Résumé
Introducción: conocer la seguridad de las drogas actualmente disponibles para el tratamiento de las enfermedades reumáticas es muy importante al momento de tomar decisiones terapéuticas objetivas e individualizadas en la consulta médica diaria. Asimismo, datos de la vida real amplían el conocimiento revelado por los ensayos clínicos. Objetivos: describir los eventos adversos (EA) reportados, estimar su frecuencia e identificar los factores relacionados con su desarrollo. Materiales y métodos: se utilizaron datos BIOBADASAR, un registro voluntario y prospectivo de seguimiento de EA de tratamientos biológicos y sintéticos dirigidos en pacientes con enfermedades reumáticas inmunomediadas. Los pacientes son seguidos hasta la muerte, pérdida de seguimiento o retiro del consentimiento informado. Para este análisis se extrajeron datos recopilados hasta el 31 de enero de 2023. Resultados: se incluyó un total de 6253 pacientes, los cuales aportaron 9533 ciclos de tratamiento, incluyendo 3647 (38,3%) ciclos sin drogas modificadoras de la enfermedad biológicas y sintéticas dirigidas (DME-b/sd) y 5886 (61,7%) con DME-b/sd. Dentro de estos últimos, los más utilizados fueron los inhibidores de TNF y abatacept. Se reportaron 5890 EA en un total de 2701 tratamientos (844 y 1857 sin y con DME-b/sd, respectivamente), con una incidencia de 53,9 eventos cada 1000 pacientes/año (IC 95% 51,9-55,9). La misma fue mayor en los ciclos con DME-b/sd (71,1 eventos cada 1000 pacientes/año, IC 95% 70,7-77,5 versus 33,7, IC 95% 31,5-36,1; p<0,001). Las infecciones, particularmente las de la vía aérea superior, fueron los EA más frecuentes en ambos grupos. El 10,9% fue serio y el 1,1% provocó la muerte del paciente. El 18,7% de los ciclos con DME-b/sd fue discontinuado a causa de un EA significativamente mayor a lo reportado en el otro grupo (11,5%; p<0,001). En el análisis ajustado, las DME-b/sd se asociaron a mayor riesgo de presentar al menos un EA (HR 1,82, IC 95% 1,64-1,96). De igual manera, la mayor edad, el mayor tiempo de evolución, el antecedente de enfermedad pulmonar obstructiva crónica, el diagnóstico de lupus eritematoso sistémico y el uso de corticoides se asociaron a mayor riesgo de EA. Conclusiones: la incidencia de EA fue significativamente superior durante los ciclos de tratamientos que incluían DME-b/sd.
Introduction: knowing the efficacy and safety of the drugs currently available for the treatment of rheumatic diseases is very important when making objective and individualized therapeutic decisions in daily medical consultation. Likewise, real-life data extends the knowledge revealed by clinical trials. Objectives: to describe the reported adverse events (AEs), estimate their frequency and identify factors associated to them. Materials and methods: BIOBADASAR data were used, which is a voluntary, prospective follow-up registry of AEs of biological and synthetic treatments in patients with immune-mediated rheumatic diseases. Patients are followed until death, loss of followup, or withdrawal of informed consent. To carry out this analysis, the data collected up to January 31, 2023 was extracted. Results: a total of 6253 patients were included, who contributed with 9533 treatment periods, including 3647 (38.3%) periods without b/ts-DMARDs and 5886 (61.7%) with b/ts-DMARDs. Among the latter, the most used were TNF inhibitors and abatacept. A total of 5890 AEs were reported in a total of 2701 treatments (844 and 1857 without and with b/ts-DMARDs, respectively), with an incidence of 53.9 events per 1000 patients/ year (95% CI 51.9-55.9). It was higher during the periods with b/ts-DMARDs (71.1 events per 1000 patients/year, 95% CI 70.7-77.5 vs 33.7, 95% CI 31.5-36.1, p<0.001). Infections, particularly those of the upper respiratory tract, were the most frequent AEs in both groups. 10.9% were severe and 1.1% were associated with the death of the patient. 18.7% of the periods with b/ts-DMARDs were discontinued due to an AE, significantly higher than that reported in the other group (11.5%; p<0.001). In the adjusted analysis, b/ts-DMARDs were associated with a higher risk of presenting at least one AE (HR 1.82, 95% CI 1.64-1.96). Similarly, older age, longer evolution time, history of chronic obstructive pulmonary disease, diagnosis of systemic lupus erythematosus, and use of corticosteroids were associated with a higher risk of AE. Conclusions: the incidence of AEs was significantly higher during those treatment periods that included DME-b/sd.
