Poormoghim Hadi, GaffariRad Fatemeh, Rahmani Shahrzad, Mohtasham Negin, Almasi Simin, Sobhani Ali, Salimi-Beni Maryam, Andalib Elham, Naeini Parsa Amiri, Jalali Arash
Iran University of Medical Sciences, Tehran, Iran.
Mediterr J Rheumatol. 2023 Jun 30;34(2):172-179. doi: 10.31138/mjr.34.2.172. eCollection 2023 Jun.
Our knowledge of the COVID-19 infection impact on systemic sclerosis (SSc) is scarce. This study aimed to assess the prevalence of COVID-19 infection and to determine the predictive factors of worse outcomes and death in SSc patients.
In this cohort study all patients who attended our clinic between 20 February 2020 and 20th May 2021 were followed, and those with a history of COVID-19 infection completed the questionnaire. Results of para-clinical tests were extracted from the SSc database. The outcomes were classified as: alive vs. deceased and, mild vs. worse outcomes. Descriptive statistics and binary logistic regression models were applied.
Of the total 192 SSc patients studied, COVID-19 affected 12.5%; 6% experienced mild disease, 7% were hospitalized and 3% died. The worse outcome was associated with: older age [95%CI: 1.00-1.08], smoking [95%CI: 2.632-33.094], diabetes [95%CI: 1.462-29.654], digital pitting scars (DPS) [95%CI: 1.589-21.409], diffusing capacity of the lungs for carbon monoxide [DLCO<70 [95%CI: 1.078-11.496], left ventricular ejection fraction (LVEF)<50% [95%CI: 1.080-38.651], systolic pulmonary artery pressure (sPAP)>40 mmHg [95%CI: 1.332-17.434], pericardial effusion (PE) [95%CI: 1.778-39.206], and tendon friction rub [95%CI: 1.091-9.387]. Death was associated with male gender [95%CI: 1.54-88.04], hypertension [95%CI: 1.093-2.155], digital ulcers (DU) [95%CI: 0.976-18.34], low forced vital capacity (FVC) [95%CI: 0.03-0.81], and joint flexion contracture (JFC) [95%CI: 1.226-84.402].
Risk factors for the worse outcome in COVID-19 infected SSc patients included, older age, smoking, diabetes, DPS, DLCO<70, LVEF<50%, sPAP>40 mmHg, PE, and TFR. Death was associated with the male gender, hypertension, DU, low FVC, and JFC.
我们对2019冠状病毒病（COVID-19）感染对系统性硬化症（SSc）的影响了解甚少。本研究旨在评估COVID-19感染的患病率，并确定SSc患者预后较差和死亡的预测因素。
在这项队列研究中，对2020年2月20日至2021年5月20日期间到我们诊所就诊的所有患者进行随访，有COVID-19感染史的患者填写问卷。从SSc数据库中提取辅助检查结果。结局分为：存活与死亡，以及轻症与预后较差。应用描述性统计和二元逻辑回归模型。
在总共192例研究的SSc患者中，COVID-19感染率为12.5%；6%为轻症，7%住院，3%死亡。预后较差与以下因素相关：年龄较大[95%置信区间：1.00-1.08]、吸烟[95%置信区间：2.632-33.094]、糖尿病[95%置信区间：1.462-29.654]、指凹性瘢痕（DPS）[95%置信区间：1.589-21.409]、肺一氧化碳弥散量[DLCO<70][95%置信区间：1.078-11.496]、左心室射血分数（LVEF）<50%[95%置信区间：1.080-38.651]、收缩期肺动脉压（sPAP）>40 mmHg[95%置信区间：1.332-17.434]、心包积液（PE）[95%置信区间：1.778-39.206]和肌腱摩擦音[95%置信区间：1.091-9.387]。死亡与男性[95%置信区间：1.54-88.04]、高血压[95%置信区间：1.093-2.155]、指端溃疡（DU）[95%置信区间：0.976-18.34]、低用力肺活量（FVC）[95%置信区间：0.03-0.81]和关节屈曲挛缩（JFC）[95%置信区间：1.226-84.402]相关。
COVID-19感染的SSc患者预后较差的危险因素包括年龄较大、吸烟、糖尿病、DPS、DLCO<70、LVEF<50%、sPAP>40 mmHg、PE和肌腱摩擦音。死亡与男性、高血压、DU、低FVC和JFC相关。
