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Objective: To compare the incidence of complications and the need for hospitalization for COVID-19 in groups of patients older than and younger than 60 years of age with rheumatic diseases (RD). Material(s) and Method(s): The study involved 89 patients with RD who underwent COVID-19, verified by RT-PCR for SARS-CoV- 2 RNA, for the period from 05/15/2020 to 12/01/2021. Participants in the study, after talking with the research physician, filled out questionnaires on past COVID-19 and post-COVID syndrome. The information was supplemented with data from discharge records after inpatient treatment for COVID-19. Statistica program (version 12) was used for statistical processing. Result(s): The data obtained were differentiated depending on the age of the participants: < 60 years (group 1), N = 69 and > = 60 years (group 2), N = 20. Both groups were dominated by women (82.6% and 85%). The average age in group 1 was 41.9 +/- 11.6 years, in group 2 -68.5 +/- 5.1 years. 19 patients (48.7%) in group 1 and 13 patients (65%) in group 2 were hospitalized. Of these, oxygen support was statistically more frequent (P < 0.05) in group 2 patients: 9 (69.2%) vs 5 (26.3%). Complications were registered in group 1 in 9 cases (13%): venous thrombosis in 1 patient, acute respiratory failure in 4 patients and the development of concomitant infections in 4 patients. In group 2, complications were noted significantly more often (P < 0.05) -in 8 cases (40%): venous thrombosis in 2, acute respiratory failure in 1, acute heart failure in 1, acute cerebrovascular accident in 1 and the development of concomitant infections in 3 patients. 7 patients (10.1%) in group 1 had COVID-19 again on average 11.5 +/- 2.2 months after the first case. Of these, 1 patient required hospitalization. There were no recurrences of COVID-19 in group 2. Conclusion(s): Elderly patients with RD with COVID-19 are more likely to need oxygen support. Also in this group, COVID-19 is more likely to cause serious complications, including cardiovascular and respiratory failure and thrombotic complications.
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Purpose: To compare the frequency of occurrence of various symptoms of post-covid syndrome (PCS) in groups of patients with rheumatic diseases (RD) of the elderly to young. Material(s) and Method(s): The study involved 89 patients with RD who underwent COVID-19, verified by RT-PCR for SARS-CoV- 2 RNA, for the period from 05/15/2020 to 12/01/2021. Participants in the study, after talking with the research physician, completed questionnaires on past COVID-19 and post-COVID syndrome (PCS). The information was supplemented with data from discharge records after inpatient treatment for COVID-19. Result(s): The data obtained were differentiated depending on the age of the participants: <60 years (group 1), N = 69 and >=60 years (group 2), N = 20. Both groups were dominated by women (82.6% and 85%). The average age in group 1 was 41.9 +/- 11.6 years, in group 2 -68.5 +/- 5.1 years. 33 (47.8%) patients in group 1 and 10 (50%) in group 2 noted the development of PCS. In group 1, the following symptoms of PCS prevailed: memory impairment -in 17 (51.5%) patients, fatigue, weakness -in 14 (42.4%), problems with concentration -in 14 (42.4%), arthralgia -in 12 (36.4%) %, shortness of breath during physical exertion -in 11 (33.3%), drowsiness -in 10 (30.3%), irritability -in 9 (27.3%). In group 2, the most common memory impairment -in 8 (80%) patients, weakness, fatigue -in 7 (70%), arthralgia -in 7 (70%), problems with concentration -in 6 (60%), weight loss -in 5 (50%), irritability -in 5 (50%), sleep disturbance -in 5 (50%). The frequency of occurrence of different manifestations of PCS did not differ significantly between the groups. On average (median), each patient in group 1 noted 4 [2;8], group 2 -10 [8.25;12.5] symptoms of PCS at the same time, but the differences did not reach statistical significance. Conclusion(s): The frequency of occurrence of various clinical manifestations of PCS did not have statistically significant differences between the study groups. In a comparative assessment, the group of elderly patients noted a greater number of symptoms of PCS at the same time.
