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
Por:
Sattui S.E., Conway R., Putman M.S., Seet A.M., Gianfrancesco M.A., Beins K., Hill C., Liew D., Mackie S.L., Mehta P., Neill L., Gomez G., Salinas M.I.H., Maldonado F.N., Mariz H.A., de Sousa Studart S.A., Araujo N.C., Knight A., Rozza D., Quartuccio L., Samson M., Bally S., Maria A.T., Chazerain P., Hasseli R., Müller-Ladner U., Hoyer B.F., Voll R., Torres R.P., Luis M., Ribeirio S.L.E., Al-Emadi S., Sparks J.A., Hsu T.Y.-T., D'Silva K.M., Patel N.J., Wise L., Gilbert E., Almada M.V., Duarte-García A., Ugarte-Gil M., Jacobsohn L., Izadi Z., Strangfeld A., Mateus E.F., Hyrich K.L., Gossec L., Carmona L., Lawson-Tovey S., Kearsley-Fleet L., Schaefer M., Sirotich E., Hausmann J.S., Sufka P., Bhana S., Liew J.W., Grainger R., Machado P.M., Wallace Z.S., Yazdany J., Robinson P.C., Dahou B., Rath E., Piette Y., Devinck M., Maeyaert B., Machado Ribeiro F., Euzebio Ribeiro S.L., Pinheiro M., Quintana R., Gómez G., Roberts K., Baez R.M., Castro Coello V., Haye Salinas M.J., Reyes Torres A.A., Alle G., Tanten R., Maldonado Ficco H., Nieto R., Gobbi C., Tissera Y., Pisoni C., Paula A., Albiero J.A., Schmid M.M., Cosatti M., Gamba M.J., Leandro C., Cusa M.A., German N., Bellomio V., Takashima L., Pera M., Cogo K., Gálvez Elkin M.S., Medina M.A., Savio V., Rojas Tessel I.R., Perez Alamino R., Werner M.L., Ornella S., Casalla L., de la Vega M., Severina M., García M., Gonzalez Lucero L., Romeo C., Moyano S., Barbich T., Bertoli A., Baños A., Petruzzelli S., Matellan C., Conti S., Lazaro M.A., Rodriguez Gil G.F., Risueño F., Quaglia M.I., Scafati J., Cuchiaro N.L., Rebak J.E., Pineda S.I., Calvo M.E., Picco E., Gallino Yanzi J., Maid P., Guaglianone D., Morbiducci J.S., Porta S., Herscovich N., Velasco Zamora J.L., Kisluk B., Castaños Menescardi M.S., Gallo R., Martire M.V., Maldini C., Goizueta C., de la Vega Fernandez S.S., Aeschlimann C., Subils G., Ibáñez S., Chassin-Trubert A.-M., Dong L., Cajas L., Barešic M., Anic B., Culo M.-I., Pavelic T.A., Kovacevic Stranski K., Karanovic B., Vencovsky J., Píchová M., Filkova M., Hamoud H., Vassilopoulos D., Guzman Melgar G.M., So H., Király M., Vojdanian M., Balbir-Gurman A., Abutiban F., Zepa J., Bulina I., Bukauskiene L., Zaueta B., Castillo Ortiz A.A., Zamora Tehozol E., Vega D., Cervántes Rosete D., Martín Nares E., Rodriguez-Reyna T.S., Rull Gabayet M., Alpízar-Rodríguez D., Irazoque F., Jimenez X., Geurts-van Bon L., Zijlstra T., Hoekstra M., Al-Adhoubi N., Salim B., Giraldo E., Salinas A., Nowakowski J., Flood R., McCarthy G., Felea I., Filipescu I., Rednic S., Groseanu L., Tamas M.M., Mlynarikova V., Skamlova M., Zlnay M., Miceková D., Capova L., Macejova Z., Štenová E., Raffayova H., Belakova G., Strakova E., Sencarová M., Žlnayová S., Anna Sabová A., Spisakova D., Oetterová M., Lukacova O., Bakosova M., Hocevar A., de la Torre-Rubio N., Alegre Sancho J.J., Corteguera Coro M., Cobeta Garcia J.C., Torres Martin M.C., Campos J., Gomez Puerta J.A., Yardimci G.K., Akar S., Icacan O.C., Çelik S., Vasylets V., Yeoh S.-A., Vandevelde C., Dunt S., Leeder J., Macphie E., Salerno R., Graver C., Williams K., O'Reilly S., Devine K., Tyler J., Warner E., Pilcher J., Patel S., Nikiphorou E., Chadwick L., Jones C.M., Harrison B., Thornton L., O'Kane D., Fusi L., Low A., Horton S., Jatwani S., Baig S., Bajwa H., Berglund V., Dahle A., Dorman W., Hargrove J., Hilton M., Lebedoff N., Leonard S., Morgan J., Pfeifer E., Skemp A., Wilson J., Wolff A., Cepeda E., D'Silva K., Hsu T., Patel N., Sparks J., Todd D., Wallace Z., Hare D., Calabrese C., Adams C., Khosroshahi A., Kilian A., White D., Winter M., Fields T., Siegel C., Daver N., Harvey M., Kramer N., Lamore C., Hogarty S., Yeter K., Siddique F., Ban B., Tanner T., Ruderman E., Davis W., Quinet R., Scopelitis E., Toribio Toribio K., Webb-Detiege T., Zakem J., Abbass K., Kepecs G., Miranda L., Guma M., Haikal A., Mody S., Mueller D., Jayatilleke A., Zell J., Bays A., Dao K., Fatemeh E., Parks D., Karp D., Quiceno G., Global Rheumatology Alliance
