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Romatolojik Hastalıklarda COVID-19: Tek Merkez Deneyimi

Year 2024, Volume: 77 Issue: 4, 311 - 318, 29.12.2024

Abstract

Amaç: Koronavirüs hastalığı-2019 (COVID-19) enfeksiyonu, Mart 2020’de pandemi olarak ilan edildi ve tüm dünyayı etkisi altına aldı. Pandeminin başından itibaren romatolojik hastalığı olanlar ve immünosüpresif ilaç kullananlarda COVID-19’un morbidite ve mortaliteye etkisi merak edildi.

Gereç ve Yöntem: Bu çalışmaya, Ağrı ilinde Kasım 2018-Haziran 2021 tarihleri arasında romatoloji polikliniğine başvurup romatolojik hastalık tanısı ile izlenen hastalar dahil edildi. Demografik, romatolojik hastalık ilişkili ve COVID-19 verilerine retrospektif olarak ulaşıldı.

Bulgular: Çalışmaya dahil edilen 1.170 hastanın %58,6’sı (686) kadın, %41,4’ü (484) erkekti, ortalama yaş 45,6±15,7 ve hastaların %18,9’unda (221) COVID-19 tespit edildi. COVID-19 pozitif hastaların hospitalizasyon oranı %13, yoğun bakım yatış oranı %5, ölüm %3,2, bilgisayarlı tomografi ile saptanmış akciğer tutulum oranı %19 izlendi. COVID-19 pozitifliği cinsiyet (p=0,04), sülfasalazin (SLZ) kullanımı (p=0,01), hipertansiyon (HT) (p=0,02) ve yaş (p=0,008) ile ilişki saptandı. COVID pozitifliği risk faktörlerinin belirlenmesi için yapılan regresyon analizinde yalnızca SLZ kullanımı 2,1 kat COVID risk artışı ile ilişkili bulundu. COVID-19 pozitif hasta popülasyonunda ölüm ile rituksimab kullanımı (p<0,001), HT (p=0,001) ve yaş (p=0,001) ile ilişki saptandı. COVID-19 pozitif hastalarda ölüm risk faktörlerinin belirlenmesi için yapılan regresyon analizinde yalnızca yaş ölüm riski ile ilişkili bulundu.

Sonuç: Tek merkezde takipli romatoloji hastalarının COVID-19 deneyiminin paylaşıldığı bu çalışma ile romatoloji hastalarında COVID-19 sıklığı Türkiye geneli ile benzer oranda, COVID-19’a bağlı ölüm ise yaş ile ilişkili bulundu.