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Objective: to compare the features of COVID-19 in groups of patients older and younger than 60 years of age with rheumatic diseases (RD). Material(s) and Method(s): The study involved 89 patients with RD who underwent COVID-19, verified by RT-PCR for SARS-CoV- 2 RNA. Participants in the study, after talking with the research physician, completed questionnaires on the past COVID-19. The information was supplemented with data from discharge records after inpatient treatment for COVID-19. Result(s): The data obtained were differentiated depending on the age of the participants: <60 years (group 1), N = 69 and >=60 years (group 2), N = 20. In both groups, RDs were predominantly represented by rheumatoid arthritis (53.6% and 75%, respectively). Both groups were dominated by women (82.6% and 85%). The average age in group 1 was 41.9 +/- 11.6 years, in group 2 -68.5 +/- 5.1 years. At the time of the development of COVID-19, the severity of symptoms of RD according to VAS did not have significant differences in both groups and amounted to 4.3 +/- 2.8 in group 1 and 4.8 +/- 2.7 in group 2. Among the clinical manifestations of COVID-19 in both groups, weakness, fatigue -in 65 (94.2%) and 18 (90%) patients, respectively, fever -in 56 (81.1%) and 15 (75%), anosmia -in 43 (62.3%) and 14 (70%) patients, arthralgia -in 37 (53.6%) and 13 (65%) patients, myalgia -in 32 (46.4%) and 16 (80%) patients. In group 2, myalgia occurred significantly more often than in group 1 (P < 0.05). During the COVID-19 period, CT scan was performed in group 1 -39 patients, in group 2 -14. Changes corresponding to CT-0 were detected in groups 1 and 2 in 10 (25.5%) and 0 patients, respectively, CT-1 -in 19 (48.7%) and 4 (28.6%), CT-2 -in 9 (23.2%) and 5 (35.7%), CT-3 -in 1 (2.6%) and 4 (28.6%), CT-4 -in 0 and 1 (7.1%). Statistically, severe lung damage (CT-3.4) was significantly more common in group 2, and patients in group 1 more often had the disease without lung damage (CT-0), P < 0.05. Conclusion(s): Weakness, fever, arthralgia, myalgia and anosmia were the most common manifestations of COVID-19 in the study groups. Myalgia was significantly more common in patients over 60 years of age. When assessing pulmonary changes, the severe course of COVID-19 was significantly more common in the group of elderly patients.
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Objective: To describe the clinical, laboratory and pharmacokinetic features of elderly patients with rheumatoid arthritis (RA), with insufficient response to methotrexate (MTX) therapy for 24 weeks compared with patients with a good response. Material(s) and Method(s): The study included 32 patients with RA, according to the older age category according to WHO criteria, 65 (82%) women and 14 (18%) men, BMI was 27 +/- 4 kg/m2, DAS28 was 5.9 +/- 1. In each case, MTX was administered parenterally, at the rate of 10-15 mg/m2 of body surface. therapeutic drug monitoring was carried out, it was the determination of the concentrations of MTX monoglutamate (initial form) and MTX compounds: polyglutamates and 7-hydroxymethotrexate (7-OH- MT) in erythrocytes (ER) and mononuclear cells (MO) after 4, 12 and 24 weeks. We used high performance liquid chromatography with mass spectrometric detection. The MTX metabolite index was calculated (the ratio of the metabolite concentration to the initial concentration of unchanged MT). Achievement of therapy targets (good response to therapy) was established in accordance with the EULAR criteria. The lack of achievement of therapy goals corresponded to an insufficient response to therapy. Result(s): By week 24, 12 patients (36%, group 1) achieved therapy targets, 17 patients (53%, group 2) did not reach treatment targets, and in 3 more, MTX was discontinued due to Adverse reactions (ARs) and/or the development of COVID-19. A comparison was made of clinical and laboratory parameters before the start of MTX treatment and during MTX therapy. At all stages of the study the groups did not differ in terms of: sex, age, BMI, disease duration, VAS (pain), DAS28 index, creatinine, taking glucocorticoids, statins, the presence and frequency of comorbid pathology (arterial hypertension, diabetes mellitus, chronic autoimmune thyroiditis). The 7-OH- MTX( ER) metabolic index after 12 weeks of treatment was higher in group 1 (1.35 [0.8;2.1] versus 0.35 [0.19;0.73] in group 2). Metabolic indices of other MTX metabolites did not differ. ARs were less common in group 1 (in 1 (18%) versus 6 (35%) in group 2), P = 0.09. Conclusion(s): Clinical and laboratory characteristics of patients of the older age group did not differ in groups with different responses to methotrexate therapy. The 7-OH- MT( ER) metabolism index after 12 weeks of treatment was higher in the group of patients with a good response to therapy, which most likely indicates a more rapid catabolism of MTX in this group of patients.
