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1.
Rheumatol Int ; 42(4): 601-608, 2022 04.
Article in English | MEDLINE | ID: covidwho-1680771

ABSTRACT

This study aims to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the management of rheumatic diseases (RD). An online survey included 10 questions were designed to assess potential differences in rheumatology practice. The survey was conducted between March 2021 and June 2021. Marginal homogeneity test was used to compare frequencies of outpatient clinic patients between the pre-pandemic and pandemic. Other results were analyzed by descriptive statistics. One hundred three clinicians (75.7% in rheumatology practice for at least five years) responded to the survey. Almost 70% examined < 30 patients per day during the pandemic while nearly 70% examined ≥ 30 patients per day before the pandemic (p < 0.001). They indicated following reasons for decreasing outpatient clinic activity were concerns regarding COVID-19 transmission risk of the patients (95%) and the clinicians (53%), being able to supply chronic medications directly from the pharmacy (85%), lockdown (71%), limited outpatient appointments (64%) and using telemedicine (20%). The frequencies of rheumatology daily routine procedures were decreased as follows; patient hospitalization for diagnosing (80%) and treatment (78%), labial salivary gland biopsy (63%), Schirmer's test/salivary flow rate test (56%), nail bed video-capillaroscopy (52%), musculoskeletal ultrasonography (51%) and Pathergy test (50%). Clinicians hesitated to use rituximab (63%) mostly, followed by cyclophosphamide (53%), glucocorticoids (43%), tofacitinib (41%), mycophenolate mofetil (36%), and azathioprine (33%). In this first national survey, the prominent differences in the management of RD have decreased outpatient clinic activity, reduced rheumatology daily procedures, and hesitancy to use some rheumatic drugs.


Subject(s)
COVID-19 , Rheumatic Diseases , Telemedicine , Communicable Disease Control , Humans , Pandemics/prevention & control , Rheumatic Diseases/diagnosis , Rheumatic Diseases/drug therapy , Rheumatic Diseases/epidemiology , SARS-CoV-2
3.
Pediatr Rheumatol Online J ; 19(1): 170, 2021 Dec 09.
Article in English | MEDLINE | ID: covidwho-1566526

ABSTRACT

BACKGROUND: During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients. METHODS: Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total and sub-scale (usefulness, ease of use, effectiveness, satisfaction) scores were calculated and classified as "positive" based on responses of "agree" or "strongly agree" on a 5-point Likert scale. Results were analyzed using standard descriptive statistics and Wilcoxon signed rank testing. The association between demographic and clinical characteristics with TUQ scores was assessed using univariate linear regression. RESULTS: 597 patients/caregivers met inclusion criteria, and the survey response rate was 42% (n = 248). Juvenile idiopathic arthritis was the most common diagnosis (33.5%). The majority of patients were diagnosed greater than 6 months previously (72.6%) and were prescribed chronic medications (59.7%). The median total TUQ score was 4 (IQR: 4-5) with positive responses in 81% of items. Of the subscales, usefulness scores were lowest (median: 4, p < 0.001). Telehealth saves time traveling was the highest median item score (median = 5, IQR: 4-5). Within subscales, items that scored significantly lower included convenience, providing for needs, seeing rheumatologist as well as in person, and being an acceptable way to receive rheumatology services (all p < 0.001). There were no significant demographic or clinical features associated with TUQ scores. CONCLUSIONS: Our results suggest telehealth is a promising mode of healthcare delivery for pediatric rheumatic diseases but also identifies opportunities for improvement. Innovation and research are needed to design a telehealth system that delivers high quality and safe care that improves healthcare outcomes. Since telehealth is a rapidly emerging form of pediatric rheumatology care, improved engagement and training of patients, caregivers, and providers may help improve the patient experience in the future.


