|
1
|
Wu T, Li Y, Huang D, Wu Y, Liang X, Cheng L, Liao Z, Xu F, Chen Y, Zhao J, Xia Z, Tan C, Liu Y, Herrmann M. Interplay between COVID-19 and Secukinumab treatment in Spondylarthritis patients during the omicron surge: a retrospective cohort study. Autoimmunity 2024; 57:2281242. [PMID: 38093504 DOI: 10.1080/08916934.2023.2281242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/05/2023] [Indexed: 12/18/2023]
Abstract
The objective of this retrospective cohort study was to assess the relationship between Corona Disease 2019 (COVID-19) and Secukinumab treatment in patients with Spondylarthritis (SpA) in China during the omicron surge. Researchers retrieved 1018 medical records of Secukinumab-treated patients between January 2020 and January 2023 from the West China Hospital of Sichuan University. Out of these, 190 SpA patients from the rheumatology clinic were selected for the study. Guided phone questionnaires were administered by research staff to collect baseline characteristics, SpA disease status, and COVID-19 clinical outcomes. Cohabitants served as the control group and provided COVID-19 related data. Of the 190 potential SpA patients, 122 (66%) completed the questionnaire via phone, along with 259 cohabitants. 84.4% of SpA patients were diagnosed with Ankylosing Spondylitis (AS), and 15.6% were diagnosed with Psoriatic Arthritis (PsA). The rate of SARS-CoV-2 infection was 83.6% in the Secukinumab group and 88.8% in the cohabitants control group, with no significant difference (OR = 0.684, CI 0.366-1.275). One instance of severe COVID-19 was observed in the Secukinumab group, while two were identified in the cohabitants control group. Patients in the Secukinumab group had less time with fever caused by COVID-19 (p = 0.004). Discontinuing Secukinumab after SARS-CoV-2 infection did not significantly affect the course of COVID-19 or worsen SpA status according to our data. Our study suggests that administering Secukinumab to SpA patients does not increase their susceptibility to contracting SARS-CoV-2, and may have a positive effect on the course of SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Tong Wu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Yanhong Li
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Deying Huang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Yinlan Wu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Xiuping Liang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Lu Cheng
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Zehui Liao
- Meishan People's Hospital, Meishan, China
| | - Fang Xu
- Meishan People's Hospital, Meishan, China
| | - Ye Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Jing Zhao
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Zijing Xia
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Chunyu Tan
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Yi Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Martin Herrmann
- Department of Medicine 3, Universitäts-klinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie DZI, Universitätsklinikum Erlangen, Erlangen, Germany
| |
Collapse
|
|
2
|
Xu M, Chen R, Wang Y, Huang X, Zhang H, Zhao W, Zhang M, Xu Y, Liu S, Hao CM, Xie Q. Obinutuzumab treatment for membranous nephropathy: effectiveness and safety concerns during the COVID-19 pandemic. Clin Kidney J 2024; 17:sfae299. [PMID: 39507289 PMCID: PMC11540158 DOI: 10.1093/ckj/sfae299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Indexed: 11/08/2024] Open
Abstract
Background Obinutuzumab is a humanized and glycoengineered anti-CD20 monoclonal antibody that has been shown to induce more profound B-cell depletion than rituximab. The effectiveness and safety of obinutuzumab in the treatment of membranous nephropathy remain unclear. Methods This was a retrospective study conducted in Huashan Hospital, Fudan University between 1 December 2021 and 30 November 2023. Patients with membranous nephropathy were included to assess the effectiveness and safety of obinutuzumab and prevalence of severe pneumonia during the outbreak of COVID-19 in China. Results Eighteen patients were included in the study assessing the effectiveness of obinutuzumab. After a 12-month follow-up, 14 patients (78%) achieved remission, with six (33%) achieving complete remission and eight (44%) achieving partial remission. Among the 18 obinutuzumab-treated patients contracting COVID-19 for the first time, six (33%) developed severe pneumonia, and one died. By contrast, two of the 37 patients receiving glucocorticoids combined with cyclophosphamide, and none of the 44 patients on calcineurin inhibitors or the 46 patients on rituximab developed severe pneumonia. However, compared to patients receiving rituximab or glucocorticoids plus cyclophosphamide, the obinutuzumab-treated patients had a longer duration of membranous nephropathy and immunosuppressive therapy. Therefore, cardinal matching was employed to balance these baseline characteristics. Owing to small sample size for each regimen, patients receiving all the three non-obinutuzumab immunosuppressive regimens were grouped as a control cohort. After matching for age, gender, remission status, duration of membranous nephropathy, duration of immunosuppressive therapy, and ongoing immunosuppression, the obinutuzumab-treated patients still had a significantly higher incidence of severe pneumonia compared to those on other regimens (P = .019). Conclusion Obinutuzumab was an effective treatment option for patients with membranous nephropathy. On the other hand, it was associated with a higher incidence of severe pneumonia following COVID-19 infection compared to other immunosuppressive regimens.
Collapse
Affiliation(s)
- Mingyue Xu
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ruiying Chen
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yifeng Wang
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoyun Huang
- Center for Systems Biology, Intelliphecy, Shenzhen, China
| | - Hanzhen Zhang
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenqian Zhao
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Min Zhang
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yunyu Xu
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shaojun Liu
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuan-Ming Hao
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qionghong Xie
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
|
3
|
Rutskaya-Moroshan K, Abisheva S, Abisheva A, Amangeldiyeva Z, Vinnik T, Batyrkhan T. Clinical Characteristics, Prognostic Factors, and Outcomes of COVID-19 in Autoimmune Rheumatic Disease Patients: A Retrospective Case-Control Study from Astana, Kazakhstan. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1377. [PMID: 39336418 PMCID: PMC11433992 DOI: 10.3390/medicina60091377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/30/2024]
Abstract
Background: Viral infections, including coronavirus disease 2019 (COVID-19), in patients with autoimmune rheumatic diseases (AIRDs) tend to present more severe disease. This study aims to investigate the clinical characteristics and risk factors for severe infection in rheumatologic patients. Methods: We included patients with a diagnosis of AIRD and COVID-19 infection between January 2022 and July 2023. Patients with AIRDs infected with SARS-CoV-2 were matched with control patients of the general population according to age (±5 years) and sex in a 1:1 ratio. Confirmed infection was defined if a patient had a positive polymerase chain reaction (PCR) test. The severity was divided into mild, moderate, severe, and critical according to the guidelines of the United States National Institutes of Health (NIH). Results: A total of 140 individuals (37 males, 103 females; mean age 56.1 ± 11.3 years) with rheumatic disease diagnosed with COVID-19 infection were enrolled in the study. AIRDs included rheumatoid arthritis (RA) (n = 63, 45%), ankylosing spondylitis (AS) (n = 35, 25%), systemic lupus erythematosus (SLE) (n = 26, 8.6%), and systemic sclerosis (SSc) (n = 16, 11.4%). The AIRDs group had more SARS-CoV-2-related dyspnea (38.6%), arthralgia (45.7%), and depression (27.1%) than the control group (p = 0.004). The rate of lung infiltration on radiographic examination was higher in 58 (41.4%, p = 0.005) patients with rheumatic diseases than in those without them. Severe SARS-CoV-2 infection was more common in the AIRDs group than in the control group (22% vs. 12%; p = 0.043). Conclusions: Patients with AIRDs experienced more symptoms of arthralgia, depression, and dyspnea. There was a trend towards an increased severity of the disease in patients with AIRDs. Patients with arterial hypertension, diabetes, chronic lung, and kidney disease, treated with corticosteroids, had a longer duration, and high activity of autoimmune disease had an increased risk of severe COVID-19.
Collapse
Affiliation(s)
- Kristina Rutskaya-Moroshan
- Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan; (K.R.-M.); (A.A.); (Z.A.); (T.V.); (T.B.)
| | - Saule Abisheva
- Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan; (K.R.-M.); (A.A.); (Z.A.); (T.V.); (T.B.)
| | - Anilim Abisheva
- Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan; (K.R.-M.); (A.A.); (Z.A.); (T.V.); (T.B.)
| | - Zhadra Amangeldiyeva
- Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan; (K.R.-M.); (A.A.); (Z.A.); (T.V.); (T.B.)
| | - Tatyana Vinnik
- Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan; (K.R.-M.); (A.A.); (Z.A.); (T.V.); (T.B.)
- Department of Molecular Biology, Ariel University, Ariel 40700, Israel
| | - Tansholpan Batyrkhan
- Department of Family Medicine №1, NJSC «Astana Medical University», Astana 010000, Kazakhstan; (K.R.-M.); (A.A.); (Z.A.); (T.V.); (T.B.)
| |
Collapse
|
|
4
|
Velikova T, Valkov H, Aleksandrova A, Peshevska-Sekulovska M, Sekulovski M, Shumnalieva R. Harnessing immunity: Immunomodulatory therapies in COVID-19. World J Virol 2024; 13:92521. [PMID: 38984079 PMCID: PMC11229839 DOI: 10.5501/wjv.v13.i2.92521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/02/2024] [Accepted: 04/11/2024] [Indexed: 06/24/2024] Open
Abstract
An overly exuberant immune response, characterized by a cytokine storm and uncontrolled inflammation, has been identified as a significant driver of severe coronavirus disease 2019 (COVID-19) cases. Consequently, deciphering the intricacies of immune dysregulation in COVID-19 is imperative to identify specific targets for intervention and modulation. With these delicate dynamics in mind, immunomodulatory therapies have emerged as a promising avenue for mitigating the challenges posed by COVID-19. Precision in manipulating immune pathways presents an opportunity to alter the host response, optimizing antiviral defenses while curbing deleterious inflammation. This review article comprehensively analyzes immunomodulatory interventions in managing COVID-19. We explore diverse approaches to mitigating the hyperactive immune response and its impact, from corticosteroids and non-steroidal drugs to targeted biologics, including anti-viral drugs, cytokine inhibitors, JAK inhibitors, convalescent plasma, monoclonal antibodies (mAbs) to severe acute respiratory syndrome coronavirus 2, cell-based therapies (i.e., CAR T, etc.). By summarizing the current evidence, we aim to provide a clear roadmap for clinicians and researchers navigating the complex landscape of immunomodulation in COVID-19 treatment.
Collapse
Affiliation(s)
- Tsvetelina Velikova
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
| | - Hristo Valkov
- Department of Gastroenterology, University Hospital “Tsaritsa Yoanna-ISUL”, Medical University of Sofia, Sofia 1527, Bulgaria
| | | | - Monika Peshevska-Sekulovska
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
- Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
| | - Metodija Sekulovski
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
- Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, Sofia 1407, Bulgaria
| | - Russka Shumnalieva
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
- Department of Rheumatology, Clinic of Rheumatology, University Hospital "St. Ivan Rilski", Medical University-Sofia, Sofia 1612, Bulgaria
| |
Collapse
|
|
5
|
Yurdakul F, Bodur H, Cengiz AK, Durmaz Y, Duruöz MT, Kaya T, Ketenci S, Cüzdan N, Güler T, Günendi Z, Sarıkaya S, Çapkın E, Önder ME, Alkan Melikoğlu M, Güzel R, Şen N, Bora Ayna A, Akgül Ö, Eser E, Ataman Ş. Pandemic of the century: COVID-19 in inflammatory rheumatic diseases of a national cohort with 3,532 patients. Arch Rheumatol 2024; 39:203-212. [PMID: 38933732 PMCID: PMC11196221 DOI: 10.46497/archrheumatol.2024.10313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/24/2023] [Indexed: 06/28/2024] Open
Abstract
Objectives This study aimed to assess the clinical outcomes and risk factors for severe coronavirus disease 2019 (COVID-19) in patients with inflammatory rheumatic disease (IRD) of a national cohort. Patients and methods The multicenter cross-sectional study was carried out between July 15, 2020, and February 28, 2021. Data collection was provided from a national network database system, and 3,532 IRD patients (2,359 males, 1,173 females; mean age: 48.7±13.9 years; range; 18 to 90 years) were analyzed. Demographics, clinics about rheumatic disease, comorbidities, smoking status, being infected with COVID-19, and the course of the infection were questioned by rheumatology specialists. Results One hundred seventeen patients were infected with COVID-19, the hospitalization rate due to COVID-19 was 58.9%, and the mortality rate was 1.7%. There was no difference between the COVID-19 positive and negative groups in terms of rheumatic disease activities and receiving drugs. It was observed that patients with COVID-19 had worse compliance with isolation rules, and bacillus Calmette-Guérin (BCG) vaccination was less common. The mean age and the rate of smoking of hospitalized COVID-19 patients were higher than those without hospitalization. Conclusion In this cohort, in which real-life data were analyzed, COVID-19 rates in IRD patients were similar to the general population for the same period. Compliance with the isolation rules and BCG vaccination attracted attention as components that reduce the risk of COVID-19 infection. The risk factors for hospitalization were older age and smoking.
Collapse
Affiliation(s)
- Fatma Yurdakul
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
| | - Hatice Bodur
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Yıldırım Beyazıt University, Ministry of Health Ankara City Hospital, Ankara, Türkiye
| | - Ahmet Kıvanç Cengiz
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Ondokuz Mayıs University, Samsun, Türkiye
| | - Yunus Durmaz
- Rheumatology Clinic, Karabük Training and Research Hospital, Karabük, Türkiye
| | - Mehmet Tuncay Duruöz
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Marmara University, Istanbul, Türkiye
| | - Taciser Kaya
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Türkiye
| | - Sertaç Ketenci
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Ondokuz Mayıs University, Samsun, Türkiye
| | - Nihan Cüzdan
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Hatay Mustafa Kemal University, Hatay, Türkiye
| | - Tuba Güler
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
| | - Zafer Günendi
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Gazi University, Ankara, Türkiye
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Bülent Ecevit Üniversitesi, Zonguldak, Türkiye
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Karadeniz Technical University, Trabzon, Türkiye
| | - Mustafa Erkut Önder
- Department of Rheumatology, Aksaray University Training and Research Hospital, Aksaray, Türkiye
| | - Meltem Alkan Melikoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Atatürk University, Erzurum, Türkiye
| | - Rengin Güzel
- Department of Physical Medicine and Rehabilitation, Medicine Faculty of Çukurova University, Adana, Türkiye
| | - Nesrin Şen
- Rheumatology Clinic, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Türkiye
| | - Ata Bora Ayna
- Rheumatology Clinic, Çekirge State Hospital, Bursa, Türkiye
| | - Özgür Akgül
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Manisa Celal Bayar University, Manisa, Türkiye
| | - Erhan Eser
- Department of Public Health, Medicine Faculty of Manisa Celal Bayar University, Manisa, Türkiye
| | - Şebnem Ataman
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Ankara University, Ankara, Türkiye
| |
Collapse
|
|
6
|
Huang S, Ma X, Cao J, Du M, Zhao Z, Wang D, Xu X, Liang J, Sun L. Effect of traditional therapeutics on prevalence and clinical outcomes of coronavirus disease 2019 in Chinese patients with autoimmune diseases. J Transl Autoimmun 2024; 8:100227. [PMID: 38188040 PMCID: PMC10764252 DOI: 10.1016/j.jtauto.2023.100227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
The impact of the Coronavirus disease 2019 (COVID-19) pandemic on autoimmune diseases (AID) patients has been an important focus. This study was undertaken to characterize the incidence, clinical manifestations and hospitalization among AID affected by COVID-19 and to analyze the association between immunomodulatory medication and these outcomes. Clinical, demographic, maintenance treatment, symptoms and disease course data and outcomes of AID patients with COVID-19 infection were assessed via an online survey tool and printed copy from 1 January till February 28, 2023. A total of 432 patients with AID were enrolled in the study. The results showed the most common conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was hydroxychloroquine (HCQ). The usage of csDMARDs didn't increase the risk of COVID-19 infection. Patients who warranted hospitalization were significantly older. ILD was associated with higher hospitalization rate. No csDMARDs other than calcineurin inhibitor (CNI) was associated with increased risk of hospitalization. HCQ intake was associated with cough. Compared with no glucocorticoids (GCs) group, high doses of GCs were accompanied with higher proportion of gastrointestinal symptoms and tachycardia, lower proportion of sore throat and ageusia. GCs didn't provoke the COVID-19 infection in patients with AID, but chronic use of oral GCs was significantly more common in those requiring hospitalization, and higher dose of GCs were correlated with higher risk of hospitalization. 97 patients discontinued csDMARDs after infection, which resulted in an elevated risk of hospitalization. Meanwhile, withdrawal of csDMARDs was associated with higher odds of disease flare and lower proportion of remission than maintenance groups. Collectively, our analysis provides the evidence that maintenance treatment of csDMARDs may be more prudent for AID patients during COVID-19 pandemic.