Sujets)
Biothérapie , Thérapie moléculaire ciblée , Médicaments de synthèseRésumé
Non-communicable diseases (NCDs) are the world's single leading cause of preventable morbidity and mortality, which cause both rich and poor nations to experience hardships. Globally, these diseases - particularly diabetes, cardiovascular diseases, cancers, and chronic lung disease have reached veritable epidemic proportions. Guyana is a lower middle-income country with a growing incidence of NCDs that seems to reflect the global trend and accounted for over 68% of all deaths. In an effort to reduce the burden of NCDs, countries of the Caribbean Community (CARICOM) including Guyana, signed the Declaration of Port of Spain 2007: Uniting to Stop the Epidemic of NCDs, in the quest to foster inter regional collaboration and facilitate multi-sector partnerships which were intended to serve as a model for nationallevel partnership platforms and multisectoral action aimed at reducing NCDs. Based on the context, the aim of this study is to analyse intersectoral collaboration among Government Ministries (Agriculture, Education, Finance, Health and Trade) for the implementation of the Declaration of Port of Spain 2007 in Guyana. Qualitative study, guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ). Participants were senior staff (programme managers, departmental heads) currently employed in one of the five selected Ministries and senior staff who worked at these Ministries after 2007, the year that the Declaration of Port of Spain was introduced. Participants were selected because of their decision-making roles and responsibilities related to implementation of prevention and control interventions, policies, and programmes for NCDs, and risk factors within their respective Ministries. Senior decision makers with responsibility for implementation of prevention and control policies for NCDs and risk factors were divided into strata according to sex. Selection of the participants from these two strata was done by purposive sampling. Data was collected through virtual interviews by an experienced research assistant using a semi-structured questionnaire. Thematic analysis was conducted guided by the elements of the Health Policy Triangle framework which was the theoretical underpinning of the study and the research questions. Four themes emerged from content analysis: awareness, earmarking of priorities, scoping of priorities and timing of implementation. All participants had some knowledge about the Declaration of Port of Spain 2007 or elements of it. All 13 participants (100%) noted that earmarking of priorities was administered by an inter-ministerial government agency with private sector/industry representation. Participants identified various positives to earmarking priorities which included the importance of alignment of priorities across ministries so that all actors could be focused on the same priority at the same time; make strategic budgetary allocations to health, and garner public and private support for policy action. There was general agreement that the health-related issues such as NCDs prevention and treatment were a major focus of inter-sectoral collaboration, with each ministry acting based on their unique ministerial portfolios and interests. Eight participants (61%) pointed to the adverse impact of political/government changeovers on policy momentum and prioritisation in the analysis of the policy context. The double burden of NCDs and communicable diseases experienced by Guyana was articulated as detrimental to NCDs' prioritisation. All participants (100%) highlighted the harmful impact of the COVID-19 pandemic which resulted stalled work on policy implementation stalled and halted momentum; and the important and diverse influence of international organizations on intersectoral collaboration. Regarding policy actors, all participants detailed the influence of political commitment and leadership on the design and implementation of the Declaration and highlighted the importance of inter-sectoral collaboration as a necessary, though insufficient condition for policy implementation. Four interviewees (31%) identified that turnover of senior health experts who had a more sustained commitment to measures than career politicians, and ad-hoc and reactive instances of policy support by politicians, led to under-resourced, conflicting and piecemeal policy responses, that undermined progress with the prevention and control of NCDs. Four participants described industries' use of pre-emptive action to stave off regulatory measures of products that had seen economic growth, as a major cause of NCDs. Intentional framing of industry activity as a significant source of employment and contributor to economic