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Epstein-Barr virus (EBV) belongs to the family of herpesviruses (herpes type 4) and is one of the most common and highly contagious. During the pandemic of a new coronavirus disease, it was found that in patients previously infected with EBV, COVID-19 can cause its reactivation, which is often manifested by the clinic of acute hepatitis. The article presents a clinical case of the development of acute hepatitis in a patient with mixed infection with EBV and SARS-CoV-2 in combination with allergic toxic reaction while taking sulfasalazine prescribed for spondyloarthritis. A feature of this case was the development of severe hepatitis of mixed genesis with a favorable outcome. The importance of adherence to drug monitoring rules for newly prescribed drugs for COVID-19 was emphasized. In severe cases of the disease, the possibility of mixed infection should be taken into account. © 2022, Ima-Press Publishing House. All rights reserved.
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Background: Almost two years after the start of the pandemic, it has become clear that the severity of COVID-19 is not limited to the manifestations of the acute phase of SARS-CoV-2 infection. The so-called post-covid syndrome (PCS) can occur even in patients who have experienced mild or moderate COVID-19 and includes long-term symptoms that may be associated with residual infammation, organ damage, non-specifc effects of hospitalization or prolonged ventilation, social isolation, or comorbid diseases. In October 2021, the WHO defned PCS as a condition that occurs in individuals with a history of probable or confrmed infection with the SARS-CoV-2 virus, usually within 3 months of the onset of COVID-19, and is characterized by the presence of symptoms for at least 2 months, as well as the impossibility of explaining them with an alternative diagnosis. Objectives: To conduct a comparative assessment of clinical and demographic indicators in groups of patients with rheumatoid arthritis who underwent COVID-19, with and without PCS. Methods: The material of the questionnaires flled in by patients of the V.A. Nasonova Research Institute of Rheumatology, who underwent COVID-19, ver-ifed by RT-PCR for SARS-CoV-2 RNA. The information was supplemented with data from discharge records after inpatient treatment for COVID-19. Statistica program (version 12) was used for statistical processing. The results of correlation analysis were considered signifcant at p<0.05. Results: The study included 23 adult patients (over 18 years of age) with a reliable diagnosis of rheumatoid arthritis (ACR/EULAR). Of these, 11 (47.8%) patients noted the development of PCS (Group 1), and 12 patients underwent COVID-19 without consequences (Group 2). Both groups were represented predominantly by women (90.9% and 91.7%, respectively). The average age in both groups did not differ sig-nifcantly and amounted to 56.73±14.79 years in group 1, and 48.17±19.59 years in group 2. The median number of comorbid diseases was 2 [1;4] in group 1 and 0.5 [0;2.5] in group 2. PCS was presented by the following symptoms: weakness, increased fatigue-in 6 patients, problems with attention, concentration-in 7, memory impairment-in 6, sleep disturbances-in 7, increased pain in the joints-in 7, shortness of breath during exercise-in 6, fuctuations in blood pressure-in 5, tachycardia-in 4. On average (median), each patient noted 10 [6.5;12] symptoms of PCS at a time. When assessing the number of symptoms in the infectious phase, in group 1, patients reported 20 [16;23], and in group 2, 10 [7;12] symptoms of COVID-19. At the time of development of COVID-19, the severity of RA symptoms, assessed by VAS, was 5.64±3.26 in group 1 and 4.75±2.99 in group 2. In group 1, 5 (45.5%) patients needed hospitalization, 3 of them needed oxygen support. In group 2, 4 (33.3%) patients were hospitalized, two of them needed oxygen support. 3 patients in group 1 suffered COVID-19 again on average 9.33±2.52 months after the frst illness. One of them has been vaccinated. All patients in this group were treated as outpatients, while the frst case of COVID-19 required one hospitalization and oxygen support. Statistical assessment of signifcant differences (p<0.05) between groups in terms of sex, age, number of comorbid diseases, number of COVID-19 symptoms in the infectious phase, severity of RA symptoms, and hospitalization rate was not revealed. Conclusion: Even though when assessing the socio-demographic characteristics, no statistically significant differences were found between the study groups, the average age, the number of comorbid diseases, and the severity of RA symptoms at the time of COVID-19 were higher in the group of patients with RA and PCS. Patients with PCS reported higher rates of hospitalizations and more severe COVID-19. There were also repeated cases of COVID-19 in this group. It is necessary to continue the study on a larger cohort.