Subject(s)
Parents , Patient Acceptance of Health Care , Patient Satisfaction , Pediatrics , Rheumatic Diseases/therapy , Rheumatology , Telemedicine , Adolescent , Ambulatory Care , Arthritis, Juvenile , COVID-19 , Child , Child, Preschool , Female , Humans , Lupus Erythematosus, Systemic , Male , Musculoskeletal Pain , Rheumatic Diseases/diagnosis , SARS-CoV-2
4.
Clin Rheumatol ; 41(2): 337-348, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1540227

ABSTRACT

Long-term sequel of acute COVID-19, commonly referred to as long COVID, has affected millions of patients worldwide. Long COVID patients display persistent or relapsing and remitting symptoms that include fatigue, breathlessness, cough, myalgia, arthralgia, sleep disturbance, cognitive impairment and skin rashes. Due to the shared clinical features, laboratory and imaging findings, long COVID could mimic rheumatic disease posing a diagnostic challenge. Our comprehensive literature review will help rheumatologist to be aware of long COVID manifestations and differentiating features from rheumatic diseases to ensure a timely and correct diagnosis is reached.


Subject(s)
COVID-19 , Rheumatic Diseases , Rheumatology , COVID-19/complications , Humans , Rheumatic Diseases/complications , Rheumatic Diseases/diagnosis , SARS-CoV-2
5.
J Rheumatol ; 49(2): 219-224, 2022 02.
Article in English | MEDLINE | ID: covidwho-1518659

ABSTRACT

OBJECTIVE: Early diagnosis of autoimmune rheumatic diseases (ARDs) is key to achieving effective treatment and improving prognosis. The coronavirus disease 2019 (COVID-19) pandemic has led to major changes in clinical practice on a global scale. We aimed to evaluate the impact of the COVID-19 pandemic on rheumatological clinical practice and autoimmunity testing demands. METHODS: Data regarding the first rheumatological visits and new diagnoses, together with the autoimmunity laboratory testing volumes related to the COVID-19 pandemic phase (January-December 2020), were collected from medical records and the laboratory information system of a regional reference hospital (Basilicata, Italy) and compared with those obtained during the corresponding period in 2019. RESULTS: A significant decrease in the 2020 autoimmunity laboratory test volume was found when compared with the same period in 2019 (9912 vs 14,100; P < 0.05). A significant decrease in first rheumatological visits and diagnosis (1272 vs 2336; P < 0.05) was also observed. However, an equivalent or higher percentage of positive autoimmunity results from outpatient services was recorded during 2020 when compared to the prepandemic state. Of note, COVID-19-associated decline in new diagnoses affected mainly less severe diseases. In contrast, ARDs with systemic involvement were diagnosed at the same levels as in the prepandemic period. CONCLUSION: The COVID-19 pandemic has affected access to health services. However, our study highlighted that during the outbreak, greater appropriateness of the requests for laboratory tests and visits emerged, as shown by a greater percentage of positive test results and new diagnoses of more severe ARDs compared to the prepandemic period.


Subject(s)
COVID-19 , Rheumatic Diseases , Ambulatory Care , Humans , Pandemics , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , SARS-CoV-2
6.
Pediatr Rheumatol Online J ; 19(1): 148, 2021 Sep 30.
Article in English | MEDLINE | ID: covidwho-1502004

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, telemedicine has provided an alternative to in-person visits for patients practicing social distancing and undergoing quarantine. During this time, there has been a rapid expansion of telemedicine and its implementation in various clinical specialties and settings. In this observational study we aim to examine the utility of telemedicine in a pediatric rheumatology clinic, for 3 months during the COVID-19 pandemic. METHODS: A review of outpatient pediatric rheumatology telemedicine encounters were conducted from April-June 2020. Telemedicine visits (n = 75) were compared to patients seen in practice over the prior year in office-based visits (March 2019-March 2020) (n = 415). Patient characteristics, information on no-show visits, completed visits, new patient or follow-up status, and if new patients had received a visit within 2 weeks of calling to schedule an appointment were analyzed by chart review. An independent sample t-test and Chi Square statistic was used to determine statical significance between the two groups. A two-proportion z-test was used to compare visit metrics. RESULTS: The percentage of new patients utilizing telemedicine (60%) was lower and statistically significant compared to the percentage of new patient office visits (84%) the previous year (p < 0.0001). There was no change in no-show rate between groups and patient characteristics were similar. CONCLUSIONS: This study demonstrates a statistically significant decrease in new patient visits during the pandemic with telemedicine-only appointments compared to in-office visits over the previous year. This suggests a possible hesitation to seek care during this time. However, there was no significant difference among patient characteristics between telemedicine visits during the pandemic and during in-office visits in the previous year. In our experience, patient visits were able to be conducted via telemedicine with a limited physical exam using caregiver's help during the pandemic. However, further studies will need to ascertain patient satisfaction and preference for telemedicine in the future.