Anahtar Kelimeler: COVID-19, romatoloji, morbidite, mortalite

Ethical Statement

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Project Number

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Thanks

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References

  • 1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
  • 2. Flacco ME, Acuti Martellucci C, Soldato G, et al. Predictors of SARS-CoV-2 infection and severe and lethal COVID-19 after three years of follow-up: a population-wide study. Viruses. 2023;15:1794.
  • 3. Costantino F, Bahier L, Tarancon LC, et al. COVID-19 in French patients with chronic inflammatory rheumatic diseases: clinical features, risk factors and treatment adherence. Joint Bone Spine. 2021;88:105095.
  • 4. Favalli EG, Bugatti S, Klersy C, et al. Impact of corticosteroids and immunosuppressive therapies on symptomatic SARS-CoV-2 infection in a large cohort of patients with chronic inflammatory arthritis. Arthritis Res Ther. 2020;22:290.
  • 5. Chevallard M, Belloli L, Ughi N, et al. Use of telemedicine during the COVID-19 pandemic in patients with inflammatory arthritis: a retrospective study on feasibility and impact on patient-reported outcomes in a real-life setting. Rheumatol Int. 2021;41:1253-1261.
  • 6. Hoffmann-Vold AM, Distler O, Bruni C, et al. Systemic sclerosis in the time of COVID-19. Lancet Rheumatol. 2022;4:566-575.
  • 7. Haslak F, Yildiz M, Adrovic A, et al. Management of childhood-onset autoinflammatory diseases during the COVID-19 pandemic. Rheumatol Int. 2020;40:1423-1431.
  • 8. Kharouf F, Ishay Y, Kenig A, et al. Incidence and course of COVID-19 hospitalizations among patients with familial Mediterranean fever. Rheumatology (Oxford). 2021;60:SI85-SI89.
  • 9. Güven SC, Erden A, Karakaş Ö, et al. COVID-19 outcomes in patients with familial Mediterranean fever: a retrospective cohort study. Rheumatol Int. 2021;41:715-719.
  • 10. Bourguiba R, Delplanque M, Vinit C, et al. Clinical course of COVID-19 in a cohort of 342 familial Mediterranean fever patients with a longterm treatment by colchicine in a French endemic area. Ann Rheum Dis. 2021;80:539-540.
  • 11. Quartuccio L, Treppo E, Binutti M, et al. Timing of rituximab and immunoglobulin level influence the risk of death for COVID-19 in ANCAassociated vasculitis. Rheumatology (Oxford). 2021;60:3476-3477.
  • 12. Cordtz R, Lindhardsen J, Soussi BG, et al. Incidence and severeness of COVID-19 hospitalization in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark. Rheumatology (Oxford). 2021;60:SI59-SI67.
  • 13. Landewé RBM, Kroon FPB, Alunno A, et al. EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update. Ann Rheum Dis. 2022;81:1628-1639.
  • 14. Mikuls TR, Johnson SR, Fraenkel L, et al. American College of Rheumatology guidance for the management of rheumatic disease in adult patients during the COVID-19 pandemic: version 3. Arthritis Rheumatol. 2021;73:1-12.
  • 15. Grainger R, Kim AHJ, Conway R, et al. COVID-19 in people with rheumatic diseases: risks, outcomes, treatment considerations. Nat Rev Rheumatol. 2022;18:191-204.
  • 16. Pablos JL, Abasolo L, Alvaro-Gracia JM, et al. Prevalence of hospital PCRconfirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases. Ann Rheum Dis. 2020;79:1170-1173.
  • 17. Shin YH, Shin JI, Moon SY, et al. Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: a nationwide cohort study. Lancet Rheumatol. 2021;3:698-706.
  • 18. Conway R, Grimshaw AA, Konig MF, et al. SARS-CoV-2 infection and COVID-19 outcomes in rheumatic diseases: a systematic literature review and meta-analysis. Arthritis Rheumatol. 2022;74:766-775.
  • 19. Wang F, Ma Y, Xu S, et al. Prevalence and risk of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis. Clin Rheumatol. 2022;41:2213-2223.
  • 20. Sözeri B, Demir F, Kalın S, et al. SARS-CoV-2 infection in children with rheumatic disease: Experience of a tertiary referral center. Arch Rheumatol. 2021;36:381-388. Handan Yarkan Tuğsal. Romatoloji Hastalarında COVID-19 Ankara Üniversitesi Tıp Fakültesi Mecmuası 2024;77(4):311-318 318
  • 21. Esatoglu SN, Tascilar K, Babaoğlu H, et al. COVID-19 Among patients with inflammatory rheumatic diseases. Front Immunol. 2021;12:651715.
  • 22. Kokturk N, Babayigit C, Kul S, et al. The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients. Respir Med. 2021;183:106433. 23. Strangfeld A, Schäfer M, Gianfrancesco MA, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. AnnRheum Dis. 2021;80:930-942.
  • 24. Xu C, Yi Z, Cai R, et al. Clinical outcomes of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis of global data. Autoimmun Rev. 2021;20:102778.
  • 25. RECOVERY Collaborative Group; Horby P, Lim WS, et al. Dexamethasone in hospitalized patients with COVID-19. N Engl J Med. 2021;384:693-704.
  • 26. Fadel R, Morrison AR, Vahia A, et al. Early short-course corticosteroids in hospitalized patients With COVID-19. Clin Infect Dis. 2020;71:2114-2120.
  • 27. Yang R, Xiong Y, Ke H, et al. The role of methylprednisolone on preventing disease progression for hospitalized patients with severe COVID-19. Eur J Clin Invest. 2020;50:e13412.
  • 28. Edalatifard M, Akhtari M, Salehi M, et al. Intravenous methylprednisolone pulse as a treatment for hospitalised severe COVID-19 patients: results from a randomised controlled clinical trial. Eur Respir J. 2020;56:2002808.
  • 29. WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group; Sterne JAC, Murthy S, et al. Association between administration of systemic corticosteroids and mortality among critically ıll patients with COVID-19: A Meta-analysis. JAMA. 2020;324:1330-1341.
  • 30. Patel C, Parmar K, Patel D, et al. Effect of corticosteroid therapy on mortality in COVID-19 patients-a systematic review and meta-analysis. Rev Med Virol. 2022;32:e2386.
  • 31. Sparks JA, Wallace ZS, Seet AM, et al. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: results from the COVID-19 Global Rheumatology Alliance physician registry. Ann Rheum Dis. 2021;80:1137-1146.
  • 32. Guimaraes PO, Quirk D, Furtado RH, et al. Tofacitinib in patients hospitalized with COVID-19 pneumonia. N Engl J Med. 2021;385:406-415.
  • 33. Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with COVID-19. N Engl J Med. 2021;384:795-807.
  • 34. Loarce-Martos J, García-Fernández A, López-Gutiérrez F, et al. High rates of severe disease and death due to SARS-CoV-2 infection in rheumatic disease patients treated with rituximab: a descriptive study. Rheumatol Int.2020;40:2015-2021.
  • 35. Bachiller-Corral J, Boteanu A, Garcia-Villanueva MJ, et al. Risk of severe COVID-19 infection in patients with inflammatory rheumatic diseases. J Rheumatol. 2021;48:1098-1102.
  • 36. Jones JM, Faruqi AJ, Sullivan JK, et al. COVID-19 Outcomes in patients undergoing B cell depletion therapy and those with humoral immunodeficiency states: a scoping review. Pathog Immun. 2021;6:76-103.

