Clinical spectrum of COVID-19 in patients with underlying rheumatic disease -data from Pakistan

ABSTRACT

Objectives: To evaluate the clinical features of COVID-19 in patients with underlying rheumatic diseases. Methods: Data about rheumatic disease patients with COVID-19 was collected by an online survey form. The form was sent to all the rheumatologists working in Pakistan. Parameters analyzed included patient ' s age, gender, smoking status;details of underlying rheumatic disorder;method of COVID-19 diagnosis, treatment and outcome. Chi-square, student ' s t-test and regression tests were used for analysis. Results: 46 patients were included. The mean age was 40.86 ± 13.41 (range 21-65 years). 29 (69%) were females. 10 (23.8%) patients died. The most common symptoms were fever 35 (83.3%), cough 26 (61.9%) and myalgia 23 (54.8%). Dyspnea was strongly associated with high mortality, ICU admission, ventilation and hospitalisation (p < 0.05). Rheumatic disease activity and long term steroid use also predicted mortality (p < 0.05). ICU admission and ventilation need was significantly higher in patients with ongoing steroids and HCQ use during COVID 19. (p < 0.05). Among DMARDs, MMF was related to ICU admission, ventilation and hospitalization (p < 0.05). Conclusions: Long-term steroids use, High disease activity, ongoing use of steroids and HCQ during COVID infection, MMF and Dyspnoea are associated with severe COVID-19 disease.