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Background: COVID-19 remains a serious problem almost two years later, despite the ongoing active search for effective tools to control it. To date, it is known that COVID-19 not only proceeds as an acute respiratory illness, but also leads to a systemic infammatory response and hypercoagulability through activation of both the innate and adaptive immune systems. Patients with rheumatic and musculoskeletal diseases appear to be more vulnerable to the development of severe forms of COVID-19 due to the impaired immune response associated with RMD. In addition, immunosuppressants prescribed to control RMD increase the risk of infections. And fnally, RMD is often combined with comorbid conditions from the group of risk factors for severe forms of COVID-19 such as arterial hypertension, diabetes mellitus and obesity. Objectives: to characterize the features of the course of COVID-19 in patients with rheumatoid arthritis. Methods: We studied the material of questionnaires flled out by patients of the hospital of the V.A. Nasonova Research Institute of Rheumatology who underwent COVID-19, verifed by RT-PCR to SARS-CoV-2 RNA, for the period from 05/15/2020 to 12/15/2021. The information was supplemented with data from discharge reports after inpatient treatment of COVID-19. Statistica software (version 12) was used for statistical processing. The results of the correlation analysis were considered reliable at p≤0.05. Results: The study included 32 adult (over 18 years old) patients (29 women, 90%) with a reliable diagnosis of rheumatoid arthritis (ACR/EULAR). The average age of patients is 50.75 ± 16.48 years. In the study group, 29 (90.6%) patients never smoked, 2 smoked in the past and 1 was an active smoker. The duration of the course of RA (median) was 8 [4;14.5] years. The most common comorbidities were diseases of the cardiovascular system (in 20 patients), diseases of the gastrointestinal tract (in patients), diabetes (in 4 patients) and obesity (in 5 patients). The median number of comorbid diseases was 1 [0;3]. At the time of the development of COVID-19, the severity of RA symptoms, assessed by the VAS, was 4.78 ± 3.06. As antirheu-matic therapy, 10 (31.25%) patients took glucocorticoids at an average dose of 5 ± 3.9 mg/day. (prednisolone equivalent), 22 (68.75%)-DMARDs. 19 patients received bDMARDs, incl. 12-rituximab (37.5%, of which 7 received the last infusion within 6 months or less before the frst symptoms of COVID-19 appeared). Among the clinical manifestations of COVID-19, weakness was most often noted, fatigue-in 29 (90.6%), fever-in 23 (71.9%), anosmia-in 20 (62.5%), dysgeusia-in 19 (59.4%), increased arthralgia-in 17 (53.1%), shortness of breath during exercise-in 16 (50%), cough-in 15 (46.9%). There was a signifcant positive correlation between increased arthralgia during COVID-19 and RA activity. On average (median), each patient reported 13.5 [9.75;19.25] symptoms associated with COVID-19. There was no signifcant correlation between the number of COVID-19 symptoms and RA activity. During COVID-19, CT scan was performed in 19 patients: CT-0-in 1 patient (5.3%), CT-1-in 9 (47.4%), CT-2-in 5 (26.3%), CT-3-in 3 (15.7%), CT-4-in 1 (5.3%). There was no correlation between the CT stage and RA activity. 12 patients (37.5%) were hospitalized, of which needed oxygen support. Rituximab treatment was not associated with hospitaliza-tion rates. Complications were reported in 4 cases (12.5%): venous thrombosis in 2 patients and acute respiratory failure in 2 more patients. Conclusion: 37.5% of COVID-19 patients in the study group required inpatient treatment. In 12.5%-COVID-19 proceeded with complications. The number of symptoms associated with COVID-19 did not correlate with RA activity. However, patients with higher RA activity more often noted increased arthralgia.