Collapse
Affiliation(s)
- Saisai Huang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Xiaolei Ma
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Juan Cao
- Department of Geriatrics, Nanjing Drum Hospital, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Mengru Du
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Zhiling Zhao
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Dandan Wang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Xue Xu
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Jun Liang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| | - Lingyun Sun
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University , 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China
| |
Collapse
|
|
7
|
Zhao X, Wu H, Li S, Gao C, Wang J, Ge L, Song Z, Ni B, You Y. The impact of the COVID-19 pandemic on SLE. Mod Rheumatol 2024; 34:247-264. [PMID: 36961736 DOI: 10.1093/mr/road030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/21/2023] [Accepted: 03/11/2023] [Indexed: 03/25/2023]
Abstract
Little is known about the association between coronavirus disease 2019 (COVID-19) and autoimmune diseases, especially in the case of systemic lupus erythematosus (SLE). SLE patients met with many questions during the pandemic in COVID-19, such as how to minimize risk of infection, the complex pathological features and cytokine profiles, diagnosis and treatment, rational choice of drugs and vaccine, good nursing, psychological supervision, and so on. In this study, we review and discuss the multifaceted effects of the COVID-19 pandemic on patients living with SLE using the available literature. Cross-talk in implicated inflammatory pathways/mechanisms exists between SLE and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and SARS-CoV-2 displays similar clinical characteristics and immuno-inflammatory responses to SLE. Current epidemiological data inadequately assess the risk and severity of COVID-19 infection in patients with SLE. More evidence has shown that hydroxychloroquine and chloroquine cannot prevent COVID-19. During the pandemic, patients with SLE had a higher rate of hospitalization. Vaccination helps to reduce the risk of infection. Several therapies for patients with SLE infected with COVID-19 are discussed. The cases in the study can provide meaningful information for clinical diagnosis and management. Our main aim is to help preventing infection and highlight treatment options for patients with SLE infected with COVID-19.
Collapse
Affiliation(s)
- Xingwang Zhao
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Haohao Wu
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shifei Li
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Cuie Gao
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Juan Wang
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Lan Ge
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhiqiang Song
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Bing Ni
- Department of Pathophysiology, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yi You
- Department of Dermatology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| |
Collapse
|
|
8
|
Hong X, Wang X, Dai N, Sun Y, Liu H, Cheng X, Ye J, Shi H, Hu Q, Meng J, Zhou Z, Yang C, Teng J, Su Y, Chi H. Characteristics of COVID-19 and Impact of Disease Activity in Patients with Adult-Onset Still's Disease. Rheumatol Ther 2024; 11:201-212. [PMID: 38183598 PMCID: PMC10796879 DOI: 10.1007/s40744-023-00632-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/11/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION This study aimed to characterize the morbidity, hospitalization, and mortality rates among patients with adult-onset Still's disease (AOSD) affected by coronavirus disease 2019 (COVID-19) and explore the impact of COVID-19 on the disease activity of AOSD. METHODS Data on the clinical and demographic characteristics, COVID-19-related symptoms, and outcomes were retrospectively collected. Patients were stratified according to COVID-19 severity and associations between risk factors and outcomes were analyzed using multivariate logistic regression. The disease activity of patients with AOSD flares after COVID-19 was described. RESULTS A total of 188 patients with AOSD were followed up, of whom 75.5% (n = 142) had a confirmed or highly suspected COVID-19. Patients on medium or high-dose oral glucocorticoids or Janus kinase (JAK) inhibitors were at increased risk of developing moderate to severe COVID-19. Six patients suffered flares of AOSD following COVID-19 in a short period; however, the relapse rate was not statistically increased compared with patients without COVID-19. CONCLUSION Patients with AOSD receiving medium or high-dose glucocorticoid therapy or JAK inhibitors had worse COVID-19 outcomes. Further work is needed to explore risk factors affecting COVID-19 outcomes and the impact of COVID-19 on disease activity in AOSD.
Collapse
Affiliation(s)
- Xinyue Hong
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Xiaoming Wang
- Department of General Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningqi Dai
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Yue Sun
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Honglei Liu
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Xiaobing Cheng
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Junna Ye
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Hui Shi
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Qiongyi Hu
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Jianfen Meng
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Zhuochao Zhou
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Chengde Yang
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Jialin Teng
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Yutong Su
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China
| | - Huihui Chi
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Second Road, Shanghai, 200025, China.
| |
Collapse
|
|
9
|
Been Sayeed SKJ, Moniruzzaman M, Kabir AKMH, Mallik MU, Chandra Mondal B, Mahmud S, Rahman FT, Rahman M, Rahman MM. Pattern and Predictors of Infection Among Patients With Rheumatological Disease on Immunosuppressive Medications: A Retrospective Study in a Tertiary Care Hospital in Bangladesh. Cureus 2024; 16:e52817. [PMID: 38406079 PMCID: PMC10883793 DOI: 10.7759/cureus.52817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Background Immunomodulatory therapy for chronic rheumatic disease carries a risk for infectious complications. In Bangladesh, there is limited information regarding patterns and factors associated with infections among patients receiving immunosuppressive medications. Objective The present study aimed to find out patterns and predictors associated with infection among patients who were on different immunosuppressive medications due to chronic rheumatological disease. Methodology This was a retrospective study; all confirmed cases of (new and old) different rheumatological diseases on disease-modifying agents attended at the rheumatology clinic of Dhaka Medical College Hospital from January 2019 to December 2021 were enrolled. Result Among 489 cases, 90 (18.4%) patients had documented infections. The most common rheumatological diseases were systemic lupus erythematosus (28, 31.1%), ankylosing spondylitis (26, 28.8%), and rheumatoid arthritis (20, 22.2%). COVID-19 (28, 31.1%) was the most commonly occurring infection followed by urinary tract infection (14, 15.6%), fungal infection (12, 13.3%), herpes zoster (10, 11.1%), pulmonary tuberculosis (TB) (eight, 8.8%), latent TB (seven, 7.7%), community-acquired pneumonia (six, 6.6%), and sepsis (three, 3.3%). Infection was most prevalent among patients who received steroids of more than 10 mg per day (17, 18.8%) than those less than 10 mg steroid per day (six, 6.7%), Factors associated with infections were (odds ratio, 95% CI, p-value) underweight (2.3, [1.3-2.7], 0.001), anemia (1.8, [1.1-5.7], 0.01), neutropenia (1.6, [1.1-2.9], <0.002), hypoalbuminemia (3.1, [1.6-4.9], 0.001), hypovitaminosis D (1.9, [1.3-4.5], 0.001), high blood sugar (1.5, [1.1-5.3], 0.02), inadequate counseling of steroid side effect (1.7, [1.1-3.9], 0.03), prednisolone >10mg/day (2.2, [1.19-4.10], 0.001). Conclusion COVID-19 pneumonia, urinary tract infections, fungal infection, tuberculosis, herpes zoster, and community-acquired pneumonia were commonly occurring infections among patients receiving different immunosuppressive medications. Factors like poor nutritional status, presence of anemia, leucopenia, hypoalbuminemia, hyperglycemia, and hypovitaminosis D had a significant association with infection. Moreover, inadequate counseling of steroid side effects and history of daily intake of prednisolone (>10mg/day) were also significant factors associated with infection.
Collapse
Affiliation(s)
| | - Md Moniruzzaman
- Medicine and Rheumatology, National Institute of Neurosciences and Hospital, Dhaka, BGD
| | | | | | - Bikas Chandra Mondal
- Respiratory Medicine, National Institute of Chest Diseases and Hospital, Dhaka, BGD
| | - Shahin Mahmud
- Rheumatology, National Institute of Neurosciences and Hospital, Dhaka, BGD
| | | | - Mehrin Rahman
- Medicine, Dhaka Medical College Hospital, Dhaka, BGD
| | | |
Collapse
|
|
10
|
Krishna N, K P S, G K R. Identifying diseases associated with Post-COVID syndrome through an integrated network biology approach. J Biomol Struct Dyn 2024; 42:652-671. [PMID: 36995291 DOI: 10.1080/07391102.2023.2195003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/17/2023] [Indexed: 03/31/2023]
Abstract
A growing body of research shows that COVID-19 is now recognized as a multi-organ disease with a wide range of manifestations that can have long-lasting repercussions, referred to as post-COVID-19 syndrome. It is unknown why the vast majority of COVID-19 patients develop post-COVID-19 syndrome, or why patients with pre-existing disorders are more likely to experience severe COVID-19. This study used an integrated network biology approach to obtain a comprehensive understanding of the relationship between COVID-19 and other disorders. The approach involved building a PPI network with COVID-19 genes and identifying highly interconnected regions. The molecular information contained within these subnetworks, as well as the pathway annotations, were used to reveal the link between COVID-19 and other disorders. Using Fisher's exact test and disease-specific gene information, significant COVID-19-disease associations were discovered. The study discovered diseases that affect multiple organs and organ systems, thus proving the theory of multiple organ damage caused by COVID-19. Cancers, neurological disorders, hepatic diseases, cardiac disorders, pulmonary diseases, and hypertensive diseases are just a few of the conditions linked to COVID-19. Pathway enrichment analysis of shared proteins revealed the shared molecular mechanism of COVID-19 and these diseases. The findings of the study shed new light on the major COVID-19-associated disease conditions and how their molecular mechanisms interact with COVID-19. The novelty of studying disease associations in the context of COVID-19 provides new insights into the management of rapidly evolving long-COVID and post-COVID syndromes, which have significant global implications.Communicated by Ramaswamy H. Sarma.
Collapse
Affiliation(s)
- Navami Krishna
- School of Biotechnology, National Institute of Technology Calicut, Calicut, Kerala, India
| | - Sijina K P
- School of Biotechnology, National Institute of Technology Calicut, Calicut, Kerala, India
| | - Rajanikant G K
- School of Biotechnology, National Institute of Technology Calicut, Calicut, Kerala, India
| |
Collapse
|
|
11
|
Perrot L, Boyer L, Flipo RM, Marotte H, Pertuiset E, Miceli C, Thomas T, Seror R, Chazerain P, Roux N, Richez C, Pham T. Factors associated with COVID-19 severity in patients with spondyloarthritis: Results of the French RMD COVID-19 cohort. Joint Bone Spine 2023; 90:105608. [PMID: 37414137 DOI: 10.1016/j.jbspin.2023.105608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/15/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES The objective of the current study was to evaluate the severity of COVID-19 and identify factors associated with severe disease outcomes in patients with spondyloarthritis (SpA), a chronic inflammatory rheumatic and musculoskeletal disease (RMD). METHODS We utilized patient data from the French national multicenter RMD COVID-19 cohort (NCT04353609). The primary outcome was to describe COVID-19 characteristics in patients with SpA based on disease severity of COVID-19 (mild, moderate or severe) with serious infection including moderate and severe cases. The secondary outcome was to identify the factors associated with serious COVID-19 classification. RESULTS Among the 626 patients with SpA (56% female, mean age 49±14 years) from the French RMD cohort, COVID-19 severity was mild in 508 (81%), moderate in 93 (15%), and severe in 25 (4%) patients. Clinical signs and symptoms of COVID-19 were reported in 587 (94%) patients, with the most frequent presented symptom of fever (63%) and cough (62%), followed by flu-like symptoms (53%), agueusia (39%), anosmia (37%), dyspnea (32%) and diarrhea (19.9%). COVID-19 severity was associated with corticosteroid therapy (OR=3.08 [95% CI: 1.44-6.58], P=0.004) and age (OR=1.06 [95% CI: 1.04-1.08], P<0.001) while use of tumor necrosis factor inhibitor (TNFi, OR=0.27 [95% CI: 0.09-0.78], P=0.01) was associated with less severe disease. We did not identify an association between NSAID use and COVID-19 severity. CONCLUSIONS In this study, the majority of patients with SpA had a favorable COVID-19 outcome. We confirmed age and corticosteroids therapy had a negative impact on disease outcomes while TNFi use was protective.
Collapse
Affiliation(s)
- Léa Perrot
- Department of Rheumatology, Aix-Marseille université, AP-HM, CHU de Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - Laurent Boyer
- School of Medicine, La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of life Center, Aix-Marseille université, Marseille, France
| | - René-Marc Flipo
- Department of Rheumatology, université de Lille, CHU de Lille, Lille, France
| | - Hubert Marotte
- Department of Rheumatology, Inserm U1059, université de Lyon, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - Edouard Pertuiset
- Department of Rheumatology, centre hospitalier René-Dubos, Pontoise, France
| | - Corinne Miceli
- Department of Rheumatology, Cochin Hospital, AP-HP, Paris University, Paris, France
| | - Thierry Thomas
- Department of Rheumatology, Inserm U1059, université de Lyon, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - Raphaele Seror
- Department of Rheumatology, CHU Le Kremlin-Bicêtre, AP-HP, Inserm UMR 1184, université Paris-Sud, Paris, France
| | - Pascal Chazerain
- Department of Rheumatology, groupe hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Nicolas Roux
- Department of Rheumatology, hôpital Robert-Schuman, Metz, France
| | - Christophe Richez
- Rheumatology Department, ImmunoConcEpt, CNRS, UMR 5164, University of Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Thao Pham
- Department of Rheumatology, Aix-Marseille université, AP-HM, CHU de Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
| |
Collapse
|
|
12
|
Yıldırım R, Oliveira T, Isenberg DA. Approach to vaccination in systemic lupus erythematosus on biological treatment. Ann Rheum Dis 2023; 82:1123-1129. [PMID: 37336639 DOI: 10.1136/ard-2023-224071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/20/2023] [Indexed: 06/21/2023]
Abstract
In recent years, treat-to-target strategy and early intervention strategies with immunosuppressive agents have attempted to improve the prognosis and outcome in patients with autoimmune inflammatory rheumatic diseases. However, infectious complications due to side effects of medication remain a major concern in routine practice. In this regard, vaccine immunity and vaccination programmes are of the utmost importance in patients with systemic lupus erythematosus (SLE) in terms of morbidity and mortality. Encouragingly, research investigations have increased exponentially, both in monitoring the vaccines efficacy, and in determining the immune response while patients are on immunosuppression., However, in this biological era in rheumatology, relatively little data have been published investigating these parameters in those receiving biological agents, therefore, no definitive consensus about a vaccination policy for patients with SLE is currently available. In this review, we aim to address what is established about vaccinating patients with SLE on biological agents and discuss potential problems.
