Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sattui Sebastian E, Conway Richard, Putman Michael S, Seet Andrea M, Gianfrancesco Milena A, Beins Kaley, Hill Catherine, Liew David, Mackie Sarah L, Mehta Puja, Neill Lorna, Gomez Gimena, Salinas Maria Isabel Haye, Maldonado Federico Nicolas, Mariz Henrique Ataide, de Sousa Studart Samia Araujo, Araujo Nafice Costa, Knight Ann, Rozza Davide, Quartuccio Luca, Samson Maxime, Bally Stéphane, Maria Alexandre Tj, Chazerain Pascal, Hasseli Rebecca, Müller-Ladner Ulf, Hoyer Bimba F, Voll Reinhard, Torres Rita Pinheiro, Luis Mariana, Ribeirio Sandra Lucia Euzebio, Al-Emadi Samar, Sparks Jeffrey A, Hsu Tiffany Y-T, D'Silva Kristin M, Patel Naomi J, Wise Leanna, Gilbert Emily, Almada Maria Valenzuela, Duarte-García Alí, Ugarte-Gil Manuel, Jacobsohn Lindsay, Izadi Zara, Strangfeld Anja, Mateus Elsa F, Hyrich Kimme L, Gossec Laure, Carmona Loreto, Lawson-Tovey Saskia, Kearsley-Fleet Lianne, Schaefer Martin, Sirotich Emily, Hausmann Jonathan S, Sufka Paul, Bhana Suleman, Liew Jean W, Grainger Rebecca, Machado Pedro M, Wallace Zachary S, Yazdany Jinoos, Robinson Philip C, Global Rheumatology Alliance
Аннотация
METHODS: In this retrospective cohort study, adult patients (aged ≥18 years) diagnosed with COVID-19 between March 12, 2020, and April 12, 2021, who had a history of primary systemic vasculitis (antineutrophil cytoplasmic antibody [ANCA]-associated vasculitis, giant cell arteritis, Behçet's syndrome, or other vasculitis) or polymyalgia rheumatica, and were reported to the COVID-19 Global Rheumatology Alliance registry were included. To assess COVID-19 outcomes in patients, we used an ordinal COVID-19 severity scale, defined as: (1) no hospitalisation; (2) hospitalisation without supplemental oxygen; (3) hospitalisation with any supplemental oxygen or ventilation; or (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios (ORs), adjusting for age, sex, time period, number of comorbidities, smoking status, obesity, glucocorticoid use, disease activity, region, and medication category. Analyses were also stratified by type of rheumatic disease.
FINDINGS: Of 1202 eligible patients identified in the registry, 733 (61·0%) were women and 469 (39·0%) were men, and their mean age was 63·8 years (SD 17·1). A total of 374 (31·1%) patients had polymyalgia rheumatica, 353 (29·4%) had ANCA-associated vasculitis, 183 (15·2%) had giant cell arteritis, 112 (9·3%) had Behçet's syndrome, and 180 (15·0%) had other vasculitis. Of 1020 (84·9%) patients with outcome data, 512 (50·2%) were not hospitalised, 114 (11·2%) were hospitalised and did not receive supplemental oxygen, 239 (23·4%) were hospitalised and received ventilation or supplemental oxygen, and 155 (15·2%) died. A higher odds of poor COVID-19 outcomes were observed in patients who were older (per each additional decade of life OR 1·44 [95% CI 1·31-1·57]), were male compared with female (1·38 [1·05-1·80]), had more comorbidities (per each additional comorbidity 1·39 [1·23-1·58]), were taking 10 mg/day or more of prednisolone compared with none (2·14 [1·50-3·04]), or had moderate, or high or severe disease activity compared with those who had disease remission or low disease activity (2·12 [1·49-3·02]). Risk factors varied among different disease subtypes.
INTERPRETATION: Among patients with primary systemic vasculitis and polymyalgia rheumatica, severe COVID-19 outcomes were associated with variable and largely unmodifiable risk factors, such as age, sex, and number of comorbidities, as well as treatments, including high-dose glucocorticoids. Our results could be used to inform mitigation strategies for patients with these diseases.
FUNDING: American College of Rheumatology and the European Alliance of Associations for Rheumatology.