Mulhearn Ben, Ellis Jessica, Skeoch Sarah, Pauling John, Tansley Sarah
Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Trust, Combe Park, Bath, BA1 3NG, UK.
Department of Life Sciences, The University of Bath, Claverton Down, Bath, BA2 7AY, UK.
Heliyon. 2023 Jul 3;9(7):e17899. doi: 10.1016/j.heliyon.2023.e17899. eCollection 2023 Jul.
Following the first wave of the COVID-19 pandemic, it was observed that giant cell arteritis (GCA) diagnoses increased at the Royal National Hospital for Rheumatic Diseases (RNHRD) in Bath, UK. This finding may support the viral aetiology hypothesis of GCA. Better understanding of the causes of GCA may help improve diagnostic and treatment strategies leading to better outcomes for patients.
The study aims to estimate the local incidence of GCA during the early COVID-19 pandemic (2020-2021) and compare it to pre-pandemic (2015-2019) data. This study will also evaluate the temporal relationship between COVID-19 infections and GCA diagnoses.
Annual incidence rates of GCA were calculated between 2015 and 2021. Local COVID-19 prevalence was estimated by measuring the number of hospital beds taken up by COVID-19 positive patients. Poisson statistics were used to compare the annual mean incidence of GCA between 2019 and 2020, and Granger causality tested the temporal relationship between COVID-19 prevalence and GCA incidence.
There were 60 (95% confidence interval [CI] 46-77) GCA diagnoses made in 2020 compared to 28 (CI 19-41) in 2019 ( = 0.016). Peaks in the number of COVID-19 inpatients correlated with peaks in GCA diagnoses. Granger causality testing found a statistically significant association between these peaks with a lag period of 40-45 days.
The incidence of GCA in Bath was significantly increased in 2020 and 2021 compared to 2015-2019. The lag period between peaks was 40-45 days, suggesting that the COVID-19 virus may be a precipitating factor for GCA. More work is currently underway to interrogate the causal relationship between these two diseases.
在新冠疫情第一波流行之后，人们观察到英国巴斯皇家国立风湿病医院（RNHRD）的巨细胞动脉炎（GCA）诊断病例有所增加。这一发现可能支持GCA的病毒病因假说。更好地了解GCA的病因可能有助于改进诊断和治疗策略，从而为患者带来更好的治疗效果。
本研究旨在估计新冠疫情早期（2020 - 2021年）GCA的当地发病率，并将其与疫情前（2015 - 2019年）的数据进行比较。本研究还将评估新冠病毒感染与GCA诊断之间的时间关系。
计算2015年至2021年期间GCA的年发病率。通过测量新冠病毒阳性患者占用的医院病床数量来估计当地新冠病毒感染率。采用泊松统计方法比较2019年和2020年GCA的年均发病率，并用格兰杰因果检验来检测新冠病毒感染率与GCA发病率之间的时间关系。
2020年有60例（95%置信区间[CI] 46 - 77）GCA诊断病例，而2019年为28例（CI 19 - 41）（P = 0.016）。新冠住院患者数量的峰值与GCA诊断病例的峰值相关。格兰杰因果检验发现这些峰值之间存在统计学上的显著关联，滞后时间为40 - 45天。
与2015 - 2019年相比，2020年和2021年巴斯GCA的发病率显著增加。峰值之间的滞后时间为40 - 45天，这表明新冠病毒可能是GCA的一个诱发因素。目前正在开展更多工作来探究这两种疾病之间的因果关系。
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