Collapse
Affiliation(s)
- Reşit Yıldırım
- Rheumatology, Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Tatiana Oliveira
- Internal Medicine Unit, Department of Medicine, Hospital de Cascais, Cascais, Portugal
| | | |
Collapse
|
|
13
|
Chen Z, Wang W, Jue H, Hua Y. Bioinformatics and system biology approach to identify potential common pathogenesis for COVID-19 infection and osteoarthritis. Sci Rep 2023; 13:9330. [PMID: 37291167 PMCID: PMC10248985 DOI: 10.1038/s41598-023-32555-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/29/2023] [Indexed: 06/10/2023] Open
Abstract
A growing of evidence has showed that patients with osteoarthritis (OA) had a higher coronavirus 2019 (COVID-19) infection rate and a poorer prognosis after infected it. Additionally, scientists have also discovered that COVID-19 infection might cause pathological changes in the musculoskeletal system. However, its mechanism is still not fully elucidated. This study aims to further explore the sharing pathogenesis of patients with both OA and COVID-19 infection and find candidate drugs. Gene expression profiles of OA (GSE51588) and COVID-19 (GSE147507) were obtained from the Gene Expression Omnibus (GEO) database. The common differentially expressed genes (DEGs) for both OA and COVID-19 were identified and several hub genes were extracted from them. Then gene and pathway enrichment analysis of the DEGs were performed; protein-protein interaction (PPI) network, transcription factor (TF)-gene regulatory network, TF-miRNA regulatory network and gene-disease association network were constructed based on the DEGs and hub genes. Finally, we predicted several candidate molecular drugs related to hub genes using DSigDB database. The receiver operating characteristic curve (ROC) was applied to evaluate the accuracy of hub genes in the diagnosis of both OA and COVID-19. In total, 83 overlapping DEGs were identified and selected for subsequent analyses. CXCR4, EGR2, ENO1, FASN, GATA6, HIST1H3H, HIST1H4H, HIST1H4I, HIST1H4K, MTHFD2, PDK1, TUBA4A, TUBB1 and TUBB3 were screened out as hub genes, and some showed preferable values as diagnostic markers for both OA and COVID-19. Several candidate molecular drugs, which are related to the hug genes, were identified. These sharing pathways and hub genes may provide new ideas for further mechanistic studies and guide more individual-based effective treatments for OA patients with COVID-19 infection.
Collapse
Affiliation(s)
- Ziyi Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, No. 12, Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Wenjuan Wang
- Department of Sports Medicine, Huashan Hospital, Fudan University, No. 12, Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Hao Jue
- Department of Sports Medicine, Huashan Hospital, Fudan University, No. 12, Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, No. 12, Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China.
| |
Collapse
|
|
14
|
Chevalier K, Genin M, Jean TP, Avouac J, Flipo RM, Georgin-Lavialle S, El Mahou S, Pertuiset E, Pham T, Servettaz A, Marotte H, Domont F, Chazerain P, Devaux M, Mekinian A, Sellam J, Fautrel B, Rouzaud D, Ebstein E, Costedoat-Chalumeau N, Richez C, Hachulla E, Mariette X, Seror R. CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases. Front Med (Lausanne) 2023; 10:1152587. [PMID: 37035330 PMCID: PMC10075312 DOI: 10.3389/fmed.2023.1152587] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction 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. Materials and methods 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. Results 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)]. Conclusion 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.
Collapse
Affiliation(s)
- Kevin Chevalier
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Michaël Genin
- University of Lille, CHU Lille, ULR 2694–METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | | | | | | | | | | | | | - Thao Pham
- Hospital Sainte Marguerite, Rheumatology, Marseille, France
| | - Amelie Servettaz
- Hospital Robert Debré, Internal Medicine, Infectious Diseases and Clinical Immunology, Reims, France
| | - Hubert Marotte
- University Hospital of Saint-Étienne, Rheumatology, Saint-Priest-en-Jarez, France
| | - Fanny Domont
- University Hospitals Pitié Salpêtrière - Charles Foix, Internal Medicine and Clinical Immunology, Paris, France
| | - Pascal Chazerain
- Hopital de la Croix Saint-Simon, Rheumatology and Internal Medicine, Paris, France
| | - Mathilde Devaux
- Saint-Germain-en-Laye Intercommunal Hospital Center, Internal Medicine, Poissy, France
| | - Arsene Mekinian
- Hospital Saint-Antoine AP-HP, Internal Medicine, Paris, France
| | - Jérémie Sellam
- Hospital Saint-Antoine AP-HP, Rheumatology, Paris, France
| | - Bruno Fautrel
- Sorbonne Universite – APHP, Pitie Salpetriere Hospital, Department of Rheumatology, Pierre Louis Institute of Epidemiology and Public Health, INSERM UMRS 1136, Paris, France
| | - Diane Rouzaud
- Bichat-Claude Bernard Hospital, Internal Medicine, Paris, France
| | - Esther Ebstein
- Bichat-Claude Bernard Hospital, Rheumatology, Paris, France
| | | | | | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for Rare Systemic Autoimmune Diseases North and North-West of France (CeRAINO), CHU Lille, University of Lille, INSERM, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Raphaèle Seror
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| |
Collapse
|
|
15
|
Lee MH, Li HJ, Wasuwanich P, Kim SE, Kim JY, Jeong GH, Park S, Yang JW, Kim MS, Yon DK, Lee SW, Koyanagi A, Jacob L, Kim EY, Cheon JH, Shin JI, Smith L. COVID-19 susceptibility and clinical outcomes in inflammatory bowel disease: An updated systematic review and meta-analysis. Rev Med Virol 2023; 33:e2414. [PMID: 36504172 PMCID: PMC9877653 DOI: 10.1002/rmv.2414] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 11/08/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022]
Abstract
The susceptibility, risk factors, and prognosis of COVID-19 in patients with inflammatory bowel disease (IBD) remain unknown. Thus, our study aims to assess the prevalence and clinical outcomes of COVID-19 in IBD. We searched PubMed, EMBASE, and medRxiv from 2019 to 1 June 2022 for cohort and case-control studies comparing the prevalence and clinical outcomes of COVID-19 in patients with IBD and in the general population. We also compared the outcomes of patients receiving and not receiving 5-aminosalicylates (ASA), tumour necrosis factor antagonists, biologics, systemic corticosteroids, or immunomodulators for IBD. Thirty five studies were eligible for our analysis. Pooled odds ratio of COVID-19-related hospitalisation, intensive care unit (ICU) admission, or death in IBD compared to in non-IBD were 0.58 (95% confidence interval (CI) = 0.28-1.18), 1.09 (95% CI = 0.27-4.47), and 0.67 (95% CI = 0.32-1.42), respectively. Inflammatory bowel disease was not associated with increased hospitalisation, ICU admission, or death. Susceptibility to COVID-19 did not increase with any drugs for IBD. Hospitalisation, ICU admission, and death were more likely with 5-ASA and corticosteroid use. COVID-19-related hospitalisation (Odds Ratio (OR): 0.53; 95% CI = 0.38-0.74) and death (OR: 0.13; 95% CI = 0.13-0.70) were less likely with Crohn's disease than ulcerative colitis (UC). In conclusion, IBD does not increase the mortality and morbidity of COVID-19. However, physicians should be aware that additional monitoring is needed in UC patients or in patients taking 5-ASA or systemic corticosteroids.
Collapse
Affiliation(s)
- Min Ho Lee
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Han Jacob Li
- University of Florida College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Paul Wasuwanich
- University of Florida College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Sung Eun Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Yeob Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gwang Hun Jeong
- Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Seoyeon Park
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Won Yang
- Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Min Seo Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea.,Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,ICREA, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Eun-Young Kim
- Department of Health, Social and Clinical Pharmacy, Evidence-Based and Clinical Research Laboratory, College of Pharmacy, Chung-Ang University, Seoul, Korea
| | - Jae Hee Cheon
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
|
16
|
Vera-Lastra O, Ordinola Navarro A, Medina G, Cruz-Domínguez MP, Jara LJ. The effect of COVID-19 on patients with preexisting autoimmune diseases. AUTOIMMUNITY, COVID-19, POST-COVID19 SYNDROME AND COVID-19 VACCINATION 2023:495-528. [DOI: 10.1016/b978-0-443-18566-3.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
|
|
17
|
CENGİZ G, ŞAŞ S. Evaluation of COVID-19 clinical features and outcomes in individuals with rheumatic disease. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1097052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
features and course of coronavirus disease 2019 (COVID-19) in individuals with rheumatic disease.
Materials and Methods: This retrospective study was carried out at the Erciyes University rheumatology outpatient clinic from July 1 to August 1, 2021. The demographic and clinical data and summarized COVID-19 history, clinical course of COVID-19, fatigue, and pain levels of patients with rheumatic disease were obtained from our institutional electronic registration database and patient files.
Results: Recruited participants were 106 individuals (83% female, %17 male) with rheumatic disease who had been confirmed by laboratory tests to have COVID-19 and recovered from the COVID-19 infection. Their mean age and body mass index (BMI) were 48.69±11.5 years and 29.89±6.76 kg/m2, respectively. Additionally, 21 (19.8%) had been hospitalized, and five (4.7%) had been admitted to the intensive care unit. The most common rheumatic diseases were axial spondyloarthritis (40; 37.7%) and rheumatoid arthritis (26 cases; 24.5%). Patients who received conventional synthetic disease-modifying drugs (csDMARDs) reportedly experienced more pain, fatigue, and headaches than those in the biologic agent and non-steroidal anti-inflammatory drug (NSAID) groups.
Conclusion: Our study results reveal similar symptoms and hospitalization rates among patients with rheumatic disease who recovered from COVID-19 and received either csDMARDs, biologic agents, or NSAIDs. However, patients in the csDMARD group reported more pain, fatigue, and headache compared to the other groups.
Collapse
|
|
18
|
Kihara M, Sugihara T, Asano J, Sato M, Kaneko H, Muraoka S, Ohshima S, Nanki T. Clinical characteristics of COVID-19 patients with underlying rheumatic diseases in Japan: data from a multicenter observational study using the COVID-19 Global Rheumatology Alliance physician-reported registry. Clin Rheumatol 2022; 41:3661-3673. [PMID: 35974224 PMCID: PMC9380979 DOI: 10.1007/s10067-022-06305-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION To describe clinical characteristics of patients in Japan with coronavirus disease 19 (COVID-19) and pre-existing rheumatic disease and examine the possible risk factors associated with severe COVID-19. METHODS Adults with rheumatic disease and a COVID-19 diagnosis who were registered in the COVID-19 Global Rheumatology Alliance (C19-GRA) physician-reported registry from Japan between 15 May 2020 and 12 May 2021 were included. Multivariable logistic regression models were used to assess factors associated with severe COVID-19 progression, defined as death or requiring oxygen inhalation. RESULTS In total, 222 patients were included in the study. Rheumatoid arthritis (48.2%), gout (14.4%), and systemic lupus erythematosus (8.1%) were the most common types of rheumatic disease, 55.1% of patients were in remission and 66.2% had comorbid disease. Most patients were hospitalised (86.9%) for COVID-19, 43.3% received oxygen, and 9.0% died. Older age (≥ 65 years), corticosteroid use, comorbid diabetes, and lung diseases are associated with higher risk for severe COVID-19 progression (odds ratio (OR) 3.52 [95% confidence interval (CI) 1.69-7.33], OR 2.68 [95% CI 1.23-5.83], OR 3.56 [95% CI 1.42-8.88], and OR 2.59 [95% CI 1.10-6.09], respectively). CONCLUSIONS This study described clinical characteristics of COVID-19 patients with rheumatic diseases in Japan. Several possible risk factors for severe COVID-19 progression were suggested. Key points • Clinical characteristics of 222 adult patients in Japan with coronavirus disease 19 (COVID-19) and pre-existing rheumatic diseases were described. • Most patients were hospitalised (86.9%) for COVID-19 in Japan, 43.3% received oxygen, and 9.0% died. • The COVID-19 characteristics of patients with rheumatic diseases did not show any obvious different pattern from those of the general population in Japan. • In this study, older age (≥ 65 years), corticosteroid use, comorbid diabetes, and lung diseases are associated with higher risk for severe COVID-19 progression.
Collapse
Affiliation(s)
- Mari Kihara
- Department of Rheumatology, Tokyo Medical and Dental University, Tokyo, Japan.
- Pharmaceuticals and Medical Devices Agency, Office of Pharmacovigilance II, Tokyo, Japan.
| | - Takahiko Sugihara
- Graduate School of Medical and Dental Science, Department of Lifetime Clinical Immunology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichi Asano
- Pharmaceuticals and Medical Devices Agency, Office of New Drug IV, Tokyo, Japan
- Graduate School of Medical and Dental Sciences, Department of Clinical Biostatistics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Midori Sato
- Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Centre, Tokyo, Japan
| | - Hiroshi Kaneko
- Division of Rheumatic Disease, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Sei Muraoka
- Department of Internal Medicine, Ebara Hospital, Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, Japan
| | - Shiro Ohshima
- Department of Clinical Research, National Hospital Organization Osaka Minami Medical Centre, Kawachinagano, Japan
| | - Toshihiro Nanki
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan
| |
Collapse
|
|
19
|
Mekky RY, Elemam NM, Eltahtawy O, Zeinelabdeen Y, Youness RA. Evaluating Risk: Benefit Ratio of Fat-Soluble Vitamin Supplementation to SARS-CoV-2-Infected Autoimmune and Cancer Patients: Do Vitamin-Drug Interactions Exist? Life (Basel) 2022; 12:1654. [PMID: 36295089 PMCID: PMC9604733 DOI: 10.3390/life12101654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
COVID-19 is a recent pandemic that mandated the scientific society to provide effective evidence-based therapeutic approaches for the prevention and treatment for such a global threat, especially to those patients who hold a higher risk of infection and complications, such as patients with autoimmune diseases and cancer. Recent research has examined the role of various fat-soluble vitamins (vitamins A, D, E, and K) in reducing the severity of COVID-19 infection. Studies showed that deficiency in fat-soluble vitamins abrogates the immune system, thus rendering individuals more susceptible to COVID-19 infection. Moreover, another line of evidence showed that supplementation of fat-soluble vitamins during the course of infection enhances the viral clearance episode by promoting an adequate immune response. However, more thorough research is needed to define the adequate use of vitamin supplements in cancer and autoimmune patients infected with COVID-19. Moreover, it is crucial to highlight the vitamin-drug interactions of the COVID-19 therapeutic modalities and fat-soluble vitamins. With an emphasis on cancer and autoimmune patients, the current review aims to clarify the role of fat-soluble vitamins in SARS-CoV-2 infection and to estimate the risk-to-benefit ratio of a fat-soluble supplement administered to patients taking FDA-approved COVID-19 medications such as antivirals, anti-inflammatory, receptor blockers, and monoclonal antibodies.
