Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan.
Department of Molecular Biology, Ariel University, Ariel 40700, Israel.
Medicina (Kaunas). 2024 Aug 23;60(9):1377. doi: 10.3390/medicina60091377.
Viral infections, including coronavirus disease 2019 (COVID-19), in patients with autoimmune rheumatic diseases (AIRDs) tend to present more severe disease. This study aims to investigate the clinical characteristics and risk factors for severe infection in rheumatologic patients. We included patients with a diagnosis of AIRD and COVID-19 infection between January 2022 and July 2023. Patients with AIRDs infected with SARS-CoV-2 were matched with control patients of the general population according to age (±5 years) and sex in a 1:1 ratio. Confirmed infection was defined if a patient had a positive polymerase chain reaction (PCR) test. The severity was divided into mild, moderate, severe, and critical according to the guidelines of the United States National Institutes of Health (NIH). A total of 140 individuals (37 males, 103 females; mean age 56.1 ± 11.3 years) with rheumatic disease diagnosed with COVID-19 infection were enrolled in the study. AIRDs included rheumatoid arthritis (RA) ( = 63, 45%), ankylosing spondylitis (AS) ( = 35, 25%), systemic lupus erythematosus (SLE) ( = 26, 8.6%), and systemic sclerosis (SSc) ( = 16, 11.4%). The AIRDs group had more SARS-CoV-2-related dyspnea (38.6%), arthralgia (45.7%), and depression (27.1%) than the control group ( = 0.004). The rate of lung infiltration on radiographic examination was higher in 58 (41.4%, = 0.005) patients with rheumatic diseases than in those without them. Severe SARS-CoV-2 infection was more common in the AIRDs group than in the control group (22% vs. 12%; = 0.043). Patients with AIRDs experienced more symptoms of arthralgia, depression, and dyspnea. There was a trend towards an increased severity of the disease in patients with AIRDs. Patients with arterial hypertension, diabetes, chronic lung, and kidney disease, treated with corticosteroids, had a longer duration, and high activity of autoimmune disease had an increased risk of severe COVID-19.
病毒感染,包括 2019 年冠状病毒病(COVID-19),在自身免疫性风湿病(AIRD)患者中往往表现出更严重的疾病。本研究旨在探讨风湿性疾病患者严重感染的临床特征和危险因素。我们纳入了 2022 年 1 月至 2023 年 7 月期间诊断为 AIRD 且感染 COVID-19 的患者。患有 SARS-CoV-2 的 AIRD 患者与普通人群的对照患者按年龄(±5 岁)和性别 1:1 匹配。如果患者的聚合酶链反应(PCR)检测呈阳性,则定义为确诊感染。严重程度根据美国国立卫生研究院(NIH)的指南分为轻度、中度、重度和危重症。共有 140 名(37 名男性,103 名女性;平均年龄 56.1±11.3 岁)患有风湿性疾病并确诊 COVID-19 感染的患者入组本研究。AIRD 包括类风湿关节炎(RA)(=63,45%)、强直性脊柱炎(AS)(=35,25%)、系统性红斑狼疮(SLE)(=26,8.6%)和系统性硬化症(SSc)(=16,11.4%)。与对照组相比,AIRD 组更易出现与 SARS-CoV-2 相关的呼吸困难(38.6%,=0.004)、关节痛(45.7%)和抑郁(27.1%)。58 名(41.4%,=0.005)风湿性疾病患者的肺部浸润率高于无风湿性疾病患者。与对照组相比,AIRD 组严重 SARS-CoV-2 感染更为常见(22% vs. 12%;=0.043)。AIRD 患者出现更多的关节痛、抑郁和呼吸困难症状。AIRD 患者的疾病严重程度呈上升趋势。患有动脉高血压、糖尿病、慢性肺部和肾脏疾病、接受皮质类固醇治疗、疾病持续时间较长且自身免疫性疾病活动度较高的患者,感染严重 COVID-19 的风险增加。