Chest Diseases and Tuberculosis Department Faculty of Medicine Cairo University, Cairo, Egypt.
Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Int J Rheum Dis. 2023 May;26(5):870-877. doi: 10.1111/1756-185X.14662. Epub 2023 Mar 16.
People with rheumatic diseases are particularly concerned with the coronavirus disease 2019 (COVID-19) pandemic. Our work aimed to study the impact of pre-existing autoimmune rheumatic disease (AIRD) and its immunosuppressive drugs on COVID-19 severity and outcome.
This is a multicenter case-control study performed between September 2020 and February 2021 on 130 adults with COVID-19, including 66 patients with AIRD and 64 without AIRD, who served as a control group.
Regarding COVID-19 clinical manifestations; diarrhea, fatigue, and headache were found with significantly higher frequency in the AIRD group while a higher frequency of cough was found in the control group. Comparing COVID-19 complications, only septic shock was significantly higher in the AIRD group (P = 0.013). Both groups were treated with similar COVID-19 drugs except for tocilizumab and anticoagulants, which were statistically significantly more frequently used in the control group (P < 0.001 for both). No statistically significant difference was found between the groups in the outcome or severity of COVID-19. There was no impact of previous immunosuppressive drugs before COVID-19 on the severity of the disease except for a longer duration of recovery in patients on steroids (P < 0.001). Patients with hypertension had severe COVID-19 compared with those without (odds ratio 2.8, 95% confidence interval 1.2-6.9; P = 0.020).
AIRD may not affect COVID-19 severity and outcome. Similarly, immunosuppressive medications had no effect; except that patients on systemic steroids had longer duration for recovery. Comorbid conditions, such as hypertension, may be associated with more severe COVID-19 disease course.
患有风湿性疾病的人尤其关注 2019 年冠状病毒病（COVID-19）大流行。我们的工作旨在研究预先存在的自身免疫性风湿性疾病（AIRD）及其免疫抑制剂对 COVID-19 严重程度和结局的影响。
这是一项多中心病例对照研究，于 2020 年 9 月至 2021 年 2 月期间在 130 名 COVID-19 成年患者中进行，包括 66 名患有 AIRD 的患者和 64 名没有 AIRD 的患者作为对照组。
就 COVID-19 临床表现而言，在 AIRD 组中腹泻、疲劳和头痛的频率明显更高，而在对照组中咳嗽的频率更高。比较 COVID-19 并发症，只有败血症性休克在 AIRD 组中显著更高（P=0.013）。两组均接受了类似的 COVID-19 药物治疗，但托珠单抗和抗凝剂除外，对照组中这些药物的使用频率明显更高（均 P<0.001）。两组在 COVID-19 的结局或严重程度方面无统计学差异。除了接受皮质类固醇治疗的患者恢复时间更长外（P<0.001），COVID-19 之前的先前免疫抑制剂对疾病严重程度无影响。高血压患者的 COVID-19 比无高血压患者更严重（比值比 2.8，95%置信区间 1.2-6.9；P=0.020）。
AIRD 可能不会影响 COVID-19 的严重程度和结局。同样，免疫抑制剂没有影响；除了接受全身皮质类固醇治疗的患者恢复时间更长外。合并症，如高血压，可能与更严重的 COVID-19 病程有关。