Collapse
Affiliation(s)
- Radwa Y. Mekky
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA University), Cairo 12622, Egypt
| | - Noha M. Elemam
- Sharjah Institute for Medical Research (SIMR), College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Omar Eltahtawy
- Molecular Genetics Research Team (MGRT), Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo 12622, Egypt
| | - Yousra Zeinelabdeen
- Molecular Genetics Research Team (MGRT), Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo 12622, Egypt
- Faculty of Medical Sciences, University Medical Center Groningen (UMCG), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Rana A. Youness
- Molecular Genetics Research Team (MGRT), Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo 12622, Egypt
- Biology and Biochemistry Department, School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, Cairo 12622, Egypt
| |
Collapse
|
|
20
|
Yan D, Kolla AM, Young T, Fried L, Shankar S, Rangel L, Yin L, Castillo R, Steuer A, Svigos K, Izmirly P, Sekar V, Lesser R, Solomon G, Blank RB, Haberman RH, Neimann AL, Scher JU. COVID-19 outcomes in patients with psoriasis and psoriatic arthritis: A prospective cohort study. JAAD Int 2022; 8:31-33. [PMID: 35373153 PMCID: PMC8958163 DOI: 10.1016/j.jdin.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Di Yan
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Avani M. Kolla
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Trevor Young
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Lauren Fried
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Shruthi Shankar
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Lauren Rangel
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Lu Yin
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Rochelle Castillo
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Alexa Steuer
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Katerina Svigos
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Peter Izmirly
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Vaish Sekar
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Robert Lesser
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Gary Solomon
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Rebecca B. Blank
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Rebecca H. Haberman
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Andrea L. Neimann
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Jose U. Scher
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| |
Collapse
|
|
21
|
Simon D, Tascilar K, Fagni F, Kleyer A, Krönke G, Meder C, Dietrich P, Orlemann T, Mößner J, Taubmann J, Mutlu MY, Knitza J, Kemenes S, Liphardt AM, Schönau V, Bohr D, Schuster L, Hartmann F, Minopoulou I, Leppkes M, Ramming A, Pachowsky M, Schuch F, Ronneberger M, Kleinert S, Hueber AJ, Manger K, Manger B, Atreya R, Berking C, Sticherling M, Neurath MF, Schett G. Intensity and longevity of SARS-CoV-2 vaccination response in patients with immune-mediated inflammatory disease: a prospective cohort study. THE LANCET RHEUMATOLOGY 2022; 4:e614-e625. [PMID: 35966645 PMCID: PMC9363042 DOI: 10.1016/s2665-9913(22)00191-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Concerns have been raised about the reduced immunogenicity of vaccines against SARS-CoV-2 in patients with immune-mediated inflammatory diseases and the higher risk of breakthrough infections. The objective of our study was to investigate the intensity and longevity of SARS-CoV-2 vaccination responses in patients with immune-mediated inflammatory diseases, and to assess the effects of diagnosis, treatment, and adapted vaccination schedules. Methods SARS-CoV-2 IgG antibody response after SARS-CoV-2 vaccination was measured over time in a large prospective cohort of healthy controls and participants with immune-mediated inflammatory diseases (attending or admitted to affiliated centres) between Dec 15, 2020, and Dec 1, 2021. Cohort participants with immune-mediated inflammatory diseases and control participants with no diagnosis of immune-mediated inflammatory diseases, were eligible for this analysis. Demographic data and disease-specific data were collected using a questionnaire. Humoral response was compared across treatment and disease groups, and with respect to the receipt of additional vaccinations. SARS-CoV-2 antibody response was measured by ELISA using optical density ratio units and modelled over time with age and sex adjustment using mixed-effects models. Using these models, marginal mean antibody titres and marginal risks of a poor response (optical density ratio <1·1) were calculated for each week starting from week 8 after the first vaccination to week 40. Findings Among 5076 individuals registered, 2535 participants with immune-mediated inflammatory diseases (mean age 55·0 [15·2] years; 1494 [58·9%] women and 1041 [41·1%] men) and 1198 healthy controls (mean age 40·7 [13·5] years; 554 [46·2%] women and 644 [53·8%] men) were included in this analysis. Mean antibody titres were higher in healthy controls compared with people with immune-mediated inflammatory diseases at all timepoints, with a peak antibody response in healthy controls (mean optical density ratio 12·48; 95% CI 11·50–13·53) of more than twice that in participants with immune-mediated inflammatory diseases (5·50; 5·23–5·77; mean difference 6·98; 5·92–8·04). A poor response to vaccination was observed in participants with immune-mediated inflammatory diseases who were taking B-cell inhibitors (peak mean difference from healthy controls 11·68; 10·07–13·29) and T-cell inhibitors (peakmean difference from healthy controls 10·43; 8·33–12·53). Mean differences in antibody responses between different immune-mediated inflammatory diseases were small. Participants with immune-mediated inflammatory diseases who were given a third vaccine dose had higher mean antibody titres than did healthy controls vaccinated with two vaccine doses at 40 weeks after the initial vaccination (mean difference 1·34; 0·01–2·69). Interpretation People with immune-mediated inflammatory diseases show a lower and less durable SARS-CoV-2 vaccination response and are at risk of losing humoral immune protection. Adjusted vaccination schedules with earlier booster doses or more frequent re-doses, or both, could better protect people with immune-mediated inflammatory diseases. Funding Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, European Research Council, Innovative Medicine Initiative, Friedrich-Alexander-Universität Erlangen-Nürnberg, Else Kröner-Memorial Foundation.
Collapse
|
|
22
|
Bournia VK, Fragoulis GE, Mitrou P, Mathioudakis K, Tsolakidis A, Konstantonis G, Tseti I, Vourli G, Tektonidou MG, Paraskevis D, Sfikakis PP. Different COVID-19 outcomes among systemic rheumatic diseases: a nation-wide cohort study. Rheumatology (Oxford) 2022; 62:1047-1056. [PMID: 35920774 PMCID: PMC9384656 DOI: 10.1093/rheumatology/keac422] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 07/02/2022] [Accepted: 07/13/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To investigate coronavirus disease 2019 (COVID-19)-associated risk of hospitalization and death in RA, AS, PsA, SLE and SSc in comparison with the general population during the first year of the pandemic, and compare their overall mortality with 2019. METHODS Interlinking nationwide electronic registries, we recorded confirmed COVID-19-associated infections, hospitalizations and deaths, and all-cause deaths between 1 March 2020 and 28 February 2021 in all adults with RA, AS, PsA, SLE and SSc under treatment (n = 74 970, median age 67.5, 51.2, 58.1, 56.2 and 62.2 years, respectively) and in random comparators from the general population matched (1:5) on age, sex and region of domicile. Deaths from all causes during 2019 were also recorded. RESULTS Compared with the general population, incidence rates (IR) for COVID-19-associated hospitalization were higher in RA [IR ratio (IRR) 1.71(1.50-1.95)], SLE [2.0 (1.4-2.7)] and SSc [2.28 (1.29-3.90)], while COVID-19-associated death rates were higher in RA [1.91 (1.46-2.49)]. When focusing only on severe acute respiratory syndrome coronavirus 2-infected subjects, after adjusting for age and gender, the odds ratio for COVID-19 associated death was higher in RA [1.47 (1.11-1.94)] and SSc [2.92 (1.07-7.99)] compared with the general population. The all-cause mortality rate compared with the general population increased in RA during the first year of the pandemic (IRR 0.71) with reference to 2019 (0.59), and decreased in SSc (IRR 1.94 vs 4.36). CONCLUSION COVID-19 may have a more severe impact in patients with systemic rheumatic disease than in the general population. COVID-19-related mortality is increased in subgroups of patients with specific rheumatic diseases, underscoring the need for priority vaccination and access to targeted treatments.
Collapse
Affiliation(s)
| | - George E Fragoulis
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School
| | | | | | | | - George Konstantonis
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School
| | | | - Georgia Vourli
- Department of Hygiene Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria G Tektonidou
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School
| | - Dimitrios Paraskevis
- Department of Hygiene Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- Correspondence to: Petros P. Sfikakis, National and Kapodistrian University of Athens, Medical School, Laikon Hospital, 17 AgiouThoma str., 11 527 Athens, Greece. E-mail:
| |
Collapse
|
|
23
|
Patil A, Chanakya K, Shenoy P, Chandrashekara S, Haridas V, Kumar S, Daware M, Janardana R, Pinto B, Subramanian R, Nagaraj S, Singh YP, Singhai S, Jois R, Jain V, Srinivasa C, Dharmanand BG, Dharmapalaiah C, Sangeetha KN, Rao VK, Shobha V. A prospective longitudinal study evaluating the influence of immunosuppressives and other factors on COVID-19 in autoimmune rheumatic diseases. BMC Rheumatol 2022; 6:32. [PMID: 35698182 PMCID: PMC9192133 DOI: 10.1186/s41927-022-00264-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 03/16/2022] [Indexed: 12/15/2022] Open
Abstract
Background We conducted this study to identify the influence of prolonged use of hydroxychloroquine (HCQ), glucocorticoids and other immunosuppressants (IS) on occurrence and outcome of COVID-19 in patients with autoimmune rheumatic diseases (AIRDs).
Methods This was a prospective, multicenter, non-interventional longitudinal study across 15 specialist rheumatology centers. Consecutive AIRD patients on treatment with immunosuppressants were recruited and followed up longitudinally to assess parameters contributing to development of COVID-19 and its outcome. Results COVID-19 occurred in 314 (3.45%) of 9212 AIRD patients during a median follow up of 177 (IQR 129, 219) days. Long term HCQ use had no major impact on the occurrence or the outcome of COVID-19. Glucocorticoids in moderate dose (7.5–20 mg/day) conferred higher risk (RR = 1.72) of infection. Among the IS, Mycophenolate mofetil (MMF), Cyclophosphamide (CYC) and Rituximab (RTX) use was higher in patients with COVID 19. However, the conventional risk factors such as male sex (RR = 1.51), coexistent diabetes mellitus (RR = 1.64), pre-existing lung disease (RR = 2.01) and smoking (RR = 3.32) were the major contributing risk factors for COVID-19. Thirteen patients (4.14%) died, the strongest risk factor being pre-existing lung disease (RR = 6.36, p = 0.01). Incidence (17.5 vs 5.3 per 1 lakh (Karnataka) and 25.3 vs 7.9 per 1 lakh (Kerala)) and case fatality (4.1% vs 1.3% (Karnataka) and 4.3% vs 0.4% (Kerala)) rate of COVID-19 was significantly higher (p < 0.001) compared to the general population of the corresponding geographic region. Conclusions Immunosuppressants have a differential impact on the risk of COVID-19 occurrence in AIRD patients. Older age, males, smokers, hypertensive, diabetic and underlying lung disease contributed to higher risk. The incidence rate and the case fatality rate in AIRD patients is much higher than that in the general population.
Supplementary Information The online version contains supplementary material available at 10.1186/s41927-022-00264-0.
Collapse
Affiliation(s)
| | - K Chanakya
- Department of Clinical Immunology and Rheumatology, St. John's Medical College Hospital, Sarjapur Road, Bengaluru, 560034, India
| | | | | | | | | | | | - Ramya Janardana
- Department of Clinical Immunology and Rheumatology, St. John's Medical College Hospital, Sarjapur Road, Bengaluru, 560034, India
| | - Benzeeta Pinto
- Department of Clinical Immunology and Rheumatology, St. John's Medical College Hospital, Sarjapur Road, Bengaluru, 560034, India
| | | | | | | | | | | | | | | | | | | | | | | | - Vineeta Shobha
- Department of Clinical Immunology and Rheumatology, St. John's Medical College Hospital, Sarjapur Road, Bengaluru, 560034, India.
| |
Collapse
|
|
24
|
Cruz-Machado AR, Barreira SC, Bandeira M, Veldhoen M, Gomes A, Serrano M, Duarte C, Rato M, Miguel Fernandes B, Garcia S, Pinheiro F, Bernardes M, Madeira N, Miguel C, Torres R, Bento Silva A, Pestana J, Almeida D, Mazeda C, Cunha Santos F, Pinto P, Sousa M, Parente H, Sequeira G, Santos MJ, Fonseca JE, Romão VC. Risk Factors for Infection, Predictors of Severe Disease, and Antibody Response to COVID-19 in Patients With Inflammatory Rheumatic Diseases in Portugal-A Multicenter, Nationwide Study. Front Med (Lausanne) 2022; 9:901817. [PMID: 35770002 PMCID: PMC9234392 DOI: 10.3389/fmed.2022.901817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To identify risk factors for SARS-CoV-2 infection and for severe/critical COVID-19, and to assess the humoral response after COVID-19 in these patients. Methods Nationwide study of adult patients with inflammatory RMDs prospectively followed in the Rheumatic Diseases Portuguese Register-Reuma.pt-during the first 6 months of the pandemic. We compared patients with COVID-19 with those who did not develop the disease and patients with mild/moderate disease with those exhibiting severe/critical COVID-19. IgG antibodies against SARS-CoV-2 were measured ≥3 months after infection and results were compared with matched controls. Results 162 cases of COVID-19 were registered in a total of 6,363 appointments. Patients treated with TNF inhibitors (TNFi; OR = 0.160, 95% CI 0.099-0.260, P < 0.001) and tocilizumab (OR 0.147, 95% CI 0.053-0.408, P < 0.001) had reduced odds of infection. Further, TNFi tended to be protective of severe and critical disease. Older age, major comorbidities, and rituximab were associated with an increased risk of infection and worse prognosis. Most patients with inflammatory RMDs (86.2%) developed a robust antibody response. Seroconversion was associated with symptomatic disease (OR 13.46, 95% CI 2.21-81.85, P = 0.005) and tended to be blunted by TNFi (OR 0.17, 95% CI 0.03-1.05; P = 0.057). Conclusions TNFi and tocilizumab reduced the risk of infection by SARS-CoV-2. Treatment with TNFi also tended to reduce rates of severe disease and seroconversion. Older age, general comorbidities and rituximab were associated with increased risk for infection and worse prognosis, in line with previous reports. Most patients with RMDs developed a proper antibody response after COVID-19, particularly if they had symptomatic disease.
Collapse
Affiliation(s)
- Ana Rita Cruz-Machado
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sofia C. Barreira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Matilde Bandeira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marc Veldhoen
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Andreia Gomes
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marta Serrano
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Catarina Duarte
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Maria Rato
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Bruno Miguel Fernandes
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Salomé Garcia
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Filipe Pinheiro
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Miguel Bernardes
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Nathalie Madeira
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Cláudia Miguel
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Rita Torres
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Ana Bento Silva
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Jorge Pestana
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Diogo Almeida
- Rheumatology Department, Hospital de Braga, Braga, Portugal
| | - Carolina Mazeda
- Rheumatology Department, Centro Hospitalar do Baixo Vouga and iBiMED, Institute for Biomedicine, University of Aveiro, Aveiro, Portugal
| | | | - Patrícia Pinto
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marlene Sousa
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Hugo Parente
- Rheumatology Department, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Graça Sequeira
- Rheumatology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | | | - João Eurico Fonseca
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Vasco C. Romão
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| |
Collapse
|
|
25
|
Esalatmanesh K, Azadbakht J, Hajialilo M, Soroush M, Esalatmanesh R, Soleimani Z, Khabbazi A. Clinical course, chest computed tomography severity score and outcome of coronavirus disease 2019 (COVID-19) in patients with rheumatic diseases. THE EGYPTIAN RHEUMATOLOGIST 2022; 44:245-250. [PMID: 37521094 PMCID: PMC8730740 DOI: 10.1016/j.ejr.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 12/31/2021] [Indexed: 12/21/2022]
Abstract
Aim of the work To assess the clinical manifestations, imaging findings and outcomes of corona virus disease 2019 (COVID-19) in patients with rheumatic diseases. Patients and methods In a three-center study, patients with rheumatic diseases who developed COVID-19 were included. Patients were classified into two groups, i) inflammatory arthritis including rheumatoid arthritis (RA), spondyloarthritis (SpA) and undifferentiated arthritis, ii) connective tissue diseases (CTDs) including systemic lupus erythematosus (SLE), vasculitis and others. COVID-19 outcomes were assessed based on chest computed tomography severity score (CT-ss), the level of care, the number of patients who died and flare of underlying rheumatic disease. Results One hundred ninety-six patients with a mean age of 47.9 ± 15.1 years, 73.5% female, were included. Underlying rheumatic diseases were RA (57.7%), SLE and other CTDs (17.9%), SpA (11.2%), vasculitis (11.2%) and undifferentiated arthritis (2%). Myalgia, malaise and fever were the most common clinical manifestations of COVID-19. Pneumonia on computerized tomography (CT), hospitalization, admission in intensive care unit and need to mechanical ventilation were observed in 75.5, 37.2%, 10.7% and 6.6% of patients, respectively. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, diabetes and underlying pulmonary disease were predictors of moderate to severe pneumonia and hospitalization. Fifteen (7.6%) patients died. Flare of underlying rheumatic disease occurred in 16.3% of patients. Flare of disease in patients with CTDs was significantly more than other rheumatic diseases. Conclusions In rheumatic patients, treatment with NSAIDs or prednisolone, diabetes and pulmonary disease are risk factors of moderate to high CT-ss and hospitalization during COVID-19.
