Yalcin Mutlu Melek, Kleyer Arnd, Kroenke Gerhard, Fagni Filippo, Temiz Selahattin Alp, Meder Christine, Dietrich Peter, Orlemann Till, Mößner Johanna, Schoenau Verena, Bohr Daniela, Schuster Louis, Hartmann Fabian, Minopoulou Ioanna, Leppkes Moritz, Ramming Andreas, Pachowsky Milena L, Schuch Florian, Ronneberger Monika, Kleinert Stefan, Hueber Axel J, Manger Karin, Manger Bernhard, Atreya Raja, Berking Carola, Sticherling Michael, Neurath Markus F, Schett Georg, Simon David, Tascilar Koray
Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany.
Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany.
BMJ Open. 2025 Jan 7;15(1):e088486. doi: 10.1136/bmjopen-2024-088486.
Although patients with immune-mediated inflammatory diseases (IMID) are thought to be more susceptible to viral infections, it is unclear whether their presentation differs between patients with IMID and healthy controls. This study aimed to investigate the symptom pattern of common viral infections in patients with IMID and compare it with controls without IMIDs.
A cross-sectional study conducted between 1 February and 30 April 2020, using a questionnaire.
Seven tertiary regional care centers in Germany, which specialised in the care of patients with IMID (namely, in gastroenterology, dermatology, rheumatology and immunology clinical care).
One thousand nine hundred nine participants completed the survey (757 patients with IMID; 1152 non-IMID controls).
The occurrence of 11 common viral illness symptoms within the preceding 3 months in patients with IMID and non-IMID controls.
Symptom data were clustered, based on number and co-occurrance, into 3 major clusters and 2 subclusters ranked by the average number of symptoms. Patients with inflammatory bowel disease and psoriasis were significantly overrepresented in the lower-frequency subcluster of the polysymptomatic cluster. Patients with rheumatoid arthritis were overrepresented in the lower-frequency subclusters of the intermediate and oligo-/asymptomatic clusters. Controls were over-represented only in the higher-frequency subclusters of each major cluster where none of the IMIDs were over-represented. Spondyloarthritis and other IMIDs were also overrepresented in the low-frequency subcluster, but the results were not significant. Overall, patients with rheumatoid arthritis patients reported fewer symptoms (rate ratio=0.68, 95% CI, 0.59 to 0.80) than non-IMID controls.
Patients with IMID are over-represented in low-frequency subclusters, even among individuals who have reported a broad range of viral infection symptoms. This pattern suggests that the manifestations of viral infections are different between patients with IMID and controls, thus challenging the accurate and early diagnosis of infections.
尽管免疫介导的炎症性疾病（IMID）患者被认为更容易感染病毒，但尚不清楚IMID患者与健康对照者的表现是否存在差异。本研究旨在调查IMID患者常见病毒感染的症状模式，并与无IMID的对照者进行比较。
于2020年2月1日至4月30日使用问卷进行的横断面研究。
德国的七个三级区域护理中心，专门负责护理IMID患者（即胃肠病学、皮肤病学、风湿病学和免疫学临床护理）。
1909名参与者完成了调查（757名IMID患者；1152名非IMID对照者）。
IMID患者和非IMID对照者在过去3个月内出现11种常见病毒疾病症状的情况。
根据症状数量和同时出现的情况，症状数据被聚类为3个主要聚类和2个子聚类，并按平均症状数量排序。炎症性肠病和银屑病患者在多症状聚类的低频子聚类中显著过多。类风湿关节炎患者在中度和少/无症状聚类的低频子聚类中过多。对照者仅在每个主要聚类的高频子聚类中过多，而IMID患者在这些高频子聚类中均未过多。脊柱关节炎和其他IMID患者在低频子聚类中也过多，但结果不显著。总体而言，类风湿关节炎患者报告的症状少于非IMID对照者（率比=0.68，95%CI，0.59至0.80）。
即使在报告了广泛病毒感染症状的个体中，IMID患者在低频子聚类中的比例也过高。这种模式表明，IMID患者和对照者之间病毒感染的表现不同，从而对感染的准确和早期诊断构成挑战。
