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Hospital admissions in inflammatory rheumatic diseases during the peak of COVID-19 pandemic: incidence and role of disease-modifying agents.
Fernandez-Gutierrez, Benjamin; Leon, Leticia; Madrid, Alfredo; Rodriguez-Rodriguez, Luis; Freites, Dalifer; Font, Judit; Mucientes, Arkaitz; Culebras, Esther; Colome, Jose Ignacio; Jover, Juan Angel; Abasolo, Lydia.
  • Fernandez-Gutierrez B; Rheumatology Department, Hospital Clínico San Carlos, Madrid, Spain.
  • Leon L; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IDISSC), Hospital Clínico San Carlos, Martin Lagos s/n, Madrid, 28040, Spain Universidad Camilo Jose Cela, Madrid, Spain.
  • Madrid A; Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.
  • Rodriguez-Rodriguez L; Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.
  • Freites D; Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.
  • Font J; Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.
  • Mucientes A; Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.
  • Culebras E; Microbiology Department, Hospital Clínico San Carlos, Madrid, Spain.
  • Colome JI; Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.
  • Jover JA; Rheumatology Department, Hospital Clínico San Carlos, Madrid, and Medicine Department, Universidad Complutense, Madrid, Spain.
  • Abasolo L; Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.
Ther Adv Musculoskelet Dis ; 13: 1759720X20962692, 2021.
Article in English | MEDLINE | ID: covidwho-1090738
ABSTRACT

AIMS:

In this pandemic, it is essential for rheumatologists and patients to know the relationship between COVID-19 and inflammatory rheumatic diseases (IRDs). We wanted to assess the role of targeted synthetic or biologic disease-modifying antirheumatic drugs (ts/bDMARDs) and other variables in the development of moderate-severe COVID-19 disease in IRD.

METHODS:

An observational longitudinal study was conducted during the epidemic peak in Madrid (1 March to 15 April 2020). All patients attended at the rheumatology outpatient clinic of a tertiary hospital in Madrid with a medical diagnosis of IRD were included. Main

outcome:

hospital admission related to COVID-19. Independent variable ts/bDMARDs. Covariates sociodemographic, comorbidities, type of IRD diagnosis, glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Incidence rate (IR) of hospital admission related to COVID-19 was expressed per 1000 patient-months. Cox multiple regression analysis was run to examine the influence of ts/bDMARDs and other covariates on IR of hospital admission related to COVID-19.

RESULTS:

A total of 3951 IRD patients were included (5896 patient-months). Methotrexate was the csDMARD most used. Eight hundred and two patients were on ts/bDMARDs, mainly anti-TNF agents, and Rtx. Hospital admissions related to COVID-19 occurred in 54 patients (1.36%) with an IR of 9.15 (95% confidence interval 7-11.9). In the multivariate analysis, older, male, comorbidities, and specific systemic autoimmune conditions (Sjögren, polychondritis, Raynaud, and mixed connective tissue disease) had more risk of hospital admissions. Exposition to ts/bDMARDs did not achieve statistical significance. Use of glucocorticoids, NSAIDs, and csDMARDs dropped from the final model.

CONCLUSION:

This study provides additional evidence in IRD patients regarding susceptibility to moderate-severe infection related to COVID-19.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Ther Adv Musculoskelet Dis Year: 2021 Document Type: Article Affiliation country: 1759720X20962692

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Ther Adv Musculoskelet Dis Year: 2021 Document Type: Article Affiliation country: 1759720X20962692