COVID-19 in Rheumatic Diseases: A Single Center Experience

Year 2024, Volume: 77 Issue: 4, 311 - 318, 29.12.2024

Abstract

Objectives: Coronavirus disease-2019 (COVID-19) infection was declared a pandemic in March 2020 and has affected the entire world. Since the beginning of the pandemic, there has been concern about whether patients with rheumatic diseases are at an increased risk of COVID-19-related morbidity or mortality.

Materials and Methods: In this study, patients who applied to the rheumatology outpatient clinic in the Ağrı province between November 2018 and June 2021 and were followed up with a diagnosis of rheumatologic disease were included. Rheumatological diseases, demographics, and COVID-19 data were collected retrospectively.

Results: Of the 1,170 patients included in the study, 58.6% (686) were female and 41.4% (484) were male, the mean age was 45.6±15.7 years and 18.9% (221) of the patients were COVID-19 positive. COVID-19 positive patients had a hospitalization rate of 13%, an intensive care unit stays rate of 5%, a mortality rate of 3.2%, and a computed tomography-detected lung involvement rate of 19%. COVID-19 positivity was associated with gender (p=0.04), sulphasalazine (SLZ) use (p=0.01), hypertension (HT) (p=0.02) and age (p=0.008). In the regression analysis performed to determine
the risk factors for COVID positivity, only SLZ use was associated with a 2.1-fold increase in COVID risk. In the COVID-19 positive patient population, death was associated with rituximab use (p<0.001), HT (p=0.001) and age (p=0.001). In the regression analysis performed to determine the risk factors for death in COVID-19 positive patients, only age was associated with the risk of death.

Conclusion: In this study, the COVID-19 experience of rheumatology patients was followed up in a single center; the frequency of COVID-19 in rheumatology patients was found to be similar to Türkiye in general; and death from COVID-19 was found to be age-related.

