Kaitlyn D’Onofrio

DocwireNews

Researchers have been assessing how different rheumatic diseases may affect COVID-19, including through initiatives such as the <a href="https://www.docwirenews.com/docwire-pick/rheumatology-picks/covid-19-global-rheumatology-alliance-calls-for-clinicians-to-share-data-on-patients-with-covid-19/">COVID-19 Global Rheumatology Alliance</a>. An Italian study recently found that rheumatic and musculoskeletal diseases themselves may not be what affects COVID-19, but a patient&rsquo;s age and comorbidities.&ldquo;No data about the prevalence of COVID-19 among patients with rheumatic and musculoskeletal diseases were provided in the initial report of 72&#8200;314 cases from the Chinese Center for Disease Control and Prevention. Since then, small case series of SARS-CoV-2 infection in patients with rheumatic and musculoskeletal diseases have been published and several collaborative databases are collecting reports from patients with rheumatic and musculoskeletal diseases, such as the EULAR COVID-19 database (2149 cases up to June 9) and the COVID-19 Global Rheumatology Alliance (1032 cases up to June 4). Based on these limited data, rheumatic and musculoskeletal diseases do not seem to affect the disease course of COVID-19,&rdquo; the researchers stated, reporting in <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30169-7/fulltext">The Lancet Rheumatology</a>.This study took place at the Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili of Brescia, Italy. Patients with <a href="https://www.docwirenews.com/docwire-pick/rheumatology-picks/rheumatic-patients-share-perspectives-during-covid-19-in-two-surveys/">rheumatic and musculoskeletal diseases</a> from the outpatient clinic with confirmed or possible COVID-19 were identified and asked either in the clinic or by telephone to fill out a survey. A case-control study was also performed in patients with rheumatic and musculoskeletal diseases and confirmed COVID-19 pneumonia admitted to the ASST Spedali Civili of Brescia, who were age- and sex-matched to at least two controls admitted to the center with <a href="https://www.docwirenews.com/docwire-pick/rheumatology-picks/rheum-round-up-phase-3-baricitinib-covid-19-trial-kicks-off-digital-ra-monitoring-and-more/">COVID-19</a> pneumonia during the same month. Data collection took place between Feb. 24 and May 1.<h2>Rheumatic Disease Type, Pharmacological Therapy May Not Be What Drives COVID-19 Death</h2>Of 1,525 patients with rheumatic and musculoskeletal diseases, 117 (8%) presented COVID-19-compatile symptoms. Of the symptomatic patients, 65 had a swab-confirmed case of COVID-19, while 52 who presented COVID-19-comaptible symptoms were not tested. Patients with confirmed COVID-19 were older than those with suspected cases (median age, 68 years vs. 57 years) and more likely to have arterial hypertension (51% vs. 27%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.3 to 6.1) and obesity (17% vs. 2%; OR, 11.0; 95% CI, 1.3 to 83.4). Rheumatic disease and background therapy did not largely differ between confirmed and suspected patients. In the confirmed COVID-19 group, 47 patients (72%) were admitted to the hospital for pneumonia. A total of 12 deaths (10%) were reported: 10 in confirmed COVID-19 patients and two in suspected patients. In the confirmed COVID-19 group, patients who died were older than survivors (median age, 78.8 years vs. 65.5 years). Sex, comorbidities, and therapies did not differ between patients who died and survivors.In the case-control study, final analysis included 26 rheumatic and musculoskeletal diseases patients with COVID-19 and 62 controls. Duration of COVID-19 symptoms before admission, length of hospital stay, and local chest X-ray scoring system did not largely differ between cases and controls. Among the cases, 17 patients (65) received glucocorticoids for severe respiratory manifestations related to lung involvement, and six (23%) received tocilizumab. Four cases (15%) sustained thrombotic events. Four cases (15%) and six controls (10%) died.&ldquo;Based on the current findings, pre-existing systemic autoimmune disease and ongoing immunosuppressive treatment do not appear to represent the most important risk factors for SARS-CoV-2 infection and for its final outcome. Instead, mortality seems to be associated more with older age and the presence of comorbidities rather than the degree of pharmacological immunosuppression,&rdquo; the study authors concluded.

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Researchers have been assessing how different rheumatic diseases may affect COVID-19, including through initiatives such as the COVID-19 Global Rheumatology Alliance. An ...

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