Publicada:
1 ene 2021
Resumen:
Background: Patients with primary systemic vasculitis or polymyalgia rheumatica might be at a high risk for poor COVID-19 outcomes due to the treatments used, the potential organ damage cause by primary systemic vasculitis, and the demographic factors associated with these conditions. We therefore aimed to investigate factors associated with COVID-19 outcomes in patients with primary systemic vasculitis or polymyalgia rheumatica. 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. © 2021 Elsevier Ltd
Filiaciones:
Sattui S.E.:
Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, NY, United States
Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, United States
Conway R.:
Department of Rheumatology, St James's Hospital, Dublin, Ireland
Putman M.S.:
Medical College of Wisconsin, Milwaukee, WI, United States
Seet A.M.:
Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, United States
Gianfrancesco M.A.:
Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, United States
Beins K.:
Vasculitis Foundation, Kansas City, MO, United States
Hill C.:
Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, SA, Australia
Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
Liew D.:
Department of Rheumatology, Austin Health, Melbourne, Australia
Department of Medicine, University of MelbourneVIC, Australia
Mackie S.L.:
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
Mehta P.:
Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, United Kingdom
Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
Neill L.:
Polymyalgia Rheumatica and Giant Cell Arteritis Scotland, Perth, Scotland, United Kingdom
Gomez G.:
Research Unit Argentine Society of Rheumatology, Buenos Aires, Argentina
Salinas M.I.H.:
Reumatologa CEMMA, Universidad Nacional de la Rioja, La Rioja, Argentina
Maldonado F.N.:
Sanatorio Güemes, Buenos Aires, Argentina
Mariz H.A.:
Hospital das Clinicas, Universidade Federal de Pernanmbuco, Pernanmbuco, Brazil
de Sousa Studart S.A.:
Hospital Geral de Fortaleza, Fortaleza, Brazil
Araujo N.C.:
Instituto de Assistencia Medica ao Servidor Publico Estadual de Sao Paulo, Sao Paulo, Brazil
Knight A.:
Rheumatology, Institute of Medical Sciences, Uppsala University, Uppsala, Sweden
Rozza D.:
Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy
Quartuccio L.:
Clinic of Rheumatology, Department of Medicine, University of Udine, School of Rheumatology, Santa Maria della Misericordia Academic Hospital, Udine, Italy
Samson M.:
Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
Bally S.:
Nephrology and Dialysis Service, Metropole Savoie Hospital Center, Chambery, France
Maria A.T.:
Department of Internal Medicine and Multi-Organic Diseases, Saint-Eloi University Hospital of Montpellier, Montpellier, France
Chazerain P.:
Department of Rheumatology and Internal Medicine, Diaconesses Croix Saint Simon Hospital, Paris, France
Hasseli R.:
Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus Liebig University Giessen, Bad Nauheim, Germany
Müller-Ladner U.:
Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus Liebig University Giessen, Bad Nauheim, Germany
Hoyer B.F.:
Department of Rheumatology and Clinical Immunology, Clinic for Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
Voll R.:
Department of Rheumatology and Clinical Immunology, University Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
Torres R.P.:
CEDOC, Nova Medical School, Lisbon, Portugal