growth was a common tactic used to influence public and political opinion of fiscal measures and was evident in the implementation of tobacco and sugary beverages control measures. Most of the participants viewed industry involvement as a barrier to intersectoral collaboration. Nine of the 13 participants (69.2%) identified civil society engagement as integral to successful implementation of the Declaration that were specifically related to lifestyle/behavioural changes and the implementation of fiscal measures. Most of the participants (11 of 13 or 85 %) identified the direct support by bilateral agencies and multilateral agencies as critical enablers to the implementation of the Declaration of Port of Spain 2007. The common forms of support included provision of technical cooperation and financing, linking multi-sector agencies with local counterparts, supporting multi-sectoral consensus building, and supplementing Guyana's economic, technical, and legal capacities to overcome capacity constraints. Overall, the results showed that intersectoral collaboration has happened and is still taking place among the various ministries (MoA, MoE, MoF, MoH and MoT) for the implementation of the Declaration of Port of Spain 2007. All five of the ministries were also collaborating for the implementation of education and awareness programmes on prevention of NCDs and risk factors. The results showed various collaborative mechanisms with the Ministry of Health playing a major role in coordination and functioning. Factors that aided collaboration include: the country's commitment/obligation to implement the CARICOM Declaration at country level; knowledge of each ministries mandate and understanding the linkages with other ministries to achieve the overall goal; and the sustained support from international organisations for conceptualization, implementation of the Declaration. The barriers to collaboration were competition among ministries, limited financial and human resources, high level of dependency on international organisations and lack of political will. There were factors that aided and hindered collaboration among the five ministries for implementation of the Declaration of Port of Spain 2007 in Guyana.
As doenças não transmissíveis (DNTs) são a principal causa mundial de morbidade e mortalidade evitáveis, que fazem com que nações ricas e pobres passem por dificuldades. Globalmente, essas doenças - particularmente diabetes, doenças cardiovasculares, cânceres e doenças pulmonares crônicas atingiram verdadeiras proporções epidêmicas. A Guiana é um país de renda média baixa com uma incidência crescente de DNTs que parece refletir a tendência global e foi responsável por mais de 68% de todas as mortes. Em um esforço para reduzir o ônus das DNTs, os países da Comunidade do Caribe (CARICOM), incluindo a Guiana, assinaram a Declaração de Port of Spain 2007: Unindo-se para parar a epidemia de DNTs, na busca de promover a colaboração inter-regional e facilitar parcerias setoriais que deveriam servir de modelo para plataformas de parceria em nível nacional e ações multissetoriais voltadas para a redução das DCNT. Com base no contexto, o objetivo deste estudo é analisar a colaboração intersetorial entre os Ministérios do Governo (Agricultura, Educação, Finanças, Saúde e Comércio) para a implementação da Declaração de Port of Spain 2007 na Guiana. Estudo qualitativo, orientado pelos Consolidated Criteria for Reporting Qualitative Research (COREQ). Os participantes eram funcionários seniores (gerentes de programas, chefes de departamento) atualmente empregados em um dos cinco ministérios selecionados e funcionários seniores que trabalharam nesses ministérios depois de 2007, ano em que a Declaração de Port of Spain foi introduzida. Os participantes foram selecionados por causa de seus papéis de tomada de decisão e responsabilidades relacionadas à implementação de intervenções, políticas e programas de prevenção e controle para DNTs e fatores de risco em seus respectivos ministérios. Os altos decisores responsáveis pela implementação de políticas de prevenção e controle de DCNT e fatores de risco foram divididos em estratos de acordo com o sexo. A seleção dos participantes desses dois estratos foi feita por amostragem intencio nal. Os dados foram coletados por meio de entrevistas virtuais por um assistente de pesquisa experiente, usando um questionário semiestruturado. A análise temática foi realizada guiada pelos elementos do referencial do Health Policy Triangle que constituiu a sustentação teórica do estudo e as questões de pesquisa. Quatro temas emergiram da análise de conteúdo: conscientização, definição de prioridades, escopo das prioridades e tempo de implementação. Todos os participantes tinham