Subject(s)
COVID-19 , Rheumatic Diseases , Telemedicine , Adolescent , Child , Child, Preschool , Humans , Rheumatic Diseases/diagnosis , Rheumatic Diseases/therapy , Young Adult
8.
Z Rheumatol ; 80(9): 795-800, 2021 Nov.
Article in German | MEDLINE | ID: covidwho-1451968

ABSTRACT

The corona pandemic changed the lives of people in Germany in 2020. Completely new challenges had to be met in outpatient care and of course also in rheumatology practices. The rapid development, the constant changes, the readjustment, the accompaniment of patients and staff team in this global catastrophe are described. The influence on the daily work and the implementation of new scientific knowledge, e.g. the recommendations of the German Society of Rheumatology (DGRh), are reported. Experiences and insights into what can be learned and taken away from crisis situations are outlined. A detailed chronology of the events, taking the special rheumatological features into account, completes this report of experiences.


Subject(s)
Rheumatic Diseases , Rheumatology , Ambulatory Care , Germany , Humans , Pandemics , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology
9.
Z Rheumatol ; 80(9): 835-845, 2021 Nov.
Article in German | MEDLINE | ID: covidwho-1449956

ABSTRACT

Digitalization in medicine is of major interest since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This article tries to present the induced changes and technical solutions with respect to the different parts in the patient journey. Symptom checkers, new health applications, digital appointment management etc. are described. Apart from the technical and digital possibilities, the changes in the quality of communication additionally have to be mentioned. There is an urgent need for further technical standardization including the interfaces. In many cases further studies must confirm the equivalence of digital applications in comparison to analogue techniques.


Subject(s)
COVID-19 , Rheumatic Diseases , Telemedicine , Humans , Pandemics , Rheumatic Diseases/diagnosis , SARS-CoV-2
12.
Curr Rheumatol Rev ; 17(3): 318-326, 2021 Aug 30.
Article in English | MEDLINE | ID: covidwho-1328036

ABSTRACT

BACKGROUND: People with rheumatic disease may be at higher risk for more severe course with COVID- 19, and the adverse effects of drugs used to treat rheumatic diseases is a major concern. OBJECTIVE: We conducted this survey to learn about the real impact of COVID-19 pandemic on patients with rheumatic diseases. METHODS: Participants were asked to complete a questionnaire using a telephonic interview conducted by two rheumatologists. Rheumatic disease characteristics, knowledge and attitude toward COVID-19, and impacts of pandemic on rheumatology care and patient's compliance were assessed. RESULTS: We included 307 patients in the survey, and rheumatoid arthris was the main rheumatic disease. Patients had mostly moderate level of knowledge about COVID-19, and patients with higher level of education were more likely to have better knowledge. Participants respected mainly recommended preventive measures. The pandemic and sanitary containment impacted strongly the rheumatology care. Over quarter of patients noted worsening of their rheumatic disease, two-thirds reported postponed or canceled medical apointments and more than three quarters postponed their laboratory tests. Patients with higher disease activity were more likely to have lack of follow-up. Medication change was noted in more than third of cases. It was mostly stopped, and DMARDs were mainly affected. Patients living in rural areas and who had canceled, or postponed their appointments were more likely to change their treatment. CONCLUSION: Our data are useful to better manage rheumatic patients. Physicians are encouraged to renew contact with their patients to insure medication compliance.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Patient Participation , Physician-Patient Relations , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , Adult , Aged , Antirheumatic Agents/therapeutic use , COVID-19/drug therapy , Cross-Sectional Studies , Disease Management , Female , Humans , Male , Middle Aged , Pandemics , Patient Participation/trends , Rheumatic Diseases/drug therapy
13.
Z Rheumatol ; 80(7): 641-646, 2021 Sep.
Article in German | MEDLINE | ID: covidwho-1289713

