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在新冠疫情期间,哥伦比亚一家医疗服务机构的类风湿关节炎患者队列中,与新冠病毒感染相关的发病率及因素

Incidence and factors related to SARS-CoV-2 infection in a cohort of patients with rheumatoid arthritis from a health service provider in Colombia during the COVID-19 pandemic.

作者信息

Valladales-Restrepo Luis Fernando, Machado-Duque Manuel Enrique, Gaviria-Mendoza Andrés, Ospina-Arzuaga Harrison David, Ruiz-Zapata Maritza, Machado-Alba Jorge Enrique

机构信息

Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira, Audifarma S.A, Pereira, Colombia.

Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.

出版信息

Ther Adv Infect Dis. 2022 Nov 4;9:20499361221135155. doi: 10.1177/20499361221135155. eCollection 2022 Jan-Dec.

Abstract

BACKGROUND

Patients with rheumatoid arthritis (RA) have an increased risk of SARS-CoV-2 infection due to intrinsic characteristics of the pathology and the medications used to treat it. The aim was to evaluate the incidence of and factors related to SARS-CoV-2 infection in patients with RA in Colombia.

METHODS

This was an observational study of patients diagnosed with RA who were treated at a health care institution in Colombia. The study evaluated whether the patients presented SARS-CoV-2 infection and other clinical variables. Variables associated with the risk of SARS-CoV-2 infection were identified.

RESULTS

A total of 2566 patients with RA were identified. They had a median age of 61.9 years, and 81.1% were women. They were mainly treated with synthetic disease-modifying antirheumatic drugs (DMARDs) (85.3%), glucocorticoids (52.2%), and biological DMARDs (26.8%). The incidence of SARS-CoV-2 infection was 5.1%, and the factors that increased the risk included treatment with synthetic DMARDs with or without biological DMARDs but with concomitant systemic glucocorticoids [odds ratio (OR): 2.18, 95% confidence interval (CI): 1.21-3.93 and OR: 1.69, 95% CI: 1.05-2.74, respectively] and receiving antidiabetic drugs (OR: 2.24, 95% CI: 1.27-3.94). A total of 20.8% of patients with COVID-19 required hospitalization and 3.8% died.

CONCLUSION

The incidence of COVID-19 is higher among patients with RA who receive DMARDs and glucocorticoids simultaneously or who have diabetes mellitus than among patients with RA not receiving these drug combinations, which should guide treatment strategies.

摘要

背景

由于类风湿关节炎(RA)的病理内在特征以及用于治疗该病的药物,RA患者感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的风险增加。目的是评估哥伦比亚RA患者中SARS-CoV-2感染的发生率及其相关因素。

方法

这是一项对在哥伦比亚一家医疗机构接受治疗的确诊RA患者的观察性研究。该研究评估了患者是否感染SARS-CoV-2以及其他临床变量。确定了与SARS-CoV-2感染风险相关的变量。

结果

共确定了2566例RA患者。他们的中位年龄为61.9岁,81.1%为女性。他们主要接受合成改善病情抗风湿药物(DMARDs)(85.3%)、糖皮质激素(52.2%)和生物DMARDs(26.8%)治疗。SARS-CoV-2感染的发生率为5.1%,增加风险的因素包括使用或未使用生物DMARDs但同时使用全身性糖皮质激素的合成DMARDs治疗[比值比(OR):分别为2.18,95%置信区间(CI):1.21 - 3.93和OR:1.69,95%CI:1.05 - 2.74]以及接受抗糖尿病药物治疗(OR:2.24,95%CI:1.27 - 3.94)。20.8%的2019冠状病毒病(COVID-19)患者需要住院治疗,3.8%死亡。

结论

同时接受DMARDs和糖皮质激素治疗或患有糖尿病的RA患者中COVID-19的发生率高于未接受这些药物联合治疗的RA患者,这应为治疗策略提供指导。

相似文献

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COVID-19 and rheumatoid arthritis.新型冠状病毒肺炎与类风湿关节炎。
Curr Opin Rheumatol. 2021 May 1;33(3):255-261. doi: 10.1097/BOR.0000000000000786.

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