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EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337862


Background: The impact of the severe acute respiratory syndrome Coronavirus 2 disease (COVID-19) pandemic on people with systemic autoimmune rheumatic diseases (SARDs) is not fully established. It is unclear whether SARDs are an independent risk factor for infection and poor outcomes. Methods: Incidence and 30-day outcomes of COVID-19 infection were retrospectively evaluated in 40,490 SARD patients in the Lazio Italian Region and compared to the general population as incidence rate ratio adjusted for demographics and comorbidities (adjIRR). SARD diagnosis and comorbidities were derived from medical administrative records using the Chronic Related Group classification system. Data on COVID-19 infection were derived from a dedicated regional digital network. Results: The COVID-19 infection risk was increased in patients with Psoriatic Arthritis (adjIRR=1.21, 95% CI 1.10-1.33) and Undifferentiated Connective Tissue Disease (adjIRR=1.26, 95% CI 1.03-1.54). The hospitalization risk was higher in patients with Axial Spondylarthritis (adjIRR=2.16, 95% CI 1.45-3.22), and Systemic Vasculitis (adjIRR=1.81, 95% CI 1.07-3.06) while intensive care unit admission risk was higher in Systemic Erythematosus Lupus (adjIRR=3.67, 95% CI 1.52-8.83) and primary Sjögren Syndrome (adjIRR=4.13, 95% CI 1.71-9.96) patients. Increased mortality was reported in patients with Rheumatoid Arthritis (adjIRR=1.50, 95% CI 1.04-2.17), Systemic Erythematosus Lupus (adjIRR=2.67, 95% CI 1.10-6.44), primary Sjögren Syndrome (adjIRR=2.51, 95% CI 1.12-5.62), and Scleroderma (adjIRR=4.60, 95% CI 2.06-10.29). Conclusions: Each SARDs presents a peculiar pattern in terms of increased risk of COVID-19 incidence, hospitalization, intensive care unit admission, and death, that is not linked to the immunosuppressive behaviour of the disease.

Epidemiol Prev ; 44(5-6 Suppl 2): 51-59, 2020.
Article in Italian | MEDLINE | ID: covidwho-1068124


BACKGROUND: the Covid-19 pandemic has provoked a huge of clinical and epidemiological research initiatives, especially in the most involved countries. However, this very large effort was characterized by several methodological weaknesses, both in the field of discovering effective treatments (with too many small and uncontrolled trials) and in the field of identifying preventable risks and prognostic factors (with too few large, representative and well-designed cohorts or case-control studies). OBJECTIVES: in response to the fragmented and uncoordinated research production on Covid-19, the   italian Association of Epidemiology (AIE) stimulated the formation of a working group (WG) with the aims of identifying the most important gaps in knowledge and to propose a structured research agenda of clinical and epidemiological studies considered at high priority on Covid-19, including recommendations on the preferable methodology. METHODS: the WG was composed by 25 subjects, mainly epidemiologists, statisticians, and other experts in specific fields, who have voluntarily agreed to the proposal. The agreement on a list of main research questions and on the structure of the specific documents to be produced were defined through few meetings and cycles of document exchanges. RESULTS: twelve main research questions on Covid-19 were identified, covering aetiology, prognosis, interventions, follow-up and impact on general and specific populations (children, pregnant women). For each of them, a two-page form was developed, structured in: background, main topics, methods (with recommendations on preferred study design and warnings for bias prevention) and an essential bibliography. CONCLUSIONS: this research agenda represents an initial contribution to direct clinical and epidemiological research efforts on high priority topics with a focus on methodological aspects. Further development and refinements of this agenda by Public Health Authorities are encouraged.

COVID-19/epidemiology , Epidemiologic Research Design , Pandemics , Research , SARS-CoV-2 , Adult , Aged , COVID-19/drug therapy , COVID-19/therapy , Child , Epidemiology/organization & administration , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Prognosis , Societies, Scientific , Therapeutic Equipoise