ABSTRACT

The COVID-19 registry ( www.covid19-rheuma.de ) of the German Society of Rheumatology was the first registry for the acquisition and systemic evaluation of viral infections in patients with inflammatory rheumatic diseases (IRD). This has enabled rapid generation of scientific data that will help to improve the care of patients with IRD in the context of the pandemic. In addition to confirming general risk factors, such as patient age and comorbidities (e.g. cardiovascular, chronic lung and kidney diseases), the use of glucocorticoids and the disease activity of the rheumatic disease could be identified as disease-specific independent risk factors for the need of hospitalization due to COVID-19. Evaluations of the continuously growing cohort of patients with IRD and COVID-19 enable recommendations for patient care to be based on better evidence. Cooperation with international rheumatology registries (e.g. European COVID-19 registry for IRD) enables analyses of aggregated cohorts of patients with IRD and COVID-19 for international comparisons and statistically even more reliable statements.


Subject(s)
COVID-19 , Rheumatic Diseases , Rheumatology , Humans , Pandemics , Registries , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , SARS-CoV-2
14.
Rheumatol Int ; 41(8): 1441-1445, 2021 08.
Article in English | MEDLINE | ID: covidwho-1274816

ABSTRACT

Patients with rheumatic and musculoskeletal (RMD) diseases may be at higher risks for COVID-19 infection. Data on the safety of the adenoviral vector-borne ChAdOx1 nCoV-19 and the heat-inactivated BBV152 Vaccines in this group are limited. 724 patients with RMD who had received at least one dose of either the ChAdOx1 or the BBV152 were audited to find out post-vaccination adverse effect (AE) or disease flares. The AE rates in patients with autoimmune rheumatic disease (AIRD) were compared with those with non-AIRD RMDs. The mean age of the cohort was 59.9 (± 10.43) years with a female (n = 581; 80.24%) majority. 523 (70.8%) had AIRD. The ChAdOx1 and the BBV152 vaccines were received by 624 (86.18%) and 77 (10.63%), respectively. 23 (3.17%) were unaware of which vaccine they had received. 238 (32.87%) of patients had at least one comorbidity. 436 (60.22%) participants [306 (59.64%) of those with AIRD and 130 (61.61%) with other RMDs] had at least one adverse effect (AE). Four patients reported flare of arthritis that resolved within 5 days. No patient had any severe AE or required hospitalization. All AEs were self-limiting. Both the ChAdOx1 and the BBV152 vaccines appear safe in RMDs. AEs do not differ between patients with AIRD or non-AIRD. This information can help negate vaccine hesitancy amongst all stakeholders.


Subject(s)
Autoimmunity , COVID-19 Vaccines/administration & dosage , Rheumatic Diseases/immunology , Aged , Autoimmunity/drug effects , COVID-19 Vaccines/adverse effects , Cross-Sectional Studies , Female , Humans , Immunocompromised Host , Immunosuppressive Agents/therapeutic use , Male , Middle Aged , Rheumatic Diseases/diagnosis , Rheumatic Diseases/drug therapy , Vaccination , Vaccines, Inactivated/administration & dosage , Vaccines, Inactivated/adverse effects
16.
Arthritis Care Res (Hoboken) ; 73(8): 1146-1152, 2021 08.
Article in English | MEDLINE | ID: covidwho-1222590

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has had considerable economic repercussions for young workers. The current study was undertaken to examine the impact of the pandemic on the employment of young adults with rheumatic disease and on perceptions of work and health. METHODS: Surveys were administered to young adults with rheumatic disease prior to and following the onset of the COVID-19 pandemic. Surveys asked about employment status and collected information on sociodemographic, disease/health, and work-context factors. Items also asked about the perceived impact of the COVID-19 pandemic on work and health. A generalized estimating equation model was fitted to examine the effect of the pandemic on employment. RESULTS: In total, 133 young adults completed the pre-COVID-19 pandemic survey (mean age 28.9 years, 82% women). When compared to the pre-COVID-19 pandemic period, employment decreased from 86% to 71% following the pandemic, but no other changes were identified in sociodemographic, disease/health, or work-context factors. The time period following the COVID-19 pandemic was associated with a 72% lower odds of employment compared to the pre-pandemic period (odds ratio 0.28 [95% confidence interval 0.11-0.71]). Those with a postsecondary education or who reported more mental job demands were more likely to be employed following the onset of the pandemic. Also, a majority of participants reported that the pandemic affected health care (83%), treatment access (54%), working conditions (92%), and occupational health and safety (74%). CONCLUSION: The onset of the COVID-19 pandemic had socioeconomic implications for young people with rheumatic disease. To support economic recovery for individuals with rheumatic disease, strategies to promote employment should be designed that account for the young adult life phase and occupational characteristics.