Keywords: COVID-19, rheumatology, morbidity, mortality

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
  • 2. Flacco ME, Acuti Martellucci C, Soldato G, et al. Predictors of SARS-CoV-2 infection and severe and lethal COVID-19 after three years of follow-up: a population-wide study. Viruses. 2023;15:1794.
  • 3. Costantino F, Bahier L, Tarancon LC, et al. COVID-19 in French patients with chronic inflammatory rheumatic diseases: clinical features, risk factors and treatment adherence. Joint Bone Spine. 2021;88:105095.
  • 4. Favalli EG, Bugatti S, Klersy C, et al. Impact of corticosteroids and immunosuppressive therapies on symptomatic SARS-CoV-2 infection in a large cohort of patients with chronic inflammatory arthritis. Arthritis Res Ther. 2020;22:290.
  • 5. Chevallard M, Belloli L, Ughi N, et al. Use of telemedicine during the COVID-19 pandemic in patients with inflammatory arthritis: a retrospective study on feasibility and impact on patient-reported outcomes in a real-life setting. Rheumatol Int. 2021;41:1253-1261.
  • 6. Hoffmann-Vold AM, Distler O, Bruni C, et al. Systemic sclerosis in the time of COVID-19. Lancet Rheumatol. 2022;4:566-575.
  • 7. Haslak F, Yildiz M, Adrovic A, et al. Management of childhood-onset autoinflammatory diseases during the COVID-19 pandemic. Rheumatol Int. 2020;40:1423-1431.
  • 8. Kharouf F, Ishay Y, Kenig A, et al. Incidence and course of COVID-19 hospitalizations among patients with familial Mediterranean fever. Rheumatology (Oxford). 2021;60:SI85-SI89.
  • 9. Güven SC, Erden A, Karakaş Ö, et al. COVID-19 outcomes in patients with familial Mediterranean fever: a retrospective cohort study. Rheumatol Int. 2021;41:715-719.
  • 10. Bourguiba R, Delplanque M, Vinit C, et al. Clinical course of COVID-19 in a cohort of 342 familial Mediterranean fever patients with a longterm treatment by colchicine in a French endemic area. Ann Rheum Dis. 2021;80:539-540.
  • 11. Quartuccio L, Treppo E, Binutti M, et al. Timing of rituximab and immunoglobulin level influence the risk of death for COVID-19 in ANCAassociated vasculitis. Rheumatology (Oxford). 2021;60:3476-3477.
  • 12. Cordtz R, Lindhardsen J, Soussi BG, et al. Incidence and severeness of COVID-19 hospitalization in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark. Rheumatology (Oxford). 2021;60:SI59-SI67.
  • 13. Landewé RBM, Kroon FPB, Alunno A, et al. EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update. Ann Rheum Dis. 2022;81:1628-1639.
  • 14. Mikuls TR, Johnson SR, Fraenkel L, et al. American College of Rheumatology guidance for the management of rheumatic disease in adult patients during the COVID-19 pandemic: version 3. Arthritis Rheumatol. 2021;73:1-12.
  • 15. Grainger R, Kim AHJ, Conway R, et al. COVID-19 in people with rheumatic diseases: risks, outcomes, treatment considerations. Nat Rev Rheumatol. 2022;18:191-204.
  • 16. Pablos JL, Abasolo L, Alvaro-Gracia JM, et al. Prevalence of hospital PCRconfirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases. Ann Rheum Dis. 2020;79:1170-1173.
  • 17. Shin YH, Shin JI, Moon SY, et al. Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: a nationwide cohort study. Lancet Rheumatol. 2021;3:698-706.
  • 18. Conway R, Grimshaw AA, Konig MF, et al. SARS-CoV-2 infection and COVID-19 outcomes in rheumatic diseases: a systematic literature review and meta-analysis. Arthritis Rheumatol. 2022;74:766-775.
  • 19. Wang F, Ma Y, Xu S, et al. Prevalence and risk of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis. Clin Rheumatol. 2022;41:2213-2223.
  • 20. Sözeri B, Demir F, Kalın S, et al. SARS-CoV-2 infection in children with rheumatic disease: Experience of a tertiary referral center. Arch Rheumatol. 2021;36:381-388. Handan Yarkan Tuğsal. Romatoloji Hastalarında COVID-19 Ankara Üniversitesi Tıp Fakültesi Mecmuası 2024;77(4):311-318 318
  • 21. Esatoglu SN, Tascilar K, Babaoğlu H, et al. COVID-19 Among patients with inflammatory rheumatic diseases. Front Immunol. 2021;12:651715.
  • 22. Kokturk N, Babayigit C, Kul S, et al. The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients. Respir Med. 2021;183:106433. 23. Strangfeld A, Schäfer M, Gianfrancesco MA, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. AnnRheum Dis. 2021;80:930-942.
  • 24. Xu C, Yi Z, Cai R, et al. Clinical outcomes of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis of global data. Autoimmun Rev. 2021;20:102778.
  • 25. RECOVERY Collaborative Group; Horby P, Lim WS, et al. Dexamethasone in hospitalized patients with COVID-19. N Engl J Med. 2021;384:693-704.
  • 26. Fadel R, Morrison AR, Vahia A, et al. Early short-course corticosteroids in hospitalized patients With COVID-19. Clin Infect Dis. 2020;71:2114-2120.
  • 27. Yang R, Xiong Y, Ke H, et al. The role of methylprednisolone on preventing disease progression for hospitalized patients with severe COVID-19. Eur J Clin Invest. 2020;50:e13412.
  • 28. Edalatifard M, Akhtari M, Salehi M, et al. Intravenous methylprednisolone pulse as a treatment for hospitalised severe COVID-19 patients: results from a randomised controlled clinical trial. Eur Respir J. 2020;56:2002808.
  • 29. WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group; Sterne JAC, Murthy S, et al. Association between administration of systemic corticosteroids and mortality among critically ıll patients with COVID-19: A Meta-analysis. JAMA. 2020;324:1330-1341.
  • 30. Patel C, Parmar K, Patel D, et al. Effect of corticosteroid therapy on mortality in COVID-19 patients-a systematic review and meta-analysis. Rev Med Virol. 2022;32:e2386.
  • 31. Sparks JA, Wallace ZS, Seet AM, et al. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: results from the COVID-19 Global Rheumatology Alliance physician registry. Ann Rheum Dis. 2021;80:1137-1146.
  • 32. Guimaraes PO, Quirk D, Furtado RH, et al. Tofacitinib in patients hospitalized with COVID-19 pneumonia. N Engl J Med. 2021;385:406-415.
  • 33. Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with COVID-19. N Engl J Med. 2021;384:795-807.
  • 34. Loarce-Martos J, García-Fernández A, López-Gutiérrez F, et al. High rates of severe disease and death due to SARS-CoV-2 infection in rheumatic disease patients treated with rituximab: a descriptive study. Rheumatol Int.2020;40:2015-2021.
  • 35. Bachiller-Corral J, Boteanu A, Garcia-Villanueva MJ, et al. Risk of severe COVID-19 infection in patients with inflammatory rheumatic diseases. J Rheumatol. 2021;48:1098-1102.
  • 36. Jones JM, Faruqi AJ, Sullivan JK, et al. COVID-19 Outcomes in patients undergoing B cell depletion therapy and those with humoral immunodeficiency states: a scoping review. Pathog Immun. 2021;6:76-103.
There are 35 citations in total.

