ABSTRACT
Propose: Due to severe acute respiratory syndrome coronavirus 2(SARS-CoV- 2), novel coronavirus pneumonia (COVID-19) is a systemic viral disease that mostly affects the respiratory tract. Studies have shown that COVID-19 may increase the risk of autoantibody development in patients with connective tissue diseases (CTD) .However, data regarding the impact of COVID-19 pandemic on patients with CTD and drug use were relatively scarce. The prevalence of COVID-19 in CTD patients was estimated by means of meta-analysis, and the effect of the use of anti-rheumatic drugs on the clinical outcome of CTD patients with COVID-19 was investigated. Method(s): Cross-sectional investigations and case series on CTD and COVID-19 published by CBM, CNKI, China Science and Technology Journal Database, Wan Fang Data, PubMed, Embase, Web of Science, Cochrane Library and Medline from its establishment to April 5, 2022 were searched. A random effects model was used to pool data. Heterogeneity and risk of bias was examined with I-squared index (I2) statistic. Inconsistency was evaluated with the I2. Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Result(s): A total 11 studies involving 75908 participants were included in the meta-analysis (Table 1). The overall prevalence of COVID-19 among CTD patients was 3.3% (95%CI: 2.3%-4.3%) (Figure 1A), the hospitalization rate was 17.6% (95%CI: 7.5%-27.6%;Figure 1B), with the rate of 4.4% (95%CI: 2.8%-6.0%;Figure 1C)in ICU admission, and the mortality rate was 4.5% (95%CI: 2.5%-6.4%;igure 1D). Six of the studies included patients who used hydroxychloroquine as part of their treatment regimen, with 15.5% (95%CI: 5.6%-25.3%) adverse outcome rates (Figure 1E). Conclusion(s): Patients with CTD had a higher risk of COVID-19. Hydroxychloroquine might increase adverse outcome rate of COVID-19.
ABSTRACT
Purpose: Novel Coronavirus pneumonia 2019 (COVID-19) caused by the novel coronavirus severe acute respiratory syndrome (SARS) coronavirus- 2 (CoV-2) is a highly contagious infection with high morbidity and mortality1. Patients with systemic lupus erythematosus (SLE) are considered to be susceptible to coronavirus due to impaired immune function2. This study aims to systematically evaluate the prevalence of COVID-19 in SLE patients, and futher explore the impact of antirheumatic drug on the clinical outcome of COVID-19 in SLE patients. Method(s): Systematic searches of PubMed, EMBASE, Web of Science, the Cochrane Library and Medline, CNKI, CBM, China Science and Technology Journal Database and Wan Fang Data were performed. Cross-sectional investigations and case series on SLE and COVID-19 were included. Random effects model was used to pool data. Heterogeneity and risk of bias was examined with I squared index (I2) statistic and Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Result(s): A total of 14 studies comprising 5115 SLE patients and 698 COVID-19 patients were identified. Overall prevalence of COVID-19 in SLE patients was 6.7% (95%CI: 4.4-9.1%). The hospitalization rate was 31.6% (95%CI: 15.8%-47.3%), with the rate of 22.2% (95%CI: 6.2-38.2%) of patients were admitted to ICU, and the death rate was 19.3% (95%CI: 2.7%-35.9%). Eight of the studies included patients who used hydroxychloroquine as part of their treatment regimen, with 5.7% (95%CI: 3.3%-8.0%) prevalence rate. The hospitalisation rates for SLE patients with COVID-19 infection who received glucocorticoid was 69.2% (95%CI: 46.8%-91.6%). The rates of hospitalisation in patients who received hydroxychloroquine was 59.2% (95%CI: 45.8%-72.6%), and in patients who received biologic disease-modifying anti-rheumatic drugs (b-DMARD) was 61.8% (95%CI: 32.7%-90.9%). The adverse outcome rate due to COVID-19 in patients with SLE was 34.1% (95% CI: 4.3%-64%). The rate of adverse outcome in SLE patients diagnosed with COVID-19 who received glucocorticoid was 22.9% (95%CI: 9%-31.5%), and in patients who received hydroxychloroquine was 22.9% (95%CI: 0.1%-45.7%, Figure 1). Conclusion(s): Patients with SLE had a higher risk of COVID-19. Anti-rheumatic drugs may help reduce the prevalence and overall rate of adverse outcomes of COVID-19. Figure 1.
ABSTRACT
Purpose: The pandemic of novel coronavirus disease 2019 (COVID-19) caused by the emerging severe acute respiratory syndrome coronavirus 2 (sars-cov- 2) has become a global health crisis (WHO, 2020b), leading to large number of infections and deaths. Autoimmune rheumatic diseases (ARD) are characterized by immune dysfunction and more susceptible to infection. The prevalence of COVID-19 in ARD patients was estimated by means of meta-analysis, and the effect of the use of anti-rheumatic drugs on the clinical outcome of ARD patients with COVID-19 was investigated. Method(s): Cross-sectional investigations and case series on ARD and COVID-19 published by CBM, CNKI, China Science and Technology Journal Database, Wan Fang Data, PubMed, Embase, Web of Science, Cochrane Library and Medline from its establishment to June 26, 2022 were searched. Random effects model was used to pool data. Heterogeneity and risk of bias was examined with I-squared index (I2) statistic. Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Result(s): A total of 65 studies comprising 135 515 patients were identified. Overall prevalence of COVID-19 in ARD patients was 5.4% (95%CI: 4.3%-6.5%). The hospitalisation rate due to COVID-19 was 35.9% (95% CI: 28.3%-43.4%). The hospitalisation rates for ARD patients diagnosed with COVID-19 who received glucocorticoid was 35.9% (95%CI: 31.4%-40.4%). The rates of hospitalisation in patients who received hydroxychloroquine was 39.9% (95%CI: 34.5%-45.3%), and in patients who received biologic disease-modifying anti-rheumatic drugs (b-DMARD) was 38.1% (95%CI: 33.6%-42.5%), which were both higher than total hospitalisation. The mortality due to COVID-19 in patients with ARD was 6.0% (95% CI: 5.1%-6.8%). The mortality in ARD patients diagnosed with COVID-19 who received glucocorticoid was 5.3% (95%CI: 4.3%-6.2%), and in patients who received b-DMARD was 5.8% (95%CI: 4.9%-6.7%). Mortality rates for patients who received hydroxychloroquine was 5.2% (95%CI: 4.2%-6.2%) (Figure 1). Conclusion(s): Patients with ARD had a higher risk of COVID-19. Use of glucocorticoids decrease mortality in these patients suffered from COVID-19 infection. Though patients had a higher hospitalisation rates but lower mortality among patients prescribed b-DMARD or hydroxychloroquine. (Figure Presented).