Subject(s)
COVID-19/epidemiology , Employment/trends , Rheumatic Diseases/epidemiology , Surveys and Questionnaires , Adult , COVID-19/diagnosis , Canada/epidemiology , Cohort Studies , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Pandemics , Rheumatic Diseases/diagnosis
17.
J Clin Rheumatol ; 28(2): e401-e406, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1201310

ABSTRACT

BACKGROUND/OBJECTIVES: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), first described in December 2019, has infected more than 33 million people and claimed more than 1 million deaths worldwide. Rheumatic diseases are chronic inflammatory diseases, the prevalence and impact of which in COVID-19 patients are poorly known. We performed a pooled analysis of published data intending to summarize clinical presentation and patient outcomes in those with established rheumatic disease diagnosis and concurrent COVID-19. METHODS: PubMed and Google Scholar were searched to identify studies reporting data about rheumatic disease patients who were diagnosed with SARS-CoV-2 infection and published until July 22, 2020. Random-effects models were used to estimate the pooled incidence and rates of hospitalization, intensive care unit admission, and mortality among these patients, and interstudy heterogeneity was identified using I2 statistics with greater than 75% value indicating substantial interstudy variation. RESULTS: Twenty studies were included, giving a total sample size of 49,099 patients positive for SARS-CoV-2. Of 49,099 COVID-19 patients, a total of 1382 were also diagnosed with a rheumatic disease in the past. The random-effects pooled prevalence of COVID-19 among rheumatic disease patients was found to be 0.9%. The rates of hospitalization, intensive care unit admission, and mortality were 70.7%, 11.6%, and 10.2%, respectively. CONCLUSIONS: Although the prevalence of SARS-CoV-2 infection is not dramatically high in rheumatic disease patients, concurrent COVID-19 does seem to play a role in determining disease severity and outcomes to some extent. Further studies are needed to give conclusive evidence about whether this subset of the population is at a higher risk of COVID-19 and related outcomes compared with the population at large.


Subject(s)
COVID-19 , Rheumatic Diseases , Hospitalization , Humans , Intensive Care Units , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , SARS-CoV-2
18.
Rheumatol Int ; 41(6): 1097-1103, 2021 06.
Article in English | MEDLINE | ID: covidwho-1184661

ABSTRACT

This study aimed to assess the baseline characteristics and clinical outcomes of coronavirus disease 2019 (COVID-19) in patients with rheumatic diseases and identify the risk factors associated with severe COVID-19 pneumonia. This was a retrospective study in a tertiary care center conducted through the period between March 2020 and November 2020 and included all adult patients with rheumatic diseases who tested positive on the COVID-19 polymerase chain reaction (PCR) test. We assessed the patients' demographic data, history of rheumatic disease, COVID-19 symptoms and experimental treatment, if any, their disease course, and outcome. In all, 47 patients were included, and most were females. The commonest rheumatic diseases were rheumatoid arthritis (53.2%), followed by systemic lupus erythematosus (21.3%), and psoriatic arthritis (10.6%). Methotrexate and hydroxychloroquine were the most commonly used disease-modifying anti-rheumatic drugs in 36.1% and 25.5%, respectively. Out of 47 patients, 48.9% required hospitalization with a median hospital stay of 7 days. Severe COVID-19 pneumonia, defined as clinical signs of pneumonia plus one of the following: respiratory rate > 30 bpm, severe respiratory distress, or oxygen saturation < 90% in room air was observed in 19.1% of the patients, and one patient died. We found that elderly patients with a mean age of 65.3 years were more likely to develop severe COVID-19 pneumonia and that was statistically significant. Our study showed that elderly patients with a mean age of 65 years and having rheumatic diseases had an increased risk of hospital admission and development of severe COVID-19 pneumonia.