Details

Primary Language English
Subjects Pain
Journal Section Articles
Authors

Handan Yarkan Tuğsal 0000-0003-0633-790X

Project Number -
Publication Date December 29, 2024
Submission Date March 13, 2024
Acceptance Date May 31, 2024
Published in Issue Year 2024 Volume: 77 Issue: 4

Cite

APA Yarkan Tuğsal, H. (2024). COVID-19 in Rheumatic Diseases: A Single Center Experience. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 77(4), 311-318. https://doi.org/10.4274/atfm.galenos.2024.80037
AMA Yarkan Tuğsal H. COVID-19 in Rheumatic Diseases: A Single Center Experience. Ankara Üniversitesi Tıp Fakültesi Mecmuası. December 2024;77(4):311-318. doi:10.4274/atfm.galenos.2024.80037
Chicago Yarkan Tuğsal, Handan. “COVID-19 in Rheumatic Diseases: A Single Center Experience”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77, no. 4 (December 2024): 311-18. https://doi.org/10.4274/atfm.galenos.2024.80037.
EndNote Yarkan Tuğsal H (December 1, 2024) COVID-19 in Rheumatic Diseases: A Single Center Experience. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77 4 311–318.
IEEE H. Yarkan Tuğsal, “COVID-19 in Rheumatic Diseases: A Single Center Experience”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 4, pp. 311–318, 2024, doi: 10.4274/atfm.galenos.2024.80037.
ISNAD Yarkan Tuğsal, Handan. “COVID-19 in Rheumatic Diseases: A Single Center Experience”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77/4 (December2024), 311-318. https://doi.org/10.4274/atfm.galenos.2024.80037.
JAMA Yarkan Tuğsal H. COVID-19 in Rheumatic Diseases: A Single Center Experience. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77:311–318.
MLA Yarkan Tuğsal, Handan. “COVID-19 in Rheumatic Diseases: A Single Center Experience”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 4, 2024, pp. 311-8, doi:10.4274/atfm.galenos.2024.80037.
Vancouver Yarkan Tuğsal H. COVID-19 in Rheumatic Diseases: A Single Center Experience. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77(4):311-8.