Collapse
Affiliation(s)
- Kamal Esalatmanesh
- Department of Rheumatology, Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Javid Azadbakht
- Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehrzad Hajialilo
- Department of Rheumatology, Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, University Street, Tabriz, Iran
| | - Mohsen Soroush
- Rheumatology Section, Department of Internal Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Roozbeh Esalatmanesh
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Soleimani
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Khabbazi
- Department of Rheumatology, Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, University Street, Tabriz, Iran
| |
Collapse
|
|
26
|
Napuri NI, Curcio D, Swerdlow DL, Srivastava A. Immune Response to COVID-19 and mRNA Vaccination in Immunocompromised Individuals: A Narrative Review. Infect Dis Ther 2022; 11:1391-1414. [PMID: 35614299 PMCID: PMC9132351 DOI: 10.1007/s40121-022-00648-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/21/2022] [Indexed: 01/04/2023] Open
Abstract
Immunocompromised individuals are at high risk of poor coronavirus disease 2019 (COVID-19) outcomes and demonstrate a lower immune response to COVID-19 vaccines, including to the novel mRNA vaccines that have been shown to elicit high neutralizing antibody levels. This review synthesized available data on the immune response to COVID-19 and critically assessed mRNA COVID-19 vaccine immunogenicity in this vulnerable subpopulation. Patients with various immunocompromising conditions exhibit diverse responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 severity and mortality, and available vaccines elicit lower immune responses, particularly in solid organ transplant recipients. Strategies to improve vaccine responses in immunocompromised individuals are being implemented in vaccine recommendations, including the use of a third and fourth vaccine dose beyond the two-dose series. Additional doses may enhance vaccine effectiveness and help provide broad coverage against emerging SARS-CoV-2 variants. Continued investigation of vaccines and dosing regimens will help refine approaches to help protect this vulnerable subpopulation from COVID-19.
Collapse
Affiliation(s)
| | | | | | - Amit Srivastava
- Vaccines, Medical Development, Scientific and Clinical Affairs, Pfizer Inc, 300 Technology Square, 3rd Floor, Cambridge, MA, 02139, USA.
| |
Collapse
|
|
27
|
Gomides APM, de Albuquerque CP, da Mota LMH, Devidé G, Dias LH, Duarte ALBP, Giovelli RA, Karnopp TE, de Lima HD, Marinho A, de Oliveira MS, Omura F, Ranzolin A, Resende G, Ribeiro FM, Ribeiro SLE, de Carvalho Sacilotto N, Dos Santos WG, Shinjo SK, de Sousa Studart SA, Teixeira FPS, Yazbek MA, Ferreira GA, Monticielo OA, Paiva E, Pileggi GCS, Dos Reis-Neto ET, de Medeiros Pinheiro M, Marques CDL. Factors associated with hospitalizations for Covid-19 in patients with rheumatoid arthritis: data from the Reumacov Brazil registry. Adv Rheumatol 2022; 62:13. [PMID: 35505408 PMCID: PMC9062867 DOI: 10.1186/s42358-022-00244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Patients using immunosuppressive drugs may have unfavorable results after infections. However, there is a lack of information regarding COVID-19 in these patients, especially in patients with rheumatoid arthritis (RA). Therefore, the aim of this study was to evaluate the risk factors associated with COVID-19 hospitalizations in patients with RA. Methods This multicenter, prospective cohort study is within the ReumaCoV Brazil registry and included 489 patients with RA. In this context, 269 patients who tested positive for COVID-19 were compared to 220 patients who tested negative for COVID-19 (control group). All patient data were collected from the Research Electronic Data Capture database. Results The participants were predominantly female (90.6%) with a mean age of 53 ± 12 years. Of the patients with COVID-19, 54 (20.1%) required hospitalization. After multiple adjustments, the final regression model showed that heart disease (OR = 4.61, 95% CI 1.06–20.02. P < 0.001) and current use of glucocorticoids (OR = 20.66, 95% CI 3.09–138. P < 0.002) were the risk factors associated with hospitalization. In addition, anosmia was associated with a lower chance of hospitalization (OR = 0.26; 95% CI 0.10–0.67, P < 0.005). Conclusion Our results demonstrated that heart disease and the use of glucocorticoids were associated with a higher number of hospital admissions for COVID-19 in patients with RA. Trial registration: Brazilian Registry of Clinical Trials - RBR-33YTQC. Supplementary Information The online version contains supplementary material available at 10.1186/s42358-022-00244-5.
Collapse
Affiliation(s)
| | | | | | - Guilherme Devidé
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | - Laiza Hombre Dias
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | | | - Raquel Altoé Giovelli
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | - Thais Evelyn Karnopp
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | - Hugo Deleon de Lima
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | - Adriana Marinho
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | | | - Felipe Omura
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | - Aline Ranzolin
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | - Gustavo Resende
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | | | | | | | | | - Samuel Katsuyuki Shinjo
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | | | | | - Michel Alexandre Yazbek
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | | | - Odirlei A Monticielo
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | - Eduardo Paiva
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | | | | | | | - Claudia D L Marques
- Faculdade de Ciências da Educação e Saúde, Centro Universitário de Brasília, Brasília, Brazil
| | | |
Collapse
|
|
28
|
Pehlivan Ö, Aydin T. Clinical outcomes of patients with COVID-19 and inflammatory rheumatic diseases receiving biological/targeted therapy. Ann Saudi Med 2022; 42:155-164. [PMID: 35658585 PMCID: PMC9167456 DOI: 10.5144/0256-4947.2022.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Anti-cytokine treatments are used in the treatment of severe COVID-19. Other studies have shown statistical significance with TNF inhibitors but not with other biological/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD). OBJECTIVES Compare the rate of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection and the course and incidence of COVID-19 infection in patients who received b/tsDMARD with control patients. DESIGN Analytical cross-sectional SETTINGS: Tertiary care hospital PATIENTS AND METHODS: All patients who applied to the rheumatology outpatient clinic between June 2020-March 2021 and received b/tsDMARD were included in the study. All patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis who applied to the rheumatology outpatient clinic in the three months before March 2021 and did not receive b/tsDMARD were included as the control group. History of COVID-19 infection and treatments were recorded. Multivariate analysis was performed to assess factors associated with use of tumor necrosis factor (TNF) inhibitors and differences between specific biologic drugs. MAIN OUTCOME MEASURES Rate of COVID-19 disease among patients using biological/targeted synthetic therapy and non-biological/targeted synthetic therapy. COVID-19 clinical outcomes (hospitalization, intensive care admission, mechanical ventilation and death). SAMPLE SIZE 533 in total; 341 received b/tsDMARD, 212 in the control group that did not receive b/tsDMARD. RESULTS One hundred patients (18%) had been infected with SARS-COV-2. The difference in SARS-COV-2 infection between b/tsDMARD and the control was statistically significant (13, 2% vs. 25, 9%, respectively) (P<.001). The hospital stays were longer in the controls (P<.001). Multinomial regression analysis revealed that COVID-19 negative patients were more likely to use tumor necrosis factor (TNF) inhibitors (OR: 2, 911; 95% CI: 1.727-4.908; P<.001) compared to COVID-19 positive participants. Multinomial logistic regression analysis indicated that hospitalized patients were more likely to use TNF inhibitors (OR: 11, 006; 95% CI: 3.447-35.138; P<.001) and there was no significant difference between b/tsDMARDs other than TNF inhibitors in frequency of hospitalization. CONCLUSIONS Patients who were medicated with b/tsDMARD were less likely to be infected with COVID-19 and be hospitalized due to the infection. We have found that this effect was particularly dependent on the use of TNF inhibitors. LIMITATIONS Conducted in a single center and unable to provide a homogeneous study population. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Özlem Pehlivan
- From the Department of Rheumatology, Umraniye Training and Research Hospital, Umraniye, Istanbul, Turkey
| | - Tutku Aydin
- From the Department of Internal Medicine, Umraniye Training and Research Hospital, Umraniye, Istanbul, Turkey
| |
Collapse
|
|
29
|
Simon D, Tascilar K, Kleyer A, Fagni F, Krönke G, Meder C, Dietrich P, Orlemann T, Kliem T, Mößner J, Liphardt A, Schönau V, Bohr D, Schuster L, Hartmann F, Leppkes M, Ramming A, Pachowsky M, Schuch F, Ronneberger M, Kleinert S, Hueber AJ, Manger K, Manger B, Atreya R, Berking C, Sticherling M, Neurath MF, Schett G. Impact of Cytokine Inhibitor Therapy on the Prevalence, Seroconversion Rate, and Longevity of the Humoral Immune Response Against SARS-CoV-2 in an Unvaccinated Cohort. Arthritis Rheumatol 2022; 74:783-790. [PMID: 34951137 PMCID: PMC9011429 DOI: 10.1002/art.42035] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the impact of biologic disease-modifying antirheumatic drug (bDMARD) treatment on the prevalence, seroconversion rate, and longevity of the humoral immune response against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs). METHODS Anti-SARS-CoV-2 IgG antibodies were measured in a prospective cohort of health care professional controls and non-health care controls and IMID patients receiving no treatment or receiving treatment with conventional or biologic DMARDs during the first and second COVID-19 waves. Regression models adjusting for age, sex, sampling time, and exposure risk behavior were used to calculate relative risks (RRs) of seropositivity. Seroconversion rates were assessed in participants with polymerase chain reaction (PCR)-positive SARS-CoV-2 infection. Antibody response longevity was evaluated by reassessing participants who tested positive during the first wave. RESULTS In this study, 4,508 participants (2,869 IMID patients and 1,639 controls) were analyzed. The unadjusted RR (0.44 [95% confidence interval (95% CI) 0.31-0.62]) and adjusted RR (0.50 [95% CI 0.34-0.73]) for SARS-CoV-2 IgG antibodies were significantly lower in IMID patients treated with bDMARDs compared to non-health care controls (P < 0.001), primarily driven by treatment with tumor necrosis factor inhibitors, interleukin-17 (IL-17) inhibitors, and IL-23 inhibitors. Adjusted RRs for untreated IMID patients (1.12 [95% CI 0.75-1.67]) and IMID patients receiving conventional synthetic DMARDs (0.70 [95% CI 0.45-1.08]) were not significantly different from non-health care controls. Lack of seroconversion in PCR-positive participants was more common among bDMARD-treated patients (38.7%) than in non-health care controls (16%). Overall, 44% of positive participants lost SARS-CoV-2 antibodies by follow-up, with higher rates in IMID patients treated with bDMARDs (RR 2.86 [95% CI 1.43-5.74]). CONCLUSION IMID patients treated with bDMARDs have a lower prevalence of SARS-CoV-2 antibodies, seroconvert less frequently after SARS-CoV-2 infection, and may exhibit a reduced longevity of their humoral immune response.
Collapse
Affiliation(s)
- David Simon
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Koray Tascilar
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Arnd Kleyer
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Filippo Fagni
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Gerhard Krönke
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Christine Meder
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Peter Dietrich
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Till Orlemann
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Thorsten Kliem
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Johanna Mößner
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Anna‐Maria Liphardt
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Verena Schönau
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Daniela Bohr
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Louis Schuster
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Fabian Hartmann
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Moritz Leppkes
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Andreas Ramming
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Milena Pachowsky
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | | | | | | | - Axel J. Hueber
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany, and Rheumatology SectionSozialstiftung Bamberg, BambergGermany
| | | | - Bernhard Manger
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Raja Atreya
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Carola Berking
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Michael Sticherling
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Markus F. Neurath
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| | - Georg Schett
- Friedrich‐Alexander University Erlangen‐Nuremberg and Universitätsklinikum ErlangenErlangenGermany
| |
Collapse
|
|
30
|
Nuñez DF, Leon L, Garcia AM, Arce JIC, Mucientes A, Gutierrez-Fernandez B, Rodriguez L, Cristóbal IPS, Álvarez P, Prada CM, Abasolo L. Mortality related to COVID-19 in patients with rheumatic and musculoskeletal diseases, first wave of the outbreak: a single-center study. Ther Adv Musculoskelet Dis 2022; 14:1759720X221090296. [PMID: 35510167 PMCID: PMC9058342 DOI: 10.1177/1759720x221090296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/10/2022] [Indexed: 01/08/2023] Open
Abstract
Objectives The aim of this study was to assess the cause-specific mortality rate related to COVID-19 (CMR) in patients with rheumatic and musculoskeletal diseases (RMDs) and COVID-19 and to analyze the role of the different RMDs in their mortality risk. Methods An observational longitudinal study was conducted during the first pandemic wave in our center. Patients with the diagnosis of RMDs and COVID-19 were included. Main outcome is the death related to COVID-19. Independent variable - type of RMDs: autoimmune rheumatic diseases (ARD), such as chronic inflammatory arthritis (CIA) and connective tissue diseases (CTD) and non-autoimmune Rheumatic Diseases (non-ARD). Survival techniques were used to estimate the CMR per 1000 patients-month with a 95% confidence interval (CI), and Cox multivariate regression analysis was run to examine the effect of ARD compared to non-ARD on mortality risk adjusted by confounders. Results were expressed by Hazard Ratio (HR) and CI. Results Overall, 405 patients were included (642.5 patients-month). During the study period, 44 (10.86%) deaths were recorded. CMR was 68.48 (50.96-92.01). After adjusting for confounders, HR of mortality in ARD compared to non-ARD did not achieve statistical significance [HR: 1.15 (0.64-2.07)], neither CTD versus CIA nor CTD versus non-ARD. Age and certain comorbidities which are being diagnosed in March compared to April or May [HR: 2.43 (1.1-5.55)] increased the mortality risk. Glucocorticoids and disease-modifying antirheumatic drugs (DMARDs) dropped from the final model. Conclusion In patients with RMDs and COVID-19, CMR was 6.8% patients-month. This study shows that mortality risk is higher in males, older patients, and similar between CTD, CIA, and non-ARD. COVID-19 management improved after the first month of pandemic. Plain Language Summaries Mortality related to the outbreak of COVID-19 in patients with rheumatic and musculoskeletal diseases Why was this study done? - To report the COVID-19-specific mortality rate in patients with a variety of RMDs during the first pandemic peak in a tertiary hospital in Madrid and to analyze the role of specific types of ARD and other possible factors in the risk of death related to COVID-19. What did the researchers do? - We performed a retrospective observational study during the first wave of the COVID-19 pandemic in Madrid, Spain. What did the researchers find? - In this study, neither the different diagnoses of RMDs, including CIA, CTD, or non-ARD disease or its treatment were not implicated as a potential risk of death related to COVID-19- In consonance with other studies, RMDs patients and COVID-19, older age, male sex, and certain comorbidities implied more mortality risk- Our data reflect COVID-19 severity in a particular context, time, and population. In times of the absence of COVID-19 vaccine, healthcare, social, and political measures taken to contain the coronavirus outbreak have worked properly. What do the findings mean? - The presence of comorbidities in RMDs patients represents a greater risk than the different types of RMDs themselves, in the development of COVID-19 fatal outcome. It is important to integrate the control of comorbidities in the daily management.