Subject(s)
COVID-19 , Rheumatic Diseases , Adult , Aged , Cohort Studies , Female , Humans , Male , Retrospective Studies , Rheumatic Diseases/diagnosis , Rheumatic Diseases/drug therapy , Rheumatic Diseases/epidemiology , SARS-CoV-2
19.
RMD Open ; 7(1)2021 04.
Article in English | MEDLINE | ID: covidwho-1172774

ABSTRACT

AIM: To assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases (RMDs). METHODS: REUMAVID is a cross-sectional study using an online survey developed by an international multidisciplinary patient-led collaboration across seven European countries targeting unselected patients with RMDs. Healthcare access, daily activities, disease activity and function, well-being (WHO Five Well-Being Index (WHO-5)), health status, anxiety/depression (Hospital Anxiety and Depression Scale (HADS)) and access to information were evaluated. Data were collected in April-July 2020 (first phase). RESULTS: Data from the first phase included 1800 patients with 15 different RMDs (37.2% axial spondyloarthritis, 29.2% rheumatoid arthritis, 17.2% osteoarthritis and others). Mean age was 53, 80% female and 49% had undertaken university studies. During the beginning of the pandemic, 58.4% had their rheumatology appointment cancelled and 45.6% reported not having received any information relating to the possible impact of SARS-CoV-2 infection in their RMDs, with the main source being patient organisations (27.6%).Regarding habits, 24.6% increased smoking, 18.2% raised their alcohol consumption, and 45.6% were unable to continue exercising. Self-reported disease activity was high (5.3±2.7) and 75.6% reported elevated pain. Half the patients (49.0%) reported poor well-being (WHO-5) and 46.6% that their health had changed for the worse during lockdown. According to HADS, 57.3% were at risk of anxiety and 45.9% of depression. CONCLUSION: Throughout the first wave of the COVID-19 pandemic, patients with RMDs have experienced disruption in access to healthcare services, poor lifestyle habits and negative effects on their overall health, well-being and mental health. Furthermore, information on COVID-19 has not reached patients appropriately.


Subject(s)
Anxiety , COVID-19 , Depression , Exercise , Mental Health/statistics & numerical data , Musculoskeletal Diseases , Patient Acceptance of Health Care/statistics & numerical data , Rheumatic Diseases , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Europe/epidemiology , Female , Functional Status , Humans , Life Style , Male , Middle Aged , Musculoskeletal Diseases/diagnosis , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/psychology , Patient Acuity , Patient Reported Outcome Measures , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , Rheumatic Diseases/psychology , SARS-CoV-2
20.
Front Immunol ; 12: 645013, 2021.
Article in English | MEDLINE | ID: covidwho-1156124

ABSTRACT

Background: Numerous cases of the coronavirus disease 2019 (COVID-19) with autoimmune and rheumatic manifestations have been reported. Despite the available reviews that summarized its autoimmune/rheumatic manifestations, a systematic approach is still lacking. Therefore, we conducted a comprehensive systematic review in order to give an overview upon these rare but clinically significant manifestations. Methods: We performed a literature search of PubMed and EMBASE as of October 9, 2020. All articles relevant to either systemic or organ-specific autoimmune and rheumatic manifestations potentially associated with COVID-19 were collected. The reviewed literature were limited to adults ≥18 years. Results: Although most of the existing evidence was based on case reports or case series without a long-term follow-up, a variety of autoimmune/rheumatic manifestations were associated with COVID-19. The manifestations that have a consistent association with COVID-19 include autoimmune cytopenia, cutaneous vasculitis, encephalitis, and Guillain-Barre syndrome. Such association is conflicting as regards to antiphospholipid syndrome, hemophagocytic lymphohistiocytosis, and myasthenia gravis. Conclusion: Our systematic review indicated the potential of the COVID-19 virus to trigger a myriad of autoimmune and rheumatic manifestations, which should be considered amid global efforts to combat COVID-19.


Subject(s)
Autoimmune Diseases/immunology , Autoimmunity , COVID-19/immunology , Rheumatic Diseases/immunology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Autoimmune Diseases/diagnosis , Autoimmune Diseases/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Female , Host-Pathogen Interactions , Humans , Male , Middle Aged , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , Rheumatic Diseases/virology , SARS-CoV-2/pathogenicity , Young Adult
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