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Background: The key link in the therapeutic drug monitoring of methotrexate (MTX) is the measurement of the concentrations of its most stable metabolites, as well as products of the early and late stages of MTX conversion (short-chain polyglutamates). Metabolic rate of MTX can depend on the clinical characteristics of patients and concomitant drug therapy. Objectives: To reveal the regularity of the distribution of various metabolites in patients who responded and did not respond to MTX therapy. To compare groups of patients with different responses to MTX according to clinical characteristics. Methods: The study included 79 RA diagnosis according to ACR/EULAR 2010 criteria, 65 (82%) women and 14 (18%) men, aged 53 ± 11 years, naiive to MTX. All patients had normal renal excretory function (GFR more than 60 ml/min). All patients were prescribed MTX of 10-15 mg/m2 of body surface. Achievement of therapy targets was established according to the EULAR therapy response criteria. The determination of MTX monoglutamate in erythrocytes (ER) and mono-nuclear cells (MO), as well as the main metabolites of MTX-polyglutamates with 2,3 and 4 glutamate residues (MTXPG 2-4), as well as 7-hydroxymethotrexate (7-OH-MTX) was measured by the tandem chromatomass spectrometry after 4, 12 and 24 weeks of therapy, the result was expressed in nmol/L. The calculation was performed using the statistical data analysis package Statistica 10 for Windows (StatSoft Inc., USA) using the methods of parametric and nonparametric statistics. Results: By the 24th week of therapy, 34 (43%) (group 1) patients achieved the targets of therapy, 36 (46%) did not achieve (group 2). MTX withdrawn in 5 (6%) patients-due to adverse reactions. 4 (5%) were unable to continue to participate due to SARS-CoV2 pandemic. After 4 weeks of treatment, the concentration of various MTX metabolites did not differ in the groups. After 12 weeks of therapy, signifcant differences were found in the content of 7-OH MTX in the ER: 28.19 [7.28;58.07] and 5.89 [0.79;20.03], respectively (p=0.002);the concentration of the remaining fractions did not differ. Group 1 showed a higher concentration of 7-OH-MTX in MO after 24 weeks of therapy-5.23 [1.39;12.52] and 1.05 [0.07;3.55], respectively (p = 0.006). No differences between the concentrations of other MTX metabolites were found. The groups were matched for age, body mass index, duration of RA, and disease activity at the baseline. In group 2, patients used statins more often (2 (6%) versus 6 (37%), p = 0.01), however, there were no statistically signifcant differences in the concentration of MTX metabolites in the groups of patients taking and not taking statins. Conclusion: The concentration of 7-OH-MTX after 12 and 24 weeks of therapy is statistically higher in the group of patients who responded to therapy. 7-OH-MTX appears to be a more persistent metabolite of MTX, therefore, it is more applicable for therapeutic drug monitoring of MTX. Patients taking statins may be potential nonresponders to MTX therapy.
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Introduction. In modern reality postcovid syndrome (PCS) is characterized by clinical heterogeneity and multi-organ involvement, often presenting a differential diagnostic and therapeutic problem. However, in most studies of PCS, stratification of patients taking into account individual comorbid conditions was not performed. Thus, only an extremely small number of studies have been devoted to assessing the course of PCS in rheumatic diseases Purpose. To characterize the features of the course of COVID-19 in patients with rheumatoid arthritis, as well as to conduct a comparative assessment of clinical and demographic parameters in groups of patients with rheumatoid arthritis, differentiated by the presence of PCS. Materials and methods. The material of the questionnaire which contained questions regarding socio-demographic data of respondents, information on rheumatological history, comorbid diseases, data on past COVID-19, including cases of re-infection, and PCS. Results. The study included 32 adult patients (29 women, 90%) with a reliable diagnosis of rheumatoid arthritis. Of the 32 patients who underwent COVID-19, in 23 cases it was possible to form a judgment about the presence or absence of PCS. To study PCS, 23 patients were stratified into two groups: 11 (47.8%) patients developed PCS (Group 1) and 12 patients had COVID-19 without consequences (Group 2). Both groups were represented predominantly by women (90.9% and 91.7%, respectively). In the general group 37.5% of patients with COVID-19 required inpatient treatment. The number of symptoms associated with COVID-19 did not correlate with RA activity, however, patients with higher RA activity were more likely to report increased arthralgia as a symptom of COVID-19. 47.8% of COVID-19 survivors experienced PCS. The average age, the number of comorbid diseases and the severity of RA symptoms at the time of COVID-19 were relatively higher in the group of patients with RA and PKS. Patients with PKS also noted a higher frequency of hospitalizations and a more severe course of COVID-19. Conclusions. A quantitative assessment of the risk of developing PKS is needed, which will serve as a basis for developing a strategy aimed at prevention, timely diagnosis and treatment of this syndrome in patients with RS. To this end, further studies on larger cohorts of patients are required. © 2022, Remedium Group Ltd. All rights reserved.
