ABSTRACT
Background: Older age, male sex, multimorbidity and glucocorticoids emerged in rheumatic patients as risk factors for severe COVID-19. Objectives: We aimed to evaluate the frequency and severity of COVID-19 in a well-defned cohort of patients with idiopathic infammatory myopathy (IIM). Methods: We analyzed medical records of IIM patients diagnosed and followed at our secondary/tertiary center between January 2005 and December 2021. Results: During the 204-month period IIM was newly diagnosed in 191 patients, of whom 52 died before COVID-19 pandemic. Of the remaining 139 patients (69.8% females;9 polymyositis, 47 dermatomyositis;38 antisynthetase syndrome, 26 overlap syndrome;17 immune mediated necrotizing myopathy;2 inclusion body myositis), SARS-CoV-2 infection was proven in 13 (9.4%) patients (61.5% females, mean (SD) age at infection 62.9 (±16.8 years)). Seven/13 COVID-19 patients (53.8%) had a diagnosis of antisynthetase syndrome. At the time of infection IIM was in a remission in 12/13 patients and relapsed 5 weeks earlier in one patient. Seven patients were without immunomodulatory therapy, 1 patient was on steroids alone, 2 on DMARD alone, 3 on steroids and DMARD;a mean daily prednisolone equivalent dose was 5 mg). Eleven/13 (84.6%) patients had mild COVID-19 (one had an asymptomatic infection) and were treated sympto-matically, while 2 patients were hospitalized due to severe infection (respiratory insufficiency). Table 1 shows clinical characteristics and duration of COVID-19 symptoms. During pandemic overall 9/139 (6.5%) patients with IIM died, including one patient due to COVID-19. Conclusion: In our IIM cohort, antisynthetase syndrome represented a higher relative risk for COVID-19 compared to other IIIM subtypes.