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1.
BMC Rheumatol ; 6(1): 32, 2022 Jun 14.
Article in English | MEDLINE | ID: covidwho-1951409

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.

2.
researchsquare; 2021.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-805748.v1

ABSTRACT

Background: We conducted this study to identify the influence of prolonged use of hydroxychloroquine(HCQ), glucocorticoids (GC) 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 (7.5-20mg/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 


Subject(s)
COVID-19 , Diabetes Mellitus , Lung Diseases , Rheumatic Diseases
3.
J Assoc Physicians India ; 68(12): 33-34, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-946715

ABSTRACT

BACKGROUND: Incidence of viral pneumonia has been reported in several patients diagnosed with COVID-19. The infection has also been linked to the development of inflammatory syndromes and related clinical manifestations. RESULT: The present study discusses four cases of COVID infection showing varying clinical features. The post-COVID inflammation syndrome was associated with non-specific inflammation and post viral arthritis in three cases. One other subject had vasculitis leading to central retinal artery occlusion. CONCLUSION: As the number of cases of COVID-19 cases has been increasing globally, it is advisable that physicians consider the possibility of post-COVID manifestations while examining patients with non-specific inflammation. A short course of NSAIDs and hydroxychloroquine regimen has been found to be beneficial for alleviating symptoms, and in rare cases with organ threatening inflammation, steroids may be required.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Humans , Inflammation , SARS-CoV-2 , Syndrome
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