Fan Yihua, Wang Yiwen, Du Juanli, Wu Rui, Li Jianbin, Xiao Changhong, Li Qing, Zhou Mi, Liu Ying, Zhang Di, Wang Bei, Li Songwei, Zhao Zhina, Lyu Xinliang, Wu Yuanhao, Liu Yan, Ning Xiaomei, Li Zhiteng, Yu Shujiao, Chen Ensheng, Zhu Guangzhao, Zhao Yuxing, Liu Juan, Liu Yuquan, He Dongyi, Liu Wei
Department of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Front Immunol. 2024 Dec 16;15:1439242. doi: 10.3389/fimmu.2024.1439242. eCollection 2024.
Patients with rheumatic diseases who receive long-term treatment with steroids, immunosuppressants, or biologics are more susceptible to infection with pathogens than the general population. In order to explore the differences in clinical features and prognosis of Corona Virus Disease 2019 (COVID-19) infection between patients with rheumatic diseases and the general population (family members), a retrospective investigative study was used to analyze the differences between the two populations.
The study was conducted in 13 Grade A Tertiary hospitals in China to investigate the clinical symptoms and prognostic factors of patients with rheumatic diseases who were infected with COVID-19 for the first time and their families.
A total of 2,889 participants were included in this study, including 1,530 patients with rheumatic diseases and 1,359 family members. In terms of clinical symptoms, the complete recovery time from COVID-19 for patients with rheumatic disease patients was 13 days (8.00, 18.00), which was shorter than that of family members (16 days, 11.00, 20.00). The risk of developing moderate to severe cases of COVID-19 was lower in patients with rheumatic disease than in their family members (OR=0.511, =0.0026). Compared with non-use of non-steroidal anti-inflammatory drugs (NSAIDs), the risk of developing mild cases of COVID-19 was 0.595 times greater with pre-infection use of NSAIDs ( = 0.0003). The use of glucocorticoids and Chinese herbal decoctions before infection increased the probability of developing mild cases of COVID-19 (OR=1.537, 1.773, <0.05). The risk of developing moderate to severe cases with disease-modifying anti-rheumatic drugs (DMARDs) used before infection was 0.350 times that without such drugs (<0.001). In terms of prognosis, compared with family members, the complete recovery time of patients with rheumatic diseases was reduced by 2.241 days on average (<0.001), and the complete recovery time of patients with mild rheumatism was reduced by 4.178 days on average (<0.001). There was no significant difference in the complete recovery time from COVID-19 in patients with severe rheumatism compared with their family members (=0.1672). The use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions during the infection period could shorten the recovery time of COVID-19 symptoms (<0.05).
Compared with their family members, patients with rheumatic diseases had milder symptoms after infection with COVID-19, which was related to the use of glucocorticoids, DMARDs, and Chinese herbal decoctions before infection. During the COVID-19 infection phase, the use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions might shorten the recovery time from symptoms of COVID-19.
ChiCTR2300072679.
接受类固醇、免疫抑制剂或生物制剂长期治疗的风湿性疾病患者比普通人群更容易感染病原体。为了探讨风湿性疾病患者与普通人群（家庭成员）感染新型冠状病毒肺炎（COVID-19）的临床特征和预后差异，采用回顾性调查研究分析这两个人群之间的差异。
该研究在中国13家三级甲等医院进行，调查首次感染COVID-19的风湿性疾病患者及其家属的临床症状和预后因素。
本研究共纳入2889名参与者，其中风湿性疾病患者1530例，家属1359例。在临床症状方面，风湿性疾病患者从COVID-19完全恢复的时间为13天（8.00，18.00），短于家属（16天，11.00，20.00）。风湿性疾病患者发生COVID-19中重度病例的风险低于其家属（OR=0.511，=0.0026）。与未使用非甾体抗炎药（NSAIDs）相比，感染前使用NSAIDs发生COVID-19轻症病例的风险高0.595倍（=0.0003）。感染前使用糖皮质激素和中药汤剂增加了发生COVID-19轻症病例的概率（OR=1.537，1.773，<0.05）。感染前使用改善病情抗风湿药（DMARDs）发生中重度病例的风险是未使用此类药物的0.350倍（<0.001）。在预后方面，与家属相比，风湿性疾病患者的完全恢复时间平均缩短2.241天（<0.001），轻度风湿病患者的完全恢复时间平均缩短4.178天（<0.001）。重度风湿病患者从COVID-19完全恢复的时间与其家属相比无显著差异（=0.1672）。感染期间使用NSAIDs、糖皮质激素、DMARDs、生物制剂、中成药和中药汤剂可缩短COVID-19症状的恢复时间（<0.05）。
与家属相比，风湿性疾病患者感染COVID-19后症状较轻，这与感染前使用糖皮质激素、DMARDs和中药汤剂有关。在COVID-19感染阶段，使用NSAIDs、糖皮质激素、DMARDs、生物制剂、中成药和中药汤剂可能缩短COVID-19症状的恢复时间。
ChiCTR2300072679。