Collapse
Affiliation(s)
| | - Leticia Leon
- Health Research Institute (IdISSC), Hospital Clínico San Carlos, c\Prof. Martín Lagos s/n, 28040 Madrid, Spain
- Health Sciences, Camilo Jose Cela University, Madrid, Spain
| | | | | | - Arkaitz Mucientes
- Health Research Institute (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | | | - Luis Rodriguez
- Rheumatology Department, and Health Research Institute (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | | | - Paula Álvarez
- Rheumatology Department, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Lydia Abasolo
- Health Research Institute (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| |
Collapse
|
|
31
|
Shahram F, Esalatmanesh K, Khabbazi A, Rezaieyazdi Z, Mirfeizi Z, Sadeghi A, Soroosh M, Kavosi H, Alikhani M, Mostafaei S. Coronavirus disease 2019 in patients with Behcet's disease: a report of 59 cases in Iran. Clin Rheumatol 2022; 41:1177-1183. [PMID: 34842999 PMCID: PMC8628030 DOI: 10.1007/s10067-021-06004-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/10/2021] [Accepted: 11/24/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To present the clinical characteristics, disease course, management, and outcomes of COVID-19 infection in patients with Behcet's disease (BD). METHODS In this retrospective cohort study, we retrieved BD patients with definite diagnosis of COVID-19 infection. Demographic data, comorbidities, features related both to BD and COVID-19 infection, treatments, and outcomes were collected. Comparisons between patients with or without hospitalization were performed. All statistical analyzes were performed using SPSS version 25. We considered p < 0.05 statistically significant. RESULTS We identified 61 episodes of COVID-19 infection in 59 BD patients. The prevalence was 0.69%. The median age was 45 years (IQR = 20), and the median disease duration was 162 months (IQR = 195). BD features were similar except for higher rate of arterial involvement and positive pathergy test in infected patients. Thirty-five episodes (62.5%) happened in non-active patients; 39% had a comorbid disease. COVID manifestations were the same as the general population. Flu-like symptoms were the most common (85%), followed by fever (66%), ageusia/anosmia (56%), headache (51%), and pulmonary involvement (48%). There was no change in BD symptoms in 74%. Fifteen patients (25.4%) were hospitalized, and one patient (1.7%) died. Receiving glucocorticoids (p < 0.03) and cytotoxic drugs (p < 0.02) were associated with an increased rate of hospitalization. CONCLUSION The incidence of COVID-19 infection in BD patients was not higher than general population in Iran. They showed milder form of disease with lower morbidity and mortality rate. Most were on immunosuppressive drugs, or had a comorbidity apart from BD. No significant effect on BD course was shown. Key Points • The incidence of COVID-19 infection in patients with Behcet's disease is not higher. • They showed milder form of infection with lower morbidity and mortality rate. • No significant effect on Behcet's disease course was shown with COVID19 infection. • BD patients can be managed according to the guidelines used for general population.
Collapse
Affiliation(s)
- Farhad Shahram
- Behcet's Disease Unit, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Avenue, 14117-13137, Tehran, Iran.
| | - Kamal Esalatmanesh
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Khabbazi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Rezaieyazdi
- Rheumatic Diseases Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Mirfeizi
- Rheumatic Diseases Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sadeghi
- Department of Internal Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Hoda Kavosi
- Behcet's Disease Unit, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Avenue, 14117-13137, Tehran, Iran
| | - Majid Alikhani
- Behcet's Disease Unit, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Avenue, 14117-13137, Tehran, Iran
| | - Shayan Mostafaei
- Behcet's Disease Unit, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Kargar Avenue, 14117-13137, Tehran, Iran
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
|
32
|
Drosos AA, Pelechas E, Drossou V, Voulgari PV. Colchicine Against SARS-CoV-2 Infection: What is the Evidence? Rheumatol Ther 2022; 9:379-389. [PMID: 35107804 PMCID: PMC8808271 DOI: 10.1007/s40744-022-00425-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/20/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a matter of concern worldwide and a huge challenge for rheumatologists. Indeed, several antirheumatic drugs are currently used at different stages of COVID-19, such as several cytokine inhibitors and colchicine. Colchicine is one of the oldest medicines with potent anti-inflammatory properties. In rheumatic diseases it is widely used for the treatment of gout, calcium pyrophosphate deposition disease, and familial Mediterranean fever. It is also used off-label in cardiology to treat atrial fibrillation, pericarditis, and myocardial infarction. Over the last few years, advances in the understanding of colchicine's mechanism of action and its pharmacology and safety have made colchicine a promising candidate agent for the fight against COVID-19. In this review, we discuss COVID-19 pathophysiology highlighting colchicine's mode of action, its pleiotropic effects on neutrophils, inflammasome inhibition, and its viral activity. Finally, we discuss the main clinical studies dealing with the use of colchicine in COVID-19. Given the large body of evidence that demonstrates its effectiveness, safety, and its simple way of administration, colchicine seems to be a promising drug to reduce the risk of severe COVID-19 disease.
Collapse
Affiliation(s)
- Alexandros A. Drosos
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Eleftherios Pelechas
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Vassiliki Drossou
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Paraskevi V. Voulgari
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| |
Collapse
|
|
33
|
Vogel F, Reincke M. Endocrine risk factors for COVID-19: Endogenous and exogenous glucocorticoid excess. Rev Endocr Metab Disord 2022; 23:233-250. [PMID: 34241765 PMCID: PMC8267234 DOI: 10.1007/s11154-021-09670-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 01/08/2023]
Abstract
Patients with endogenous or exogenous glucocorticoid (GC) excess exhibit a range of side effects, including an increased risk of infections. Via both mechanism, immune impairments and cardiometabolic concomitant diseases, patients with GC excess could be at increased risk for COVID-19. The impact on incidence and outcome of a SARS-CoV-2 infection in this population are not yet completely clear. This review aims to compile the data available to date and to discuss the existing literature on this topic. Further we highlight potential effects of SARS-CoV-2 on the hypothalamic-pituitary-adrenal axis as well as the influence of endogenous or exogenous GC excess on SARS-CoV-2 mRNA vaccination. There is growing evidence suggesting an increased risk of infection and severe outcome in patients with high-dose GC therapy after contracting SARS-CoV-2. The few data and case reports on patients with endogenous GC excess and SARS-CoV-2 infection point in a similar direction: chronic GC excess seems to be associated with an unfavorable course of COVID-19. Whether this is mainly a primary immune-mediated effect, or also triggered by the many GC-associated comorbidities in this population, is not yet fully understood. Patients with endogenous or exogenous GC excess should be considered as a vulnerable group during the SARS-CoV-2 pandemic. Regardless of the cause, vaccination and consistent surveillance and control of associated comorbidities are recommended.
Collapse
Affiliation(s)
- Frederick Vogel
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany.
| |
Collapse
|
|
34
|
Sozeri B, Ulu K, Kaya-Akça U, Haslak F, Pac-Kisaarslan A, Otar-Yener G, Baba O, Altug-Gucenmez O, Sahin N, Bağlan E, Sönmez HE, Cakmak F, Ozturk K, Gezgin-Yıldırım D, Şener S, Barut K, Batu ED, Yıldız M, Basaran O, Adrovic A, Sahin S, Ozdel S, Bilginer Y, Poyrazoglu MH, Demir F, Yuksel S, Kalyoncu M, Kasapcopur O, Ozen S, Aktay-Ayaz N. The clinical course of SARS-CoV-2 infection among children with rheumatic disease under biologic therapy: a retrospective and multicenter study. Rheumatol Int 2022; 42:469-475. [PMID: 34570263 PMCID: PMC8475421 DOI: 10.1007/s00296-021-05008-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/20/2021] [Indexed: 12/19/2022]
Abstract
The effects of biological disease-modifying antirheumatic drugs (bDMARDs) in the clinical course of COVID-19 on children with underlying rheumatologic diseases have not been fully demonstrated. To evaluate the course of COVID-19 infection in patients with rheumatic disease receiving bDMARD treatment. This was a retrospective, multicenter study conducted in pediatric patients infected by SARS-CoV-2 and under bDMARDs therapy. The study population consisted of 113 patients (72 female/41 male). The mean age of the patients was 12.87 ± 4.69 years. The primary diagnosis of the cohort was as follows: 63 juvenile idiopathic arthritis, 35 systemic autoinflammatory diseases, 10 vasculitides, and five cases of connective tissue diseases. The mean duration of the primary disease was 4.62 ± 3.65 years. A total of 19 patients had additional comorbid diseases. Thirty-five patients were treated with canakinumab, 25 with adalimumab, 18 with etanercept, 10 with infliximab, nine with tocilizumab, six with rituximab, four with anakinra, three with tofacitinib, and one with abatacept. The median exposure time of the biological drug was 13.5 months. Seventy-one patients had symptomatic COVID-19, while 42 were asymptomatic. Twenty-four patients required hospitalization. Five patients presented with MIS-C. The hospitalized patients were younger and had a shorter duration of rheumatic disease compared to ambulatory patients, although the difference was not statistically significant. Steroid usage, presence of fever, and dyspnea were more common among the hospitalized patients. A worsening in the course of both COVID-19 and current disease was not noticed under bDMARDs, however, to end with a strong conclusion multicentric international studies are required.
Collapse
Affiliation(s)
- Betul Sozeri
- Department of Pediatric Rheumatology, University of Health Sciences, Ümraniye Research and Training Hospital, Istanbul, Turkey.
| | - Kadir Ulu
- Pediatric Rheumatology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ummusen Kaya-Akça
- Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fatih Haslak
- Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Gulcin Otar-Yener
- Pediatric Rheumatology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Ozge Baba
- Pediatric Rheumatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | | | - Nihal Sahin
- Pediatric Rheumatology, Health Sciences University, Bursa Center Hospital, Bursa, Turkey
| | - Esra Bağlan
- Pediatric Rheumatology, Health Sciences University, Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Hafize Emine Sönmez
- Pediatric Rheumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Figen Cakmak
- Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kubra Ozturk
- Pediatric Rheumatology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | | | - Seher Şener
- Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kenan Barut
- Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ezgi Deniz Batu
- Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Yıldız
- Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozge Basaran
- Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Amra Adrovic
- Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sezgin Sahin
- Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Semanur Ozdel
- Pediatric Rheumatology, Health Sciences University, Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Yelda Bilginer
- Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Ferhat Demir
- Pediatric Rheumatology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Selcuk Yuksel
- Pediatric Rheumatology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Mukaddes Kalyoncu
- Pediatric Rheumatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Ozgur Kasapcopur
- Pediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Seza Ozen
- Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Aktay-Ayaz
- Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
|
35
|
Muñoz-Fernández S, Cebrian L, Thuissard IJ, Steiner M, García-Yubero C, Esteban AV, Sánchez F, Gómez A, Matías MA, Cobo-Ibáñez T, Esteban M, Manceñido N, Pajares R, Arribas MR, Martínez A, Andreu C, Esteban C, Romero L, Navío T. Incidence of COVID-19 in 902 Patients With Immunomediated Inflammatory Diseases Treated With Biologics and Targeted Synthetic Disease-Modifying Antirheumatic Drugs-Findings From the BIOCOVID Study. J Clin Rheumatol 2022; 28:e348-e352. [PMID: 33657593 DOI: 10.1097/rhu.0000000000001716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to examine the incidence of coronavirus disease 2019 (COVID-19) among patients with immunomediated inflammatory diseases (IMIDs) treated with biologic or targeted synthetic disease-modifying antirheumatic drugs (bDMARDs and tsDMARDs) and to evaluate the influence of either IMIDs or related therapies on the incidence and evolution of COVID-19. METHODS This observational, cross-sectional study was conducted from January 31, 2020, to May 15, 2020. Data of 902 patients were obtained from clinical records in hospitals, primary care units, and community pharmacies. Inclusion criteria were adults with IMIDs treated with bDMARDs or tsDMARDs who started therapy 3 months prior to study commencement. Patients with poor adherence to treatments were excluded. COVID-19 was classified as "definitive" (severe acute respiratory syndrome coronavirus 2 polymerase chain reaction [PCR]-positive), "possible" (characteristic symptoms and negative PCR), and "suspected" (characteristic symptoms but PCR not performed). RESULTS COVID-19 was diagnosed in 70 patients (11 definitive, 19 possible, and 40 suspected). The cumulative incidence of definitive COVID-19 was 1.2%. When considering all cases, the incidence was 7.8%. Patients on biosimilars tumor necrosis factor blockers were more likely to have a diagnosis of COVID-19 (odds ratio, 2.308; p < 0.001). Patients on anti-B-cell therapies had a lower incidence of infections (p = 0.046). Low rates of hospitalization (14.3%), pneumonia (14.3%), death (2.9%), or thrombosis (2.9%) were observed, and 94.3% of patients recovered. CONCLUSIONS The cumulative incidence of confirmed cases of COVID-19 was similar to the general population, with generally low hospitalization, intensive care management, and mortality rates. COVID-19 incidence was less frequent in patients with more severe immunosuppression.
Collapse
Affiliation(s)
- Santiago Muñoz-Fernández
- From the Rheumatology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | - Laura Cebrian
- Rheumatology Section, Hospital Universitario Infanta Leonor
| | | | - Martina Steiner
- From the Rheumatology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | | | | | | | - Alejandro Gómez
- From the Rheumatology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | | | - Tatiana Cobo-Ibáñez
- From the Rheumatology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | | | - Noemí Manceñido
- Gastroenterology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | - Ramón Pajares
- Gastroenterology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | - María Rosario Arribas
- Gastroenterology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | - Alicia Martínez
- Pharmacy Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | - Cristina Andreu
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid
| | | | - Liz Romero
- From the Rheumatology Section, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid
| | - Teresa Navío
- Rheumatology Section, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
|
36
|
Kokkotis G, Kitsou K, Xynogalas I, Spoulou V, Magiorkinis G, Trontzas I, Trontzas P, Poulakou G, Syrigos K, Bamias G. Systematic review with meta-analysis: COVID-19 outcomes in patients receiving anti-TNF treatments. Aliment Pharmacol Ther 2022; 55:154-167. [PMID: 34881430 DOI: 10.1111/apt.16717] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/22/2021] [Accepted: 11/15/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Accumulating evidence suggests a beneficial effective of tumour necrosis factor-alpha (TNF-α) inhibitors on the outcomes of COVID-19 disease, which, however is not validated by all studies. AIMS To perform a systematic review and meta-analysis of existing reports to investigate the impact of anti-TNF treatments on the clinical outcomes of COVID-19 patients. METHODS A systematic search at PubMed and SCOPUS databases using specific keywords was performed. All reports of COVID-19 outcomes for patients receiving anti-TNF therapy by September 2021 were included. Pooled effect measures were calculated using a random-effects model. The Newcastle Ottawa Scale for observational studies was used to assess bias. Studies that were not eligible for meta-analysis were described qualitatively. RESULTS In total, 84 studies were included in the systematic review, and 35 were included in the meta-analysis. Patients receiving anti-TNF treatment, compared to non-anti-TNF, among COVID-19 cases had a lower probability of hospitalisation (eight studies, 2555 patients, pooled OR = 0.53, 95% CI: 0.42-0.67, I2 = 0) and severe disease defined as intensive care unit admission or death (two studies, 1823 patients, pooled OR = 0.63, 95% CI: 0.41-0.96, I2 = 0), after adjustment for validated predictors of adverse disease outcomes. No difference was found for the risk for hospitalisation due to COVID-19 in populations without COVID-19 for patients receiving anti-TNF treatment compared to non-anti-TNF (three studies, 5 994 958 participants, pooled risk ratio = 0.97, 95% CI: 0.68-1.39, I2 = 20) adjusted for age, sex and comorbidities. CONCLUSIONS TNF-α inhibitors are associated with a lower probability of hospitalisation and severe COVID-19 when compared to any other treatment for an underlying inflammatory disease.
