Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland.
Rheumatol Int. 2023 Mar;43(3):459-466. doi: 10.1007/s00296-023-05276-8. Epub 2023 Jan 16.
This study aimed to study the impact of the COVID-19 pandemic on patients living with systemic vasculitis in Kazakhstan. A single-centre retrospective study of the medical histories of 82 patients was carried out based on the regional clinical hospital of the city for all admissions with systemic vasculitis in the period from January 2019 to December 2021. The following qualitative (gender, disability, concomitant diseases) and quantitative (age, disease experience, laboratory data, etc.) variables were studied. To conduct the study, the criteria for the inclusion and exclusion of patients in the study were determined. According to the results of the study, there is a decrease in the number of hospitalized patients with vasculitis in the rheumatology department of the regional clinical hospital. Compared to 2019, in 2021, the number of hospitalized patients decreased by almost half (Table 1). Out of 82 cases, the most common was Takayasu disease (nonspecific aortoarteritis) (43.9%), IgA-vasculitis (Schenlein-Genoch disease) (31.71%), and they are typical mainly for females of rural origin, who were admitted to the hospital in a comorbid state (p < 0.001). 41.6% of patients have disabilities, and the majority of patients have a II disability group. The average body mass index is 24.2; 27 patients out of the total number of patients suffer from obesity. The most common clinical symptoms of patients with systemic vasculitis were injuries of the musculoskeletal system (75.6%). A negative average correlation was found between the indicators of the level of ESR and haemoglobin, the correlation coefficient is -0.535. The patients had concomitant diseases, such as diabetes mellitus, iron deficiency anaemia, coronary heart disease, hypertension, gastrointestinal tract diseases and hepatitis. Women of reproductive age from rural areas are often diagnosed with systemic vasculitis. A high rate of disability revealed among the patients can be explained by two main factors, the first is that the patients consulted the doctors untimely and the second is that the medical community are insufficiently informed about the management of autoimmune rheumatic diseases, in particular about systemic vasculitis, which hinders timely diagnosis and treatment, respectively. Patients, included in this survey, were mostly suffering from diseases of the musculoskeletal system, but depending on the type of vasculitis, other organs and systems may be affected. Table 1 Frequency of patients with systemic vasculitis over 3 years Year Frequency % p-value 2019 42 51.2 χ = 12.463; p = 0.002 2020 23 28.0 2021 17 20.7 Total 82 100.0.
这项研究旨在研究 COVID-19 大流行对哈萨克斯坦系统性血管炎患者的影响。基于该市区域临床医院，对 2019 年 1 月至 2021 年 12 月期间所有因系统性血管炎入院的患者进行了 82 例患者的单中心回顾性研究。研究了以下定性（性别、残疾、并存疾病）和定量（年龄、疾病经历、实验室数据等）变量。为了进行研究，确定了患者纳入和排除研究的标准。根据研究结果，区域临床医院风湿科住院血管炎患者数量有所减少。与 2019 年相比，2021 年住院患者数量减少了近一半（表 1）。在 82 例病例中，最常见的是 Takayasu 病（非特异性主动脉炎）（43.9%）、IgA-血管炎（Schenlein-Genoch 病）（31.71%），它们主要发生在农村地区的女性，她们以合并症的状态入院（p<0.001）。41.6%的患者有残疾，大多数患者属于 II 组残疾。平均体重指数为 24.2；27 名患者患有肥胖症。系统性血管炎患者最常见的临床症状是肌肉骨骼系统损伤（75.6%）。发现 ESR 和血红蛋白水平之间存在负平均相关性，相关系数为-0.535。患者存在糖尿病、缺铁性贫血、冠心病、高血压、胃肠道疾病和肝炎等并存疾病。农村地区的育龄妇女经常被诊断为系统性血管炎。患者中发现高残疾率的原因可能有两个，第一个是患者没有及时就医，第二个是医疗界对自身免疫性风湿病的管理，尤其是对系统性血管炎的管理了解不足，分别导致了延误诊断和治疗。参与这项调查的患者主要患有肌肉骨骼系统疾病，但根据血管炎的类型，其他器官和系统也可能受到影响。表 1 3 年内系统性血管炎患者的频率 年份 频率 % p 值 2019 42 51.2 χ=12.463;p=0.002 2020 23 28.0 2021 17 20.7 总计 82 100.0.
