■自身免疫性/炎症性风湿性疾病(AIRDs)患者可能有严重COVID-19的风险。然而,这是否与疾病或治疗有关很难确定。本研究旨在确定AIRD患者中与严重COVID-19发生相关的因素,并评估AIRD是否与严重COVID-19或死亡风险增加相关。
■对两个数据库进行了分析:EDS(EntrepótdesDonnéesdeSanté,临床数据仓库),包括在巴黎大学医院和法国多中心COVID-19队列[法国风湿性和肌肉骨骼疾病(RMD)]随访的所有患者。首先,在一项联合分析中,我们比较了重度和非重度COVID-19患者,以确定与严重程度相关的因素.然后,我们在EDS数据库中进行了倾向匹配评分的病例对照研究,以比较AIRD病例和非AIRD对照.
■在1,213名患者中,195人(16.1%)经历了严重的COVID-19。在多变量分析中,年龄较大,间质性肺病(ILD),动脉高血压,肥胖,结节病,血管炎,自身炎性疾病,糖皮质激素或利妥昔单抗治疗与严重COVID-19的风险增加相关。在35,741例COVID-19EDS患者中,将316名具有AIRD的人与1,264名倾向得分匹配的对照进行比较。AIRD患者患严重COVID-19的风险较高[aOR=1.43(1.08-1.87),p=0.01],但仅限于类风湿性关节炎和脊柱关节炎的分析未发现严重COVID-19的风险增加[aOR=1.11(0.68-1.81)]。
■在这项多中心研究中,我们证实接受利妥昔单抗或皮质类固醇治疗和/或有血管炎的AIRD患者,自身炎性疾病,结节病和结节病发生严重COVID-19的风险增加。此外,AIRD患者有,总的来说,与普通人群相比,严重COVID-19的风险增加。
UNASSIGNED: Autoimmune/inflammatory rheumatic diseases (AIRDs) patients might be at-risk of severe COVID-19. However, whether this is linked to the disease or to its treatment is difficult to determine. This study aimed to identify factors associated with occurrence of severe COVID-19 in AIRD patients and to evaluate whether having an AIRD was associated with increased risk of severe COVID-19 or death.
UNASSIGNED: Two databases were analyzed: the EDS (Entrepôt des Données de Santé, Clinical Data Warehouse), including all patients followed in Paris university hospitals and the French multi-center COVID-19 cohort [French rheumatic and musculoskeletal diseases (RMD)]. First, in a combined analysis we compared patients with severe and non-severe COVID-19 to identify factors associated with severity. Then, we performed a propensity matched score case-control study within the EDS database to compare AIRD cases and non-AIRD controls.
UNASSIGNED: Among 1,213 patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher risk of severe COVID-19 [aOR = 1.43 (1.08-1.87), p = 0.01] but analysis restricted to rheumatoid arthritis and spondyloarthritis found no increased risk of severe COVID-19 [aOR = 1.11 (0.68-1.81)].
UNASSIGNED: In this multicenter study, we confirmed that AIRD patients treated with rituximab or corticosteroids and/or having vasculitis, auto-inflammatory disease, and sarcoidosis had increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of severe COVID-19 compares general population.