Collapse
Affiliation(s)
- Georgios Kokkotis
- GI Unit, 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantina Kitsou
- Immunobiology and Vaccinology Research Lab, First Department of Paediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Xynogalas
- 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Vana Spoulou
- Immunobiology and Vaccinology Research Lab, First Department of Paediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Trontzas
- 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Panagiotis Trontzas
- 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Garyphallia Poulakou
- 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Konstantinos Syrigos
- 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Giorgos Bamias
- GI Unit, 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
|
37
|
Valladales-Restrepo LF, Machado-Duque ME, Gaviria-Mendoza A, Ospina-Arzuaga HD, Ruiz-Zapata M, Machado-Alba JE. Incidence and factors related to SARS-CoV-2 infection in a cohort of patients with rheumatoid arthritis from a health service provider in Colombia during the COVID-19 pandemic. Ther Adv Infect Dis 2022; 9:20499361221135155. [PMID: 36349342 PMCID: PMC9637913 DOI: 10.1177/20499361221135155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Patients with rheumatoid arthritis (RA) have an increased risk of SARS-CoV-2
infection due to intrinsic characteristics of the pathology and the
medications used to treat it. The aim was to evaluate the incidence of and
factors related to SARS-CoV-2 infection in patients with RA in Colombia. Methods: This was an observational study of patients diagnosed with RA who were
treated at a health care institution in Colombia. The study evaluated
whether the patients presented SARS-CoV-2 infection and other clinical
variables. Variables associated with the risk of SARS-CoV-2 infection were
identified. Results: A total of 2566 patients with RA were identified. They had a median age of
61.9 years, and 81.1% were women. They were mainly treated with synthetic
disease-modifying antirheumatic drugs (DMARDs) (85.3%), glucocorticoids
(52.2%), and biological DMARDs (26.8%). The incidence of SARS-CoV-2
infection was 5.1%, and the factors that increased the risk included
treatment with synthetic DMARDs with or without biological DMARDs but with
concomitant systemic glucocorticoids [odds ratio (OR): 2.18, 95% confidence
interval (CI): 1.21–3.93 and OR: 1.69, 95% CI: 1.05–2.74, respectively] and
receiving antidiabetic drugs (OR: 2.24, 95% CI: 1.27–3.94). A total of 20.8%
of patients with COVID-19 required hospitalization and 3.8% died. Conclusion: The incidence of COVID-19 is higher among patients with RA who receive DMARDs
and glucocorticoids simultaneously or who have diabetes mellitus than among
patients with RA not receiving these drug combinations, which should guide
treatment strategies.
Collapse
Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira, Audifarma S.A, Pereira, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira, Audifarma S.A, Pereira, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Andrés Gaviria-Mendoza
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira, Audifarma S.A, Pereira, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Harrison David Ospina-Arzuaga
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira, Audifarma S.A, Pereira, Colombia
| | | | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmcoepidemiología y Farmacovigilancia, Universidad Tecnologica de Pereira, Audifarma S.A, Calle 105 No. 14-140, Pereira 660003, Risaralda, Colombia
| |
Collapse
|
|
38
|
Kroon FPB, Najm A, Alunno A, Schoones JW, Landewé RBM, Machado PM, Navarro-Compán V. Risk and prognosis of SARS-CoV-2 infection and vaccination against SARS-CoV-2 in rheumatic and musculoskeletal diseases: a systematic literature review to inform EULAR recommendations. Ann Rheum Dis 2021; 81:422-432. [PMID: 34876462 DOI: 10.1136/annrheumdis-2021-221575] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/05/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Perform a systematic literature review (SLR) on risk and prognosis of SARS-CoV-2 infection and vaccination against SARS-CoV-2 in patients with rheumatic and musculoskeletal diseases (RMDs). METHODS Literature was searched up to 31 May 2021, including (randomised) controlled trials and observational studies with patients with RMD. Pending quality assessment, data extraction was performed and risk of bias (RoB) was assessed. Quality assessment required provision of (1) an appropriate COVID-19 case definition, and (2a) a base incidence (for incidence data) or (2b) a comparator, >10 cases with the outcome and risk estimates minimally adjusted for age, sex and comorbidities (for risk factor data). RESULTS Of 5165 records, 208 were included, of which 90 passed quality assessment and data were extracted for incidence (n=42), risk factor (n=42) or vaccination (n=14). Most studies had unclear/high RoB. Generally, patients with RMDs do not face more risk of contracting SARS-CoV-2 (n=26 studies) or worse prognosis of COVID-19 (n=14) than individuals without RMDs. No consistent differences in risk of developing (severe) COVID-19 were found between different RMDs (n=19). Disease activity is associated with worse COVID-19 prognosis (n=2), possibly explaining the increased risk seen for glucocorticoid use (n=13). Rituximab is associated with worse COVID-19 prognosis (n=7) and possibly Janus kinase inhibitors (n=3). Vaccination is generally immunogenic, though antibody responses are lower than in controls. Vaccine immunogenicity is negatively associated with older age, rituximab and mycophenolate. CONCLUSION This SLR informed the July 2021 update of the European Alliance of Associations for Rheumatology recommendations for the management of RMDs in the context of SARS-CoV-2.
Collapse
Affiliation(s)
- Féline P B Kroon
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands .,Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Aurélie Najm
- Institute of Infection, Immunity and Inflammation, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, UK
| | - Alessia Alunno
- Internal Medicine and Nephrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Jan W Schoones
- Directorate of Research Policy (formerly Walaeus Library), Leiden University Medical Center, Leiden, The Netherlands
| | - Robert B M Landewé
- Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands.,Rheumatology & Clinical Immunology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Pedro M Machado
- Department of Rheumatology, London North West University Healthcare NHS Trust, London, UK.,Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK.,National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC), University College London Hospitals (UCLH) NHS Foundation Trust, London, UK
| | | |
Collapse
|
|
39
|
Velayos FS, Dusendang JR, Schmittdiel JA. Prior Immunosuppressive Therapy and Severe Illness Among Patients Diagnosed with SARS-CoV-2: a Community-Based Study. J Gen Intern Med 2021; 36:3794-3801. [PMID: 34581984 PMCID: PMC8477718 DOI: 10.1007/s11606-021-07152-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND An estimated 10 million people in the USA are immunocompromised, a risk factor for severe COVID-19. Data informing whether immune-mediated medications lead to more severe infection are sparse. OBJECTIVE Determine whether outpatient immunosuppressive therapies that treat autoimmune inflammatory disease or prevent solid organ transplant rejection are associated with severe illness after diagnosis with SARS-CoV-2 DESIGN: Retrospective cohort study PARTICIPANTS: Adults with a positive PCR nasal swab for SARS-CoV-2 from February 25 to September 9, 2020, cared for within a large integrated health care organization MAIN MEASURES: Exposure was defined as an outpatient fill of prednisone, immunomodulator, small-molecule, or biologic therapy in the 105 days prior to a positive SARS-CoV-2 PCR test. The main outcome was either hospitalization, ICU admission, or death within 45 days after diagnosis of SARS-CoV-2. Multivariable logistic regression models were adjusted for age, race, gender, body mass index, comorbidities, and autoimmune disease. KEY RESULTS A total of 39,686 adults had a positive PCR test. In the primary analysis, prior prednisone use was associated with severe illness after diagnosis with SARS-CoV-2 (odds ratio (OR) 1.31; 95% confidence interval (CI) 1.08-1.60); however, immunomodulator (OR 0.88; 95% CI 0.57-1.34) and biologic/small-molecule therapy (OR 1.26; 95% CI 0.79-2.00) were not. Secondary analyses showed variable risk among therapies: Janus-kinase inhibitors had an increased odds of severe illness (OR 3.35; 95% CI 1.16-9.67), thiopurines/conventionaldisease-modifying antirheumatic drugs had a reduced odds (OR 0.53; 95% CI 0.32-0.88), and tumor necrosis factor inhibitors were not associated (OR 0.45; 95% CI 0.18-1.08). CONCLUSIONS AND RELEVANCE Outpatient use of prednisone is associated with severe illness after diagnosis of SARS-CoV-2. Immunomodulator and biologic/small-molecule therapy were not associated, but different risk subgroups were identified. Our findings can inform risk-benefit discussions in the clinic and risk-based recommendations for patients on these therapies.
Collapse
Affiliation(s)
- Fernando S Velayos
- Division of Gastroenterology and Hepatology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA.
| | | | - Julie A Schmittdiel
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| |
Collapse
|
|
40
|
Dewanjee S, Kandimalla R, Kalra RS, Valupadas C, Vallamkondu J, Kolli V, Dey Ray S, Reddy AP, Reddy PH. COVID-19 and Rheumatoid Arthritis Crosstalk: Emerging Association, Therapeutic Options and Challenges. Cells 2021; 10:3291. [PMID: 34943795 PMCID: PMC8699554 DOI: 10.3390/cells10123291] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 02/07/2023] Open
Abstract
Hyperactivation of immune responses resulting in excessive release of pro-inflammatory mediators in alveoli/lung structures is the principal pathological feature of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The cytokine hyperactivation in COVID-19 appears to be similar to those seen in rheumatoid arthritis (RA), an autoimmune disease. Emerging evidence conferred the severity and risk of COVID-19 to RA patients. Amid the evidence of musculoskeletal manifestations involving immune-inflammation-dependent mechanisms and cases of arthralgia and/or myalgia in COVID-19, crosstalk between COVID-19 and RA is often debated. The present article sheds light on the pathological crosstalk between COVID-19 and RA, the risk of RA patients in acquiring SARS-CoV-2 infection, and the aspects of SARS-CoV-2 infection in RA development. We also conferred whether RA can exacerbate COVID-19 outcomes based on available clinical readouts. The mechanistic overlapping in immune-inflammatory features in both COVID-19 and RA was discussed. We showed the emerging links of angiotensin-converting enzyme (ACE)-dependent and macrophage-mediated pathways in both diseases. Moreover, a detailed review of immediate challenges and key recommendations for anti-rheumatic drugs in the COVID-19 setting was presented for better clinical monitoring and management of RA patients. Taken together, the present article summarizes available knowledge on the emerging COVID-19 and RA crosstalk and their mechanistic overlaps, challenges, and therapeutic options.
Collapse
Affiliation(s)
- Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur Unversity, Kolkata 700032, India;
| | - Ramesh Kandimalla
- Applied Biology, CSIR-Indian Institute of Technology, Uppal Road, Tarnaka, Hyderabad 50000, India;
- Department of Biochemistry, Kakatiya Medical College, Warangal 506007, India
| | - Rajkumar Singh Kalra
- AIST-INDIA DAILAB, National Institute of Advanced Industrial Science & Technology (AIST), Higashi 1-1-1, Tsukuba 305-8565, Japan;
| | - Chandrasekhar Valupadas
- Department of Medicine, Mahatma Gandhi Memorial Hospital, Warangal 506007, India;
- Department of Medicine, Kakatiya Medical College Superspeciality Hospital, Warangal 506007, India
| | | | - Viswakalyan Kolli
- Department of Biochemistry, GITAM Institute of Medical Sciences and Research, Visakhapatnam 530045, India;
| | - Sarbani Dey Ray
- Department of Pharmaceutical Sciences, Assam University, Silchar 788011, India;
| | - Arubala P. Reddy
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79409, USA;
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Departments of Neurology, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| |
Collapse
|
|
41
|
Curtis JR, Zhou X, Rubin DT, Reinisch W, Yazdany J, Robinson PC, Chen Y, Benda B, Madsen A, Geier J. Characteristics, Comorbidities, and Outcomes of SARS-CoV-2 Infection in Patients with Autoimmune Conditions Treated with Systemic Therapies: a Population-based Study. J Rheumatol 2021; 49:320-329. [PMID: 34782447 DOI: 10.3899/jrheum.210888] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe characteristics and COVID-19 clinical outcomes in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ulcerative colitis (UC) receiving systemic therapies vs the general population. METHODS This descriptive retrospective cohort study used US Optum® deidentified COVID-19 electronic health record dataset (2007-2020) data. Adults with COVID-19 were stratified into 3 disease cohorts (RA, PsA, or UC patients who had received systemic therapy) and a comparator cohort not meeting these criteria. Incidence proportions of hospitalization and clinical manifestations of interest were calculated. Using logistic regression analyses, risk of endpoints was estimated, adjusting for demographics and demographics plus comorbidities. RESULTS This analysis (February 1-December 9, 2020) included 315,101 COVID-19 patients. Adjusting for demographics, COVID-19 patients with RA (N=2,306) had an increased risk of hospitalization (odds ratio 1.54 [95% CI 1.39-1.70]) and in-hospital death (1.61 [1.30-2.00]), compared with the comparator cohort (N=311,563). The increased risk was also observed when adjusted for demographics plus comorbidities (hospitalization 1.25 [1.13-1.39] and in-hospital death 1.35 [1.09-1.68]). The risk of hospitalization was lower in COVID-19 patients with RA receiving tumor necrosis factor inhibitors (TNFi) vs non-TNFi biologics (0.32 [0.20-0.53]) and the comparator cohort (0.77 [0.51-1.17]). The risk of hospitalization due to COVID-19 was similar between patients receiving tofacitinib and the comparator cohort. CONCLUSION Compared with the comparator cohort, RA patients were at a higher risk of more severe or critical COVID-19 and, except for non-TNFi biologics, systemic therapies did not further increase the risk.
Collapse
Affiliation(s)
- Jeffrey R Curtis
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Xiaofeng Zhou
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - David T Rubin
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Walter Reinisch
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Jinoos Yazdany
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Philip C Robinson
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Yan Chen
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Birgitta Benda
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Ann Madsen
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| | - Jamie Geier
- This study was sponsored by Pfizer Inc. J.R. Curtis, MD, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA; X. Zhou, PhD, Y. Chen, MD, B. Benda, MD, PhD, A. Madsen, PhD, J. Geier, PhD, Pfizer Inc, New York, NY, USA; D.T. Rubin, MD, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; W. Reinisch, MD, Medical University of Vienna, Vienna, Austria; J. Yazdany, MD, Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA; P.C. Robinson, MBChB, PhD, School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia. JRC has received grant support from, and has been a consultant for, Pfizer Inc. DTR has received grant support from Takeda; and has received consulting fees from AbbVie, AbGenomics, Allergan Inc, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corp/Syneos, Check-Cap, Dizal Pharmaceuticals, Eli Lilly, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, GSK, Ichnos Sciences S.A, Janssen, Narrow River Mgmt, Pfizer Inc, Prometheus Laboratories, Reistone, Shire, Takeda, and Techlab Inc. WR has received grant support from Abbott, AbbVie, AESCA, Centocor, Dr. Falk Pharma, Immundiagnostik, and MSD; has received lecture fees from Abbott, AbbVie, AESCA, Aptalis, Celltrion, Centocor, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Immundiagnostik, Mitsubishi Tanabe Pharma, MSD, Otsuka, PDL, Pharmacosmos, Schering-Plough, Shire, Takeda, Therakos, Vifor, and Yakult; and has received consulting fees from Abbott, AbbVie, AESCA, Amgen, AM Pharma, Astellas, AstraZeneca, Avaxia Biologics, Bioclinica, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Cellerix, Celltrion, Centocor, ChemoCentryx, Covance, Danone, Dr. Falk Pharma, Elan, Ferring Pharmaceuticals, Galapagos, Genentech, Gilead Sciences, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millennium, Mitsubishi Tanabe Pharma, MSD, Nestlé, Novartis, Ocera, Otsuka, PDL, Pfizer Inc, Pharmacosmos, Procter & Gamble, Prometheus Laboratories, Robarts Clinical Trials, Schering-Plough, Second Genome, SetPoint Medical, Takeda, Therakos, TiGenix, UCB, Vifor, Zyngenia, and 4SC. JY has received consulting fees from AstraZeneca and Eli Lilly; and has received a research grant from AstraZeneca. PCR has received personal fees from AbbVie, Atom Biosciences, Eli Lilly, Gilead Sciences, Janssen, Novartis, Pfizer Inc, Roche, and UCB; and has received grant support from Janssen, Novartis, Pfizer Inc, and UCB. XZ, YC, BB, and AM are employees and shareholders of Pfizer Inc. JG was formerly employed by Pfizer Inc. Address correspondence to Dr. X. Zhou, Pfizer Inc, 235 East 42nd Street, New York, NY 10017, USA.
| |
Collapse
|
|
42
|
Rosenbaum JT, Weisman MH, Hamilton H, Shafer C, Aslanyan E, Howard RA, Ogle K, Reveille JD, Winthrop KL, Choi D. The Interplay Between COVID-19 and Spondyloarthritis or Its Treatment. J Rheumatol 2021; 49:225-229. [PMID: 34599048 DOI: 10.3899/jrheum.210742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has created multiple uncertainties regarding rheumatic diseases or their treatment, with regard to the susceptibility to or severity of the viral disease. We aimed to address these questions as they relate to spondyloarthritis (SpA). METHODS We created a longitudinal survey from April 10, 2020, to April 26, 2021. There were 4723 subjects with SpA and 450 household contacts who participated worldwide. Of these, 3064 respondents were from the US and 70.4% of them provided longitudinal data. To control for the duration of potential risk of COVID-19, the rate of contracting the disease was normalized for person-months of exposure. RESULTS In an analysis of US subjects who provided longitudinal data, the incident rate ratio for the 159 (out of 2157) subjects who tested positive for COVID-19 was 1.16 compared to the US population as adjusted for age and sex (range 0.997-1.361, P = 0.06). A paired evaluation using patients and household members did not show a statistically significant effect to indicate a predisposition for developing COVID-19 as a result of SpA or its treatment. Our data failed to show that any class of medication commonly used to treat SpA significantly affected the risk of developing COVID-19 or increasing the severity of COVID-19. CONCLUSION These data do not exclude a small increased risk of developing COVID-19 as a result of SpA, but the risk, if it exists, is low and not consistently demonstrated. The data should provide reassurance to patients and to rheumatologists about the risk that COVID-19 poses to patients with SpA.