algum conhecimento sobre a Declaração de Port of Spain 2007 ou elementos dela. Todos os 13 participantes (100%) observaram que a atribuição de prioridades era administrada por uma agência governamental interministerial com representação do setor privado/indústria. Os participantes identificaram vários pontos positivos na definição de prioridades, que incluíam a importância do alinhamento de prioridades entre os ministérios para que todos os atores pudessem se concentrar na mesma prioridade ao mesmo tempo; fazer alocações orçamentárias estratégicas para a saúde e obter apoio público e privado para a ação política. Houve um consenso geral de que as questões relacionadas à saúde, como prevenção e tratamento de DNTs, eram o foco principal da colaboração intersetorial, com cada ministério agindo com base em seus interesses e interesses ministeriais exclusivos. Oito participantes (61%) apontaram para o impacto adverso das mudanças políticas/governamentais na dinâmica política e na priorização na análise do contexto político. A dupla carga de DNTs e doenças transmissíveis enfrentadas pela Guiana foi articulada como prejudicial à priorização das DNTs. Todos os participantes (100%) destacaram o impacto prejudicial da pandemia de COVID-19, que resultou na paralisação do trabalho na implementação de políticas e na interrupção do ímpeto; e a influência importante e diversificada de organizações internacionais na colaboração intersetorial. Com relação aos atores políticos, todos os participantes detalharam a influência do compromisso político e da liderança no desenho e implementação da Declaração e destacaram a importância da colaboração intersetorial como condição necessária, embora insuficiente para a implementação da política. Quatro entrevistados (31%) identificaram que a rotatividade de especialistas seniores em saúde que tinham um compromisso mais sustentado com as medidas do que os políticos de carreira, e instâncias ad hoc e reativas de apoio político por políticos, levaram a respostas políticas com poucos recursos, conflitantes e fragmentadas, que prejudicaram o progresso na prevenção e controle das DNTs. Quatro participantes descreveram o uso de ações preventivas pelas indústrias para evitar medidas regulatórias de produtos que tiveram crescimento econômico, como uma das principais causas de DNTs. O enquadramento intencional da atividade da indústria como uma fonte significativa de emprego e contribuinte para o crescimento econômico foi uma tática comum usada para influenciar a opinião pública e política sobre as medidas fiscais e ficou evidente na implementação de medidas de controle de tabaco e bebidas açucaradas. A maioria dos participantes via o envolvimento da indústria como uma barreira à colaboração intersetorial. Nove dos 13 participantes (69,2%) identificaram o envolvimento da sociedade civil como essencial para a implementação bem-sucedida da Declaração especificamente relacionada a mudanças de estilo de vida/comportamento e à implementação de medidas fiscais. A maioria dos participantes (11 de 13 ou 85%) identificou o apoio direto de agências bilaterais e agências multilaterais como facilitadores críticos para a implementação da Declaração de Port of Spain 2007. As formas comuns de apoio incluíam provisão de cooperação técnica e financiamento, vinculando agências multissetoriais com contrapartes locais, apoiando a formação de consenso multissetorial e complementando as capacidades econômicas, técnicas e jurídicas da Guiana para superar as restrições de capacidade. No geral, os resultados mostraram que a colaboração intersetorial aconteceu e ainda está ocorrendo entre os vários ministérios (MoA, MoE, MoF, MoH e MoT) para a implementação da Declaração de Port of Spain 2007. Todos os cinco ministérios também estavam colaborando para a implementação de programas de educação e conscientização sobre prevenção de DNTs e fatores de risco. Os resultados mostraram vários mecanismos de colaboração com o Ministério da Saúde desempenhando um papel importante na coordenação e funcionamento. Os fatores que ajudaram na colaboração incluem: o compromisso/obrigação do país de implementar a Declaração da CARICOM em nível nacional; conhecimento do mandato de cada ministério e compreensão das ligações com outros ministérios para alcançar o objetivo geral; e o apoio contínuo de organizações internacionais para a conceituação e implementação da Declaração. As barreiras à colaboração foram a competição entre ministérios, recursos financeiros e humanos limitados, alto nível de dependência de organizações internacionais e falta de vontade política. Houve fatores que facilitaram e dificultaram a colaboração entre os cinco ministérios para a implementação da Declaração de Port of Spain 2007 na Guiana.
