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Coronavirus disease 2019 (COVID-19) in autoimmune and inflammatory conditions: clinical characteristics of poor outcomes.
Rheumatol Int. 2020 Oct; 40(10):1593-1598.RI

Abstract

OBJECTIVE

To describe clinical characteristics of patients with rheumatic and musculoskeletal diseases (RMDs) and immunosuppressive therapies with Coronavirus disease 2019 (COVID-19) at an academic rheumatology center in Madrid and to identify baseline variables associated with a severe infection requiring hospitalization.

METHODS

We identified SARS-CoV-2 positive cases by polymerase chain reaction performed at our center within an updated RMDs database in our clinic. Additional RMDs patients were identified when they contacted the clinic because of a positive infection. Data extraction included diagnosis, demographics, immunosuppressive treatment, comorbidities, and laboratory tests. Comparisons between patients with or without hospitalization were performed. Multivariate logistic regression was used to analyze associations between baseline variables and need for hospitalization.

RESULTS

A total of 62 patients with COVID-19 and underlying RMDs were identified by April 24, 2020. Median age was 60.9 years, and 42% men. Forty-two patients required hospitalization; these were more frequently men, older and with comorbidities. There were no statistically significant between-group differences for rheumatologic diagnosis and for baseline use of immunosuppressive therapy except for glucocorticoids that were more frequent in hospitalized patients. Total deaths were 10 (16%) patients. In multivariate analysis, male sex (odds ratio [OR], 8.63; p = 0.018), previous lung disease (OR, 27.47; p = 0.042), and glucocorticoids use (> 5 mg/day) (OR, 9.95; p = 0.019) were significantly associated to hospitalization.

CONCLUSION

Neither specific RMD diagnoses or exposures to DMARDs were associated with increased odds of hospitalization. Being male, previous lung disease and exposure to glucocorticoids were associated with higher odds of hospitalization in RMDs patients.

Authors+Show Affiliations

Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain. fernandojose.montero@salud.madrid.org.Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain.Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain.Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain.Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain.Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain.Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain.Department of Rheumatology. Hospital General, Universitario Gregorio Marañón, 28007, Madrid, Spain.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

32794113

Citation

Montero, Fernando, et al. "Coronavirus Disease 2019 (COVID-19) in Autoimmune and Inflammatory Conditions: Clinical Characteristics of Poor Outcomes." Rheumatology International, vol. 40, no. 10, 2020, pp. 1593-1598.
Montero F, Martínez-Barrio J, Serrano-Benavente B, et al. Coronavirus disease 2019 (COVID-19) in autoimmune and inflammatory conditions: clinical characteristics of poor outcomes. Rheumatol Int. 2020;40(10):1593-1598.
Montero, F., Martínez-Barrio, J., Serrano-Benavente, B., González, T., Rivera, J., Molina Collada, J., Castrejón, I., & Álvaro-Gracia, J. (2020). Coronavirus disease 2019 (COVID-19) in autoimmune and inflammatory conditions: clinical characteristics of poor outcomes. Rheumatology International, 40(10), 1593-1598. https://doi.org/10.1007/s00296-020-04676-4
Montero F, et al. Coronavirus Disease 2019 (COVID-19) in Autoimmune and Inflammatory Conditions: Clinical Characteristics of Poor Outcomes. Rheumatol Int. 2020;40(10):1593-1598. PubMed PMID: 32794113.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronavirus disease 2019 (COVID-19) in autoimmune and inflammatory conditions: clinical characteristics of poor outcomes. AU - Montero,Fernando, AU - Martínez-Barrio,Julia, AU - Serrano-Benavente,Belén, AU - González,Teresa, AU - Rivera,Javier, AU - Molina Collada,Juan, AU - Castrejón,Isabel, AU - Álvaro-Gracia,Jose, Y1 - 2020/08/13/ PY - 2020/06/10/received PY - 2020/08/03/accepted PY - 2020/8/15/pubmed PY - 2020/9/4/medline PY - 2020/8/15/entrez KW - Autoimmune diseases KW - COVID-19 KW - Poor outcomes KW - Rheumatology SP - 1593 EP - 1598 JF - Rheumatology international JO - Rheumatol Int VL - 40 IS - 10 N2 - OBJECTIVE: To describe clinical characteristics of patients with rheumatic and musculoskeletal diseases (RMDs) and immunosuppressive therapies with Coronavirus disease 2019 (COVID-19) at an academic rheumatology center in Madrid and to identify baseline variables associated with a severe infection requiring hospitalization. METHODS: We identified SARS-CoV-2 positive cases by polymerase chain reaction performed at our center within an updated RMDs database in our clinic. Additional RMDs patients were identified when they contacted the clinic because of a positive infection. Data extraction included diagnosis, demographics, immunosuppressive treatment, comorbidities, and laboratory tests. Comparisons between patients with or without hospitalization were performed. Multivariate logistic regression was used to analyze associations between baseline variables and need for hospitalization. RESULTS: A total of 62 patients with COVID-19 and underlying RMDs were identified by April 24, 2020. Median age was 60.9 years, and 42% men. Forty-two patients required hospitalization; these were more frequently men, older and with comorbidities. There were no statistically significant between-group differences for rheumatologic diagnosis and for baseline use of immunosuppressive therapy except for glucocorticoids that were more frequent in hospitalized patients. Total deaths were 10 (16%) patients. In multivariate analysis, male sex (odds ratio [OR], 8.63; p = 0.018), previous lung disease (OR, 27.47; p = 0.042), and glucocorticoids use (> 5 mg/day) (OR, 9.95; p = 0.019) were significantly associated to hospitalization. CONCLUSION: Neither specific RMD diagnoses or exposures to DMARDs were associated with increased odds of hospitalization. Being male, previous lung disease and exposure to glucocorticoids were associated with higher odds of hospitalization in RMDs patients. SN - 1437-160X UR - https://www.unboundmedicine.com/medline/citation/32794113/Coronavirus_disease_2019__COVID_19__in_autoimmune_and_inflammatory_conditions:_clinical_characteristics_of_poor_outcomes_ DB - PRIME DP - Unbound Medicine ER -