Collapse
Affiliation(s)
- James T Rosenbaum
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Michael H Weisman
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Hedley Hamilton
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Cassie Shafer
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Elin Aslanyan
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Richard A Howard
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Kimberly Ogle
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - John D Reveille
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Kevin L Winthrop
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Dongseok Choi
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| |
Collapse
|
|
43
|
Fagni F, Simon D, Tascilar K, Schoenau V, Sticherling M, Neurath MF, Schett G. COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses. THE LANCET. RHEUMATOLOGY 2021; 3:e724-e736. [PMID: 34485930 PMCID: PMC8397302 DOI: 10.1016/s2665-9913(21)00247-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
At the beginning of the COVID-19 pandemic, patients with immune-mediated inflammatory diseases were considered to be at high risk for SARS-CoV-2 infection and the development of severe COVID-19. Data collected over the past year, however, suggest that a diagnosis of inflammatory arthritis, psoriasis, or inflammatory bowel diseases does not increase risk for SARS-CoV-2 infection or severe COVID-19 compared with people without these diseases. Furthermore, substantial data suggest that certain medications frequently used in patients with immune-mediated inflammatory diseases, in particular cytokine inhibitors, might even lower the risk for severe COVID-19. Conversely, glucocorticoids and potentially B-cell-depleting treatments seem to worsen COVID-19 outcomes. Additionally, the first data on SARS-CoV-2 vaccination in patients with these diseases suggest that tolerability of vaccination in patients with immune-mediated inflammatory diseases is good, although the immune response to vaccination can be somewhat reduced in this patient group, particularly those taking methotrexate or CD20-targeted treatment.
Collapse
Affiliation(s)
- Filippo Fagni
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Verena Schoenau
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Michael Sticherling
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Department of Dermatology, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Markus F Neurath
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| |
Collapse
|
|
44
|
Zhu Y, Zhong J, Dong L. Epidemiology and Clinical Management of Rheumatic Autoimmune Diseases in the COVID-19 Pandemic: A Review. Front Med (Lausanne) 2021; 8:725226. [PMID: 34490312 PMCID: PMC8416911 DOI: 10.3389/fmed.2021.725226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) has been in pandemic for more than 1 year, with serious negative effects produced worldwide. During this period, there have been a lot of studies on rheumatic autoimmune diseases (RADs) combined with COVID-19. The purpose of this study is to review and summarize these experiences. Pubmed, Web of science, Embase and the Cochrane library were searched from January 15, 2020 to July 15, 2021 using RADs and COVID-19 related keywords. Based on a comprehensive review of studies covering 16 countries, the prevalence of COVID-19 does not necessarily increase in RADs patients compared to the general population. In RADs population infected with COVID-19, a high proportion of female patients (54.44~95.2%), elderly patients (≥50y, 48~75.88%), and patients with pre-existing comorbidities (respiratory, 4.8~60.4%; endocrine, 8.52~44.72%; cardiovascular, 15.7~64.73%) were observed, although, this does not appear to have a decisive effect on disease severity. Many anti-rheumatic treatments have been extensively evaluated for their efficacy of treating COVID-19 in RADs patients, with TNF-α inhibitors and IL-6 receptor antagonist receiving more positive reviews. However, there is no conclusive information for most of the therapeutic regimens due to the lack of high-level evidence. Inflammatory markers or neutrophil-lymphocyte-ratio may be applied as indicators for clinical prognosis or therapeutic regimens adjustment. Thus, more research is still needed to address the prevalence, treatment, and clinical monitoring of RADs patients in COVID-19 pandemic.
Collapse
Affiliation(s)
- Yingzi Zhu
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jixin Zhong
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lingli Dong
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
|
45
|
Haberman RH, Jaros BD, Scher JU. Editorial: Rheumatology at the center of coronavirus disease 2019: pathogenesis, treatment, and clinical care. Curr Opin Rheumatol 2021; 33:409-411. [PMID: 34175865 PMCID: PMC8373389 DOI: 10.1097/bor.0000000000000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Brian D. Jaros
- Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USA
| | | |
Collapse
|
|
46
|
Sparks JA, Wallace ZS, Robinson PC. Coronavirus disease 2019: update on coronavirus disease 2019 outcomes and vaccine efficacy in patients with immune-mediated inflammatory disease. Curr Opin Rheumatol 2021; 33:412-418. [PMID: 34171857 PMCID: PMC8373387 DOI: 10.1097/bor.0000000000000812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Although the literature to date on COVID-19 outcomes in those with immune-mediated inflammatory disease has been largely reassuring there remain many unanswered questions. These include the impact of specific medications on outcomes and the antibody response after COVID-19 vaccination. RECENT FINDINGS We summarized the current literature related to COVID-19 outcomes in immune-mediated inflammatory diseases in rheumatology, gastroenterology, dermatology, and neurology. Overall, we found either no difference or modest differences in risk for severe COVID-19 for people with immune-mediated diseases compared with the general population. When considering disease-specific factors, glucocorticoid use and underlying immune-mediated disease activity were generally associated with worse outcomes. Specific medications varied in associations: tumor necrosis factor inhibitors generally had lower odds for severe COVID-19 outcomes, whereas rituximab use generally had higher odds for severe outcomes. We also detailed the recent reports of antibody response to COVID-19 vaccination in people with immune-mediated inflammatory diseases. SUMMARY Investigations of immune-mediated inflammatory diseases across several organ systems have offered important insight into the COVID-19 disease course. Overall, these studies have provided reassurance to patients and clinicians while also identifying groups who may be at higher risk for poor outcomes.
Collapse
Affiliation(s)
| | - Zachary S. Wallace
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Philip C. Robinson
- University of Queensland School of Clinical Medicine, Faculty of Medicine
- Royal Brisbane & Women's Hospital, Metro North Hospital & Health Service, Herston, Queensland, Australia
| |
Collapse
|
|
47
|
Raiker R, DeYoung C, Pakhchanian H, Ahmed S, Kavadichanda C, Gupta L, Kardeş S. Outcomes of COVID-19 in patients with rheumatoid arthritis: A multicenter research network study in the United States. Semin Arthritis Rheum 2021; 51:1057-1066. [PMID: 34450504 PMCID: PMC8376523 DOI: 10.1016/j.semarthrit.2021.08.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/31/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
Objectives To investigate outcomes of Coronavirus Disease-2019 (COVID-19) in patients with rheumatoid arthritis (RA) as compared to the general population. Additionally, outcomes were explored among RA patients stratified by sex, race, and medications use through sub-cohort analyses. Methods This comparative cohort study used a US multicenter research network (TriNetX) to extract data on all adult RA patients who were diagnosed with COVID-19, and adults without RA who were diagnosed with COVID-19 (comparative cohort) anytime from January 20, 2020 to April 11, 2021. COVID-19 outcomes were assessed within 30 days after its diagnosis. Baseline characteristics that included demographics and comorbidities were controlled in propensity score matching. Results A total of 9730 RA patients with COVID-19 and 656,979 non-RA with COVID-19 were identified. Before matching, the risk of all outcomes including mortality (RR: 2.11, 95%CI: 1.90 to 2.34), hospitalization (RR: 1.60, 1.55 to 1.66), intensive care unit-ICU admission (RR: 1.86, 1.71 to 2.05), mechanical ventilation (RR: 1.62, 1.44 to 1.82), severe COVID-19 (RR: 1.89, 1.74 to 2.06), acute kidney injury (RR: 2.13, 1.99 to 2.29), kidney replacement therapy/hemodialysis (RR: 1.40, 1.03 to 1.89), acute respiratory distress syndrome-ARDS (RR: 1.76, 1.53 to 2.02), ischemic stroke (RR: 2.62, 2.24 to 3.07), venous thromboembolism-VTE (RR: 2.30, 2.07 to 2.56), and sepsis (RR: 1.97, 1.81 to 2.13) was higher in RA compared to non-RA. After matching, the risks did not differ in both cohorts except for VTE (RR: 1.18, 1.01 to 1.38) and sepsis (RR: 1.27, 1.12 to 1.43), which were higher in the RA cohort. Male sex, black race, and glucocorticoid use increased the risk of adverse outcomes. The risk of hospitalization was higher in rituximab or interleukin 6 inhibitors (IL-6i) users compared to tumor necrosis factor inhibitors (TNFi) users, with no significant difference between Janus kinase inhibitors (JAKi) or abatacept users and TNFi users. Conclusion This large cohort study of RA-COVID-19 found that the risk of all outcomes was higher in the RA compared to the non-RA cohort before matching, with no difference in the majority of outcomes after matching, implying the risk being attributed to adjusted factors. However, the risk of VTE and sepsis was higher in RA cohort even after matching, indicating RA as an independent risk factor. Male sex, black race, and glucocorticoid use were associated with adverse outcomes in RA with COVID-19. Rituximab or IL-6i users were associated with an increased risk of hospitalization compared to TNFi users.
Collapse
Affiliation(s)
- Rahul Raiker
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Charles DeYoung
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Haig Pakhchanian
- George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Sakir Ahmed
- Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Bhubaneswar, India
| | - Chengappa Kavadichanda
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Latika Gupta
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, Uttar Pradesh, India
| | - Sinan Kardeş
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| |
Collapse
|
|
48
|
Patient*innen mit entzündlicher Arthritis und SARS-CoV-2-Infektion. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1416-9424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Ärzt*innen der WARCOV-Studiengruppe charakterisierten Krankenhausaufenthalts- und Sterblichkeitsraten bei Patient*innen mit entzündlicher Arthritis (IA), die an einer SARS-CoV-2-Infektion erkrankten. Zusätzlich analysierten sie Zusammenhänge von Komorbiditäten und immunmodulatorischer Medikamenteneinnahme mit den Infektionsergebnissen.
Collapse
|
|
49
|
Shah SB. COVID-19 and Progesterone: Part 2. Unraveling High Severity, Immunity Patterns, Immunity grading, Progesterone and its potential clinical use. ENDOCRINE AND METABOLIC SCIENCE 2021; 5:100110. [PMID: 34396354 PMCID: PMC8349364 DOI: 10.1016/j.endmts.2021.100110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 01/11/2023] Open
Abstract
Severely ill COVID–19 (Corona Virus Disease of 2019) patients have a hyperinflammatory condition with a high concentration of pro-inflammatory cytokines termed the cytokine storm. This milieu is reported to cause acute lung injury, oxygen deprivation, multiorgan damage, critical illness, and often death. Post SARS–CoV–2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection, the fight between the invading virus and the host's immune system would either terminate in recovery, with eradication of the infection and regulation of the immune system; or there would be a continuation of immune attacks even after the virus has been cleared, leading to immune dysregulation and disease. This outcome is chiefly dependent on two factors: (1) the patient's immune response, and (2) sufficiency plus efficiency of the regulator(s). Concerning the first, the present research introduces a framework based on different types of immune responses to SARS–CoV–2 along with known disease examples, and how this relates to varying clinical outcomes and treatment needs for COVID–19 patients. About the second factor of ‘regulator(s)’, part 1 of the manuscript described in depth the regulatory role of progesterone in COVID–19. The present study investigates five immunity patterns and the status of the regulatory hormone progesterone with respect to the two established demographic risk factors for COVID–19 high-severity: male sex, and old age. The study evaluates the status of progesterone as a credible determinant of immune regulation and dysregulation. It duly relates the immunity patterns to clinical outcomes and evinces indications for clinical use of progesterone in COVID–19. It proposes a clear answer to the question: "why are males and old patients most likely to have critical illness due to COVID–19?" The study highlights clinical domains for the use of progesterone in COVID–19. Part 2 of this research introduces the concept of immunity patterns and immunity grading. These concepts herewith provided for the clinical course of COVID–19 also apply to other hyperinflammatory conditions. Possible clinical applications of progesterone to treat critically ill COVID–19 patients will open an avenue for hormonal treatments of infections and other immune-related diseases.
Collapse
|
|
50
|
Bower H, Frisell T, Di Giuseppe D, Delcoigne B, Ahlenius GM, Baecklund E, Chatzidionysiou K, Feltelius N, Forsblad-d'Elia H, Kastbom A, Klareskog L, Lindqvist E, Lindström U, Turesson C, Sjöwall C, Askling J. Impact of the COVID-19 pandemic on morbidity and mortality in patients with inflammatory joint diseases and in the general population: a nationwide Swedish cohort study. Ann Rheum Dis 2021; 80:1086-1093. [PMID: 33622688 PMCID: PMC8206171 DOI: 10.1136/annrheumdis-2021-219845] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To estimate absolute and relative risks for all-cause mortality and for severe COVID-19 in inflammatory joint diseases (IJDs) and with antirheumatic therapies. METHODS Through Swedish nationwide multiregister linkages, we selected all adult patients with rheumatoid arthritis (RA, n=53 455 in March 2020), other IJDs (here: spondyloarthropathies, psoriatic arthritis and juvenile idiopathic arthritis, n=57 112), their antirheumatic drug use, and individually matched population referents. We compared annual all-cause mortality March-September 2015 through 2020 within and across cohorts, and assessed absolute and relative risks for hospitalisation, admission to intensive care and death due to COVID-19 March-September 2020, using Cox regression. RESULTS During March-September 2020, the absolute all-cause mortality in RA and in other IJDs was higher than 2015-2019, but relative risks versus the general population (around 2 and 1.5) remained similar during 2020 compared with 2015-2019. Among patients with IJD, the risks of hospitalisation (0.5% vs 0.3% in their population referents), admission to intensive care (0.04% vs 0.03%) and death (0.10% vs 0.07%) due to COVID-19 were low. Antirheumatic drugs were not associated with increased risk of serious COVID-19 outcomes, although for certain drugs, precision was limited. CONCLUSIONS Risks of severe COVID-19-related outcomes were increased among patients with IJDs, but risk increases were also seen for non-COVID-19 morbidity. Overall absolute and excess risks are low and the level of risk increases are largely proportionate to those in the general population, and explained by comorbidities. With possible exceptions, antirheumatic drugs do not have a major impact on these risks.
Collapse
Affiliation(s)
- Hannah Bower
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Frisell
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Gerd-Marie Ahlenius
- Rheumatology Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Eva Baecklund
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | | | - Helena Forsblad-d'Elia
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alf Kastbom
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lars Klareskog
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | | | - Ulf Lindström
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Turesson
- Rheumatology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Christopher Sjöwall
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Johan Askling
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|