COVID-19 预后在系统性红斑狼疮与类风湿关节炎和脊柱关节炎中的比较：来自意大利风湿病学会的 CONTROL-19 研究的结果。
COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology.
机构信息
Rheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy
Rheumatology, Allergology and Clinical Immunology, Department of 'Systems Medicine', University of Rome Tor Vergata, Rome, Italy.
出版信息
Lupus Sci Med. 2023 Oct;10(2). doi: 10.1136/lupus-2023-000945.
INTRODUCTION
Data concerning SARS-CoV-2 in patients affected by SLE are contradicting.The aim of this study was to investigate disease-related differences in COVID-19 prognosis of patients affected by rheumatic diseases before vaccination; we tested the hypothesis that patients with SLE may have a different outcome compared with those with rheumatoid arthritis (RA) or spondyloarthritis (SPA).
METHODS
We analysed data from the national CONTROL-19 Database with a retrospective, observational design, including rheumatic patients affected by COVID-19. The principal outcome measure was hospitalisation with death or mechanical ventilation. Differences between SLE, RA and SPA were analysed by univariable and multivariable logistic regression models.
RESULTS
We included 103 patients with SLE (88.2% female, mean age 48.9 years, 50.4% active disease), 524 patients with RA (74.4% female, mean age 60.6 years, 59.7% active disease) and 486 patients with SPA (58.1% female, mean age 53.2 years, 58% active disease).Outcome prevalence was not different between patients with SLE and those with RA (SLE 24.5%, RA 25.6%), while patients with SPA showed a more favourable outcome compared with those with SLE (SPA 15.9%); data from the multivariable analysis confirmed this result.In SLE, age >65 years (OR 17.3, CI 5.51 to 63.16, p<0.001), hypertension (OR 6.2, CI 2.37 to 17.04, p<0.001) and prednisone (PDN) use (OR 3.8, CI 1.43 to 11.39, p=0.01) were associated with severe outcomes, whereas hydroxychloroquine use was found to be protective (OR 0.3, CI 0.14 to 0.91, p=0.03).
CONCLUSION
Our data suggest that patients with SLE and RA do not show a different COVID-19 outcome, while patients with SPA have a more favourable disease course compared with those with SLE. Risk of hospitalisation with ventilation or death was associated with age >65 years, hypertension and PDN use in patients with SLE.
简介
有关 SARS-CoV-2 在患有 SLE 患者中的数据存在矛盾。本研究的目的是调查接种疫苗前风湿性疾病患者 COVID-19 预后的与疾病相关差异；我们检验了 SLE 患者的结局可能与类风湿关节炎（RA）或脊柱关节炎（SPA）患者不同的假设。
方法
我们通过回顾性观察性设计分析了来自国家 CONTROL-19 数据库的数据，该研究纳入了患有 COVID-19 的风湿性疾病患者。主要观察指标是住院治疗并伴有死亡或机械通气。通过单变量和多变量逻辑回归模型分析 SLE、RA 和 SPA 之间的差异。
结果
我们纳入了 103 例 SLE 患者（88.2%为女性，平均年龄 48.9 岁，50.4%为活动期疾病）、524 例 RA 患者（74.4%为女性，平均年龄 60.6 岁，59.7%为活动期疾病）和 486 例 SPA 患者（58.1%为女性，平均年龄 53.2 岁，58%为活动期疾病）。SLE 患者和 RA 患者的结局发生率无差异（SLE 为 24.5%，RA 为 25.6%），而 SPA 患者的结局优于 SLE 患者（SPA 为 15.9%）；多变量分析结果证实了这一结果。在 SLE 患者中，年龄>65 岁（OR 17.3，95%CI 5.51 至 63.16，p<0.001）、高血压（OR 6.2，95%CI 2.37 至 17.04，p<0.001）和泼尼松龙（PDN）的使用（OR 3.8，95%CI 1.43 至 11.39，p=0.01）与严重结局相关，而羟氯喹的使用则具有保护作用（OR 0.3，95%CI 0.14 至 0.91，p=0.03）。
结论
我们的数据表明，SLE 和 RA 患者的 COVID-19 结局无差异，而 SPA 患者的疾病过程优于 SLE 患者。SLE 患者中，年龄>65 岁、高血压和 PDN 使用与住院并伴有通气或死亡的风险相关。
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