Sujets)
Humains , Prévention primaire , Politique publiqueRésumé
Introducción: el lupus eritematoso sistémico (LES) es una enfermedad sistémica que se ha asociado a mayor severidad con la infección por SARS-CoV-2. Particularmente la alta actividad de la enfermedad y algunos inmunosupresores se han vinculado a peores desenlaces. Objetivos: describir las características por SARS-CoV-2 en pacientes con LES en Argentina del registro SAR-COVID y establecer los factores asociados a peor desenlace de la misma. Materiales y métodos: estudio observacional. Se incluyeron pacientes con diagnóstico de LES con infección confirmada por SARS-CoV-2 (RT-PCR y/o serología positiva) del registro SAR-COVID. Los datos se recolectaron desde agosto de 2020 hasta marzo de 2022. El desenlace de la infección se midió mediante la escala ordinal de la Organización Mundial de la Salud (EO-OMS). Se definió COVID-19 severo con un valor EO-OMS ≥5. Análisis descriptivo, test T de Student, test de Mann Whitney U, ANOVA, chi2 y Fisher. Regresión logística múltiple. Resultados: se incluyeron 399 pacientes, el 93% de sexo femenino, con una edad media de 40,9 años (DE 12,2). El 39,6% tenía al menos una comorbilidad. Al momento de la infección, el 54,9% recibía glucocorticoides, el 30,8% inmunosupresores y el 3,3% agentes biológicos. La infección por SARS-CoV-2 fue leve en la mayoría de los casos, mientras que un 4,6% tuvo curso severo y/o falleció. Estos últimos presentaban comorbilidades, usaban glucocorticoides y tenían síndrome antifosfolipídico (SAF) con mayor frecuencia y mayor actividad de la enfermedad al momento de la infección. En el análisis multivariado, la hipertensión arterial, el diagnóstico de SAF y el uso de glucocorticoides se asociaron a hospitalización severa y/o muerte por COVID-19 (EO-OMS ≥5). Conclusiones: en esta cohorte de pacientes con LES con infección por SARS-CoV-2 confirmada, la mayoría cursó de manera sintomática, un 22,1% fue hospitalizado y un 5% requirió ventilación mecánica. La mortalidad fue cercana al 3%. El diagnóstico de SAF, tener hipertensión arterial y el uso de glucocorticoides se asociaron significativamente con COVID-19 severo.
Introduction: systemic lupus erythematosus (SLE) is a systemic disease that has been associated with greater severity with SARS-CoV-2 infection. Particularly high disease activity and some immunosuppressants have been linked to worse outcomes. Objectives: to describe the characteristics due to SARS-CoV-2 in patients with SLE in Argentina from the SAR-COVID registry and to establish the factors associated with a worse outcome of the same. Materials and methods: observational study. Patients diagnosed with SLE with confirmed SARS-CoV-2 infection (RT-PCR and/or positive serology) from the SAR-COVID registry were included. Data was collected from August 2020 to March 2022. The outcome of the infection was measured using the World Health Organization - ordinal scale (WHO-OS). Severe COVID-19 was defined as an WHO-OS value ≥5. Descriptive analysis, Student's T test, Mann Whitney U, ANOVA, chi2 and Fisher. Multiple logistic regression. Results: a total of 399 patients were included, 93% female, with a mean age of 40.9 years (SD 12.2), 39.6% had at least one comorbidity. At the time of infection, 54.9% were receiving glucocorticoids, 30.8% immunosuppressants, and 3.3% biological agents. SARS-CoV-2 infection was mild in most cases, while 4.6% had a severe course and/or died. The latter had comorbidities, used glucocorticoids and had antiphospholipid syndrome (APS) more frequently and higher disease activity at the time of infection. In the multivariate analysis, high blood pressure, the diagnosis of APS, and the use of glucocorticoids were associated with severe hospitalization and/or death from COVID-19 (WHO-EO ≥5). Conclusions: in this cohort of SLE patients with confirmed SARS-CoV-2 infection, most had a symptomatic course, 22.1% were hospitalized, and 5% required mechanical ventilation. Mortality was close to 3%. The diagnosis of APS, having high blood pressure, and the use of glucocorticoids were significantly associated with severe COVID-19.
