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Risk Factors and Outcomes for COVID-19 in Autoimmune Inflammatory Diseases during the SARS-CoV-2 Pandemic: A Comparative Study.
Vera-Lastra, Olga; Cimé-Aké, Erik; Ordinola Navarro, Alberto; Morales-Gutiérrez, Joel Eduardo; Cobos-Quevedo, Orestes de Jesús; Hurtado-Díaz, Jorge; Lucero Espinoza-Sánchez, María; Peralta-Amaro, Ana Lilia; Cruz-Domínguez, María Pilar; Medