Rheumatic and musculoskeletal diseases

风湿性和肌肉骨骼疾病
  • 文章类型: Journal Article
    目的:确定灭活的SARS-CoV-2疫苗在风湿性和肌肉骨骼疾病(RMDs)患者中的有效性和安全性。
    方法:在2022年12月8日至2023年2月1日期间,对江苏省患有COVID-19的RMD患者进行了调查。人口统计信息,疾病特征,抗风湿药的使用,收集疫苗接种状态和生存状态。COVID-19相关性肺炎是主要结果。COVID-19免疫对RMD患者的影响使用多变量logistic回归评估,并评估疫苗接种后的不良事件(AE)。
    结果:在592例患有COVID-19的RMD患者中,276例(46.6%)个体经历了COVID-19相关性肺炎,290例(49.0%)患者注射了灭活疫苗。在多变量逻辑回归分析中,疫苗降低了COVID-19相关性肺炎的发病率,接受加强疫苗接种是RMD患者COVID-19相关性肺炎的独立保护因素(OR0.64,95%CI0.41-0.98,p=.034)。特别是,灭活疫苗对患有肺炎高风险的RMD患者具有保护性影响,包括45岁及以上的人群(OR0.53,95%CI0.34-0.83),并且有肺部受累(OR0.43,95%CI0.23-0.82)。疫苗的总不良事件发生率为13.9%(40/290),只有11人(3.8%)经历了RMD的复发或恶化,无严重不良事件发生。
    结论:灭活COVID-19疫苗可安全有效地降低中国RMD患者的COVID-19相关性肺炎风险。
    OBJECTIVE: To identify the effectiveness and safety of inactivated SARS-CoV-2 vaccines in rheumatic and musculoskeletal diseases (RMDs) patients.
    METHODS: RMD patients with COVID-19 in Jiangsu Province were polled between December 8, 2022, and February 1, 2023. Information on demographics, disease characteristics, antirheumatic drug use, vaccination status and survival state were collected. COVID-19-associated pneumonia was the primary outcome. The effect of COVID-19 immunization on RMD patients was assessed using multivariate logistic regression, and the adverse events (AEs) following vaccination were evaluated.
    RESULTS: Among 592 RMD patients with COVID-19, 276 (46.6%) individuals experienced COVID-19-associated pneumonia, and 290 (49.0%) patients were injected with inactivated vaccines. In multivariate logistic regression analysis, vaccines reduced the incidence of COVID-19-associated pneumonia, and receiving booster vaccine was an independent protective factor for COVID-19-associated pneumonia in RMD patients (OR 0.64, 95% CI 0.41-0.98, p = .034). In particular, inactivated vaccines have a protective impact on RMD patients with a high risk of developing pneumonia, including those aged 45 years and older (OR 0.53, 95% CI 0.34-0.83), and who have lung involvement (OR 0.43, 95% CI 0.23-0.82). The total AEs rate of vaccines was 13.9% (40/290), only 11 (3.8%) experienced the recurrence or deterioration of RMDs, and no serious AEs occurred.
    CONCLUSIONS: Inactivated COVID-19 vaccines were safe and effective in reducing the risk of COVID-19-associated pneumonia of RMD patients in China.
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  • 文章类型: Journal Article
    目的:本研究的目的是探讨风湿性和肌肉骨骼疾病(RMDs)患者感染严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)的临床特征以及RMDs复发与SARS-CoV-2感染之间的关系。
    方法:我们在585例RMD患者和619例无RMD患者中进行了一项横断面观察性研究。人口统计数据,2019年冠状病毒病的临床特征(COVID-19),抗风湿治疗,收集RMD复发情况。RMD和对照组之间的差异,受感染和未感染的群体,对复发和非复发RMDs组进行检查.还评估了COVID-19感染对药物治疗和RMD复发的影响。
    结果:在最终招募的1204名参与者中,1030例(85.5%)感染COVID-19。七百九十五(77.2%)的感染者是女性,中位年龄为40岁(IQR33,50).RMD组患者出现COVID-19症状的风险相对较低,而需要住院治疗的可能性明显更高(6.7%vs.2.2%)。在RMD组中,年龄在65岁以下的年轻患者更有可能报告更多的症状.在COVID-19感染期间,有RMD复发的患者(27,34.6%)调整了药物治疗,而没有复发的患者(59,13.2%)更多。
    结论:患有RMD的患者出现COVID-19症状的风险较低。风湿性和肌肉骨骼疾病患者复发的风险更高,特别是当他们在COVID-19感染期间调整药物治疗时。感染RMDs患者的长期预后需要进一步研究。
    OBJECTIVE: The aim of this study was to investigate the clinical features of patients with rheumatic and musculoskeletal diseases (RMDs) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the relationship between RMDs relapse and SARS-CoV-2 infection.
    METHODS: We carried out a cross-sectional observational study among 585 patients with RMDs and 619 individuals without RMDs. Data on demographics, the clinical features of coronavirus disease 2019 (COVID-19), antirheumatic therapy, and RMD relapse were collected. Differences between RMDs and control groups, infected and uninfected groups, relapse and non-relapse RMDs groups were examined. The influence of COVID-19 infection on medications and relapse of RMDs was also assessed.
    RESULTS: Among 1204 participants finally recruited for analysis, 1030 (85.5%) were infected with COVID-19. Seven hundred and ninety-five (77.2%) of infected individuals were female, and the median age was 40 years (IQR 33, 50). Patients in the RMD group had a relatively lower risk of COVID-19 symptoms whereas were significantly more likely to require hospitalization (6.7% vs. 2.2%). In the RMDs group, younger patients who were under the age of 65 were more likely to report more symptoms. More patients with RMD relapse (27, 34.6%) adjusted their medications during the period of COVID-19 infection than those without relapse (59, 13.2%).
    CONCLUSIONS: Patients with RMDs were at lower risk of symptoms of COVID-19. Rheumatic and musculoskeletal disease patients experience a higher risk of relapse especially when they adjust medications during COVID-19 infection. The long-term prognosis of infected RMDs patients need further investigation.
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  • 文章类型: Journal Article
    BACKGROUND: In 2001, the European League Against Rheumatism developed and disseminated the first guidelines for musculoskeletal (MS) ultrasound (US) in rheumatology. Fifteen years later, the dramatic expansion of new data on MSUS in the literature coupled with technological developments in US imaging has necessitated an update of these guidelines.
    OBJECTIVE: To update the existing MSUS guidelines in rheumatology as well as to extend their scope to other anatomic structures relevant for rheumatology.
    METHODS: The project consisted of the following steps: (1) a systematic literature review of MSUS evaluable structures; (2) a Delphi survey among rheumatologist and radiologist experts in MSUS to select MS and non-MS anatomic structures evaluable by US that are relevant to rheumatology, to select abnormalities evaluable by US and to prioritise these pathologies for rheumatology and (3) a nominal group technique to achieve consensus on the US scanning procedures and to produce an electronic illustrated manual (ie, App of these procedures).
    RESULTS: Structures from nine MS and non-MS areas (ie, shoulder, elbow, wrist and hand, hip, knee, ankle and foot, peripheral nerves, salivary glands and vessels) were selected for MSUS in rheumatic and musculoskeletal diseases (RMD) and their detailed scanning procedures (ie, patient position, probe placement, scanning method and bony/other landmarks) were used to produce the App. In addition, US evaluable abnormalities present in RMD for each anatomic structure and their relevance for rheumatology were agreed on by the MSUS experts.
    CONCLUSIONS: This task force has produced a consensus-based comprehensive and practical framework on standardised procedures for MSUS imaging in rheumatology.
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