Sujets)
PandémiesRésumé
Introducción: la artritis reumatoidea (AR) y los tratamientos indicados para su manejo pueden afectar la respuesta a la vacuna para SARS-CoV-2. Sin embargo, aún no se cuenta con datos locales. Objetivos: evaluar la respuesta humoral de la vacuna para SARS-CoV-2 y su seguridad en esta población. Materiales y métodos: estudio observacional. Se incluyeron pacientes ≥18 años, con AR ACR/EULAR 2010 que recibieron la vacunación para SARS-CoV-2. Detección de IgG anti-proteína S (kit COVIDAR). Resultados: se incluyeron 120 pacientes con AR. El 24,4% recibió tratamiento con glucocorticoides, 50,9% drogas biológicas y 13,3% inhibidores de JAK (janus kinases). El 6% había tenido infección por SARS-CoV-2 previamente. La vacuna más utilizada en la primera dosis fue Sputnik V (52,9%). El 25% recibió esquemas heterólogos. Luego de la primera dosis, el 59% presentó una prueba no reactiva o indeterminada, y un 18% luego de la segunda dosis. La aplicación de esquemas homólogos de vacuna Sinopharm (63,6% vs 13,3%, p<0,0001), y el uso de abatacept (27,3% vs 5,1%, p=0,005) y rituximab (18,2% vs 0%, p=0,001) al momento de la vacunación se asociaron a un resultado no reactivo o indeterminado. Conclusiones: similar a lo reportado en otras poblaciones internacionales, en esta cohorte, dos de cada 10 pacientes no desarrollaron anticuerpos. Una menor respuesta se asoció con la vacuna Sinopharm y al tratamiento con abatacept y rituximab.
Introduction: rheumatoid arthritis (RA) and its treatments can affect the response to the SARS-CoV-2 vaccine. However, we still do not have local data. Objectives: to evaluate the humoral response of the SARS-CoV-2 vaccine and its safety in this population. Materials and methods: observational study. Patients ≥18 years of age, with RA ACR/EULAR 2010 who had received vaccination for SARS-CoV-2 were included. Detection of anti-protein S IgG (COVIDAR Kit). Results: a total of 120 patients with RA were included. A quarter was receiving glucocorticoids, 50.9% biological drugs and 13.3% JAK inhibitors (janus kinases). Only 6% had a history SARS-CoV-2 infection. The most used vaccine was Sputnik V (52.9%) and 25% received mixed regimenes. After the first dose, 59% had a non-reactive or indeterminate test, and after the second, 18% were still having this result. The application of homologous Sinopharm vaccine regimen (63.6% vs 13.3%, p<0.0001) and the use of abatacept (27.3% vs 5.1%, p=0.005) and rituximab (18.2% vs 0%, p=0.001) at vaccination was associated with a non-reactive or indeterminate result. Conclusions: similar to other international populations, in this cohort, two out of 10 patients did not develop antibodies. A lower response was associated with the Sinopharm vaccine and treatment with abatacept and rituximab.