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To describe the clinical case of coronavirus disease-2019, in a patient with rheumatoid arthritis. The patient A., 54, woman, was admitted in a rheumatologic hospital on April 27, 2020 due to the exacerbation of RA. The patient has been observed with the diagnosis of RA since 2013. At the time of admission, the patient took selective NSAIDs only. RNA SARS-CoV-2 (April 24, 2020) was negative. Results of the hospital examination (April 28, 2020): body mass index 32.63 kg/m2. CRP 13 mg/l, rheumatoid factor 65.4 IU/ml, MCV antibodies 30.7 U/ml, beta-2-glycoprotein antibodies IgG > 100 U/ml, ESR 35 mm/hour. Hospital treatment was carried out: methylprednisolone in a total dose of 2 grams intravenously drop-by-drop (from April 30 to May 4, 2020), methylprednisolone in tablets 6 mg/day, leflunomide 20 mg/day. On May 5, 2020 the patient presented with fever up to 38.5°C, which lasted two days, weakness, headache, abundant sweating, SpO2 96%, CRP 45 mg/l. CT of chest (May 7, 2020) was performed: numerous seals of pulmonary tissue of the type of "matte glass" with a peribronchial and subpleural localization on both lungs (severe double pneumonia) (Fig. 1). RNA SARS-?oV-2 (May 7, 2020) was positive. The patient was transferred to the infectious clinic. The patient received therapy with Azithromycin, Levofloxacin, Ambroxol, Hydroxychloroquine, Paracetamol, Enoxaparin Sodium, and oxygen therapy. CT of chest (May 11, 2020): 70% reduction in lung damage. The patient was discharged in a satisfactory condition on May 15, 2 020. Currently, the dominant concept is that patients with rheumatic diseases have a higher risk of developing severe forms of COVID-19 than in the general population. The presented data demonstrate a case of undisturbed COVID-19 course in a patient with active rheumatoid arthritis and a risk factor (obesity), who did not have such typical signs as coughing and shortness of breath, as well as a short-term fever course. According to the authors, earlier therapy with glucocorticoids (intravenously and further per os) could facilitate the faster regress of COVID-19.
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Purpose of the Study: To assess the autoimmune profile of patients with IIRD recovered from COVID-19. Materials and Methods: The study included 33 patients (17 women, 16 men, mean age 47.4 ± 19 years) with the following diagnoses: psoriatic arthritis (PSA) -9 (27%), osteoarthritis (OA) -9 (27%), spondyloarthritis (SpA) 15 (46%). 21% of patients denied a history of COVID-19 symptoms. 79% reported any signs of COVID-19 3.095 ± 1.45 months before this research (Median 3 [2;4] months). All patients underwent a SARSCoV-2 IgG/IgM chromatographic rapid test (Xiamen Biotime Biotechnology, China) for antibodies to SARS-CoV-2, and IgG antibodies were detected. All patients underwent analyzes for ANFHep2 and Anti-ds-DNA (hardware method), antibodies to beta 2 glycoprotein IgM, IgG, Antibodies to citrullinated cytoplasmatic peptide (ACCP), Rheumatoid factor, Anti-Sm, Anti-centr, Anti-SCL, C3-and C4 complement components, AT to -Jo-1 by ELISA. The autoimmune profile of patients with IIRD can be described as follows. ACCP were found in 3 (9%) patients: SpA-2, PSA-1;ANF-Hep2, (hardware method) were found in 7 (20%) patients: SpA-4, PSA-3, with 1 case in a low titer (1/160), 2 -on average (1/320), 4-high (1/640). All patients did not have: Anti-ds-DNA (hardware method), Rheumatoid factor, Anti-Sm, Anti-center, Anti-SCL, AT to -Jo-1, Antibodies to beta 2 glycoprotein IgM. Antibodies to beta 2 glycoprotein IgG were detected in 1 (3%) patient with SpA. C3c below 0.9 were found in 4 (11%) patients: SpA-1, PSA-1, OA-2;C4c below 0.1 were found in 1 (3%) patient with SpA. Conclusions: The data obtained suggest the possibility of the development of autoimmune reactions leading to the emergence of new autoantibodies in the study group. A decrease in the C3c component of complement in 11% of patients may be the result of a SARS-CoV2 infection. Further prospective study is needed to study the clinical and immunological characteristics of patients with IIRD who had recovered from COVID-19.