Rheumatology Service, Egas Moniz Hospital, Lisboa Occidental Hospital Centre, Lisbon, Portugal
Luis M.:
Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
School of Medicine, Universidade de Coimbra, Coimbra, Portugal
Ribeirio S.L.E.:
Federal University of Amazonas, Amazonas, Brazil
Al-Emadi S.:
Hamad Medical Corporation, Doha, Qatar
Sparks J.A.:
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
Hsu T.Y.-T.:
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
D'Silva K.M.:
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
Patel N.J.:
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
Wise L.:
Los Angeles County Hospital, Los Angeles, CA, United States
University of South California Medical Center, Los Angeles, CA, United States
Gilbert E.:
Division of Rheumatology, Mayo Clinic Health System, Jacksonville, FL, United States
Almada M.V.:
Division of Rheumatology, Mayo Clinic Health System, Rochester, MN, United States
Duarte-García A.:
Division of Rheumatology, Mayo Clinic Health System, Rochester, MN, United States
Ugarte-Gil M.:
School of Medicine, University Cientifica del Sur, Lima, Peru
Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
Jacobsohn L.:
Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, United States
Izadi Z.:
Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, United States
Strangfeld A.:
German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
Mateus E.F.:
Portuguese League Against Rheumatic Diseases, Lisbon, Portugal
Hyrich K.L.:
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
National Institute of Health Research Manchester Biomedical Research Centre, University of Manchester, Manchester, United Kingdom
National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Trust, Manchester, United Kingdom
Gossec L.:
Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
Department of Rheumatology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France
Carmona L.:
Instituto de Salud Musculoesquelética, Madrid, Spain
Lawson-Tovey S.:
Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom
Manchester Academic Health Science Centre, Manchester, United Kingdom
Kearsley-Fleet L.:
Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, United Kingdom
Schaefer M.:
German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
Sirotich E.:
McMaster University, Hamilton, ON, Canada
Canadian Arthritis Patient Alliance, Toronto, ON, Canada
Hausmann J.S.:
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
Boston Children's Hospital, Boston, MA, United States
Sufka P.:
HealthPartners, St Paul, MN, United States
Bhana S.:
Crystal Run Health, Middletown, NY, United States
Liew J.W.:
Boston University School of Medicine, Boston, MA, United States
Grainger R.:
University of Otago, Wellington, New Zealand
Machado P.M.:
Centre for Rheumatology and Department of Neuromuscular Diseases, University College London, United Kingdom
National Institute for Health Research, University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom
Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, United Kingdom
Wallace Z.S.:
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
Yazdany J.:
Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, United States
Robinson P.C.:
University of Queensland, Brisbane, QLD, Australia
Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, Australia
Gómez G.:
Research Unit Argentine Society of Rheumatology, Buenos Aires, Argentina
D'Silva K.:
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
Hsu T.:
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
Patel N.:
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
Sparks J.:
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
Wallace Z.:
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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