Sujets)
Humains , Mâle , Femelle , Adulte d'âge moyen , Sujet âgé , Polyarthrite rhumatoïde/immunologie , Immunité humorale , Vaccins contre la COVID-19/immunologie , Études longitudinales , Vaccins contre la COVID-19/effets indésirables , COVID-19/immunologie , COVID-19/prévention et contrôle ,Résumé
Con el fin de evaluar el impacto de la infección por SARS-CoV-2 en pacientes con enfermedades reumáticas, la Sociedad Argentina de Reumatología desarrolló el Registro Nacional de Pacientes con Enfermedades Reumáticas y COVID-19 (SAR-COVID). El objetivo del presente trabajo fue evaluar las características sociodemográficas y clínicas de los pacientes con enfermedades reumáticas e infección por SARS-CoV-2 incluidos en el registro SAR-COVID y describir las complicaciones y desenlaces de la COVID-19 en esta población. Material y métodos: SAR-COVID es un registro nacional, multicéntrico y observacional, en el cual se incluyen de manera consecutiva pacientes ≥18 años de edad, con diagnóstico de alguna enfermedad reumática que hayan cursado infección por SARS-CoV-2. Se consignan datos sociodemográficos, comorbilidades, enfermedad reumática y su tratamiento, características clínicas, laboratorio, complicaciones y tratamientos de la infección por SARS-CoV-2. Resultados: Se incluyeron 525 pacientes, con una edad media de 51.3 años (DE 15.2). Las enfermedades reumatológicas más frecuentes fueron artritis reumatoidea (40.4%), lupus eritematoso sistémico (14.9%) y espondiloartritis (8.2%). El 72.9% recibía tratamiento inmunosupresor o inmunomodulador al momento del inicio de la infección y 36.9% glucocorticoides. En la mayoría de los casos, el diagnóstico de infección por SARS-CoV-2 se llevó a cabo mediante RT-PCR (95%), 39.4% en la consulta externa, 32.2% en el departamento de urgencias, y 14.7% durante la hospitalización. La mayoría de los pacientes presentaron síntomas, siendo los más frecuentes fiebre (56.2%), tos (46.7%) y cefalea (39.2%). Durante la infección, 35.1% requirieron hospitalización y 11.6% en unidad de cuidados intensivos. El 75.1% se recuperó completamente, 8.4% presentó secuelas y 6.9% murieron a causa de COVID-19. Conclusión: En este primer reporte del registro SAR-COVID encontramos una amplia distribución de enfermedades reumáticas. La mayoría de los pacientes tuvieron una buena evolución de la infección, sin embargo un 7% falleció como consecuencia de la misma, datos comparables a los reportados por otros registros latinoamericanos con poblaciones similares.
In order to assess the impact of SARS-CoV-2 infection in patients with rheumatic diseases, the Argentine Society of Rheumatology has developed the National Registry of Patients with Rheumatic Diseases and COVID-19 (SAR-COVID). The aim of this study was to evaluate the sociodemographic and clinical characteristics of patients with rheumatic diseases and SARS-CoV-2 infection included in the SAR-COVID registry and to describe the complications and outcomes of COVID-19 in this population. Methods: SAR-COVID is a national, multicenter and observational registry, in which patients ≥18 years of age, with a diagnosis of a rheumatic disease who had SARS-CoV-2 infection are consecutively included. Sociodemographic data, comorbidities, underlying rheumatic disease and treatment, clinical characteristics, complications, laboratory and treatment of the SARS-CoV-2 infection were recorded. Results: A total of 525 patients were included, with a mean age of 51.3 years (SD 15.2). The most frequent rheumatic diseases were rheumatoid arthritis (40.4%), systemic lupus erythematous (14.9%) and spondyloarthritis (8.2%). At the time of the infection, 72.9% were receiving immunosuppressive or immunomodulatory treatment and 36.9% glucocorticoids. Most of the patients were diagnosed using RT-PCR (95%), at outpatient consultation (39.4%), at the emergency room (32.2%) or during hospitalization (14.7%). Symptoms were present in 96% of the patients, the most frequent being fever (56.2%), cough (46.7%) and headache (39.2%). During infection, 35.1% were hospitalized, 11.6% were admitted to the ICU and 6.9% died due to COVID-19. Most of them (75.1%) recovered completely. Conclusions: In this first report of the SAR-COVID registry we found a wide distribution of rheumatic diseases. Most of the patients had a good evolution of the infection, however 7% died as a result of it, comparable to other Latin American registries with similar populations.