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Aim: To characterize the clinical and demographic indicators of patients with immunoinflammatory rheumatic diseases (IIRD) who underwent COVID-19, to assess the severity of the course and outcomes of infection in the study group, to identify patterns characteristic of patients with IIRD. Material and Methods: We studied the material of the Russian database (RIR/ARR-COVID-19), formed on the basis of reports from practicing rheumatologists, which included information about adults (over 18 years old) patients with different IIRD who underwent COVID-19. Results: Data were obtained on 132 patients (100 women, 75%) aged 51.814.4 years, of which 29 (21.9%) were 65 years old and older. In 40.2% of patients, the condition was aggravated by concomitant arterial hypertension, in 13.6% -by ischemic heart disease, in 7.6% -by diabetes mellitus and in 14.4% -by obesity (BMI 30). IIRZ activity at the time of COVID-19 disease was assessed in 122 patients, incl. high -in 19 (15.7%), moderate -in 43 (35.2%), low -in 43 (35.2%), remission -in 17 (13.9%). The most frequent clinical manifestations of COVID-19 were fever (60.6%), cough (40.2%), anosmia (38.6%), shortness of breath (35.5%), headache (27.3%), malaise (27.3%). When conducting a correlation analysis, the deterioration in the course of IIRD after suffering COVID-19 was associated with the male sex (r = 0.22, P < 0.05), a high level of C-reactive protein (75 mg /l) (r = 0.2, P < 0.05) and high activity of IIRZ (r = -0.3, P < 0.05) at the time of development of COVID-19. Conclusion: The course of COVID-19 was predominantly favorable, despite the presence of signs of clinical and laboratory activity of IIRZ and comorbid conditions. Further research in a larger cohort is needed to study in detail the characteristics of the course of COVID-19 in patients with IIRD.
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Background: An accessible and sensitive and sensitive method for determining antibodies to a new coronavirus infection is often the key to timely provision of the necessary medical care to patients with rheumatic diseases Objectives: Compare methods for determining antibodies to SARS-CoV-2 using a rapid test and enzyme-linked immunosorbent assay (ELISA) Methods: Methods for determining antibodies to SARS-CoV-2 using an express test (Chromatographic express test SARS-CoV-2 IgG / IgM (Xiamen Biotime Biotechnology, China)) and by ELISA (Reagent kit for enzyme immunoassay of class G immunoglobulins and class M to SARS-CoV-2 (Vector-Best, Russia)) were compared. 80 patients were included with a diagnosis of rheumatoid arthritis 26 (33%), psoriatic arthritis -9 (11%), osteoarthritis -15 (19%), rheumatic heart disease 1 (1%), SLE 2 (3%), deramtomyositis 3 (4%), systemic sclerosis 5 (6%), systemic connective tissue diseases 4 (5%), including Sjogren's syndrome, spondyloarthritis 15 (19%). 17 (21%) denied a history of COVID-19 symptoms. 63 (79%) noted any signs of COVID-19 3.095 ± 1.45 months before the test (Median 3 [2;4] months). 63 (79%) noted any signs of COVID-19 109 ± 43 days before the test (Median 111 [78;135] months). The ELISA method was considered the standard. Results: When comparing the results of the express test and the determination of IgG antibodies to SARS-CoV-2 in serum, the following was obtained: the sensitivity of the express test is 99%. When comparing the results of the express test and the determination of IgM antibodies to SARS-CoV-2 in serum, it was obtained: among 66 samples with a negative result by the express test method, IgM was detected in 6 cases by ELISA/ So, 7.5% of 80 samples were false negative. In 3 of 14 samples with a positive result by the express test, IgM by ELISA was not detected. So, 3.75% of 80 samples were false-positive. (Table 1). When comparing the results of the IgM express test and ELISA, the following was obtained: the sensitivity of the express test was 33%, the specificity was 85%.Conclusion: When comparing the results of the express test and the determination of IgG antibodies to SARS-CoV-2 in serum, the sensitivity of the express test is 99%. Determination of IgM antibodies to SARS-CoV-2 using a rapid test is less reliable than determination using ELISA.