡风险。
结果
我们共纳入了 117 例 SAID 患者（性别比 0.84，17 例为儿童），并与 1545 例非自身炎症性免疫介导性疾病（非 SAID）患者进行了比较。67 例患者患有单基因 SAID（64 例为家族性地中海热）。其他 SAIDs 包括贝切特病（n=21）、未分化 SAID（n=16）、成人Still 病（n=9）和全身型幼年特发性关节炎（n=5）。10 例成人患者出现严重疾病（8.6%）。6 例患者死亡。所有儿童患者均为良性疾病。在按年龄±7 岁、性别和合并症数量匹配后，两组在住院时间和感染严重程度方面无显著差异。
结论
与法国 RMD COVID-19 队列中的所有患者一样，接受皮质类固醇治疗且合并多种合并症的 SAID 患者更容易出现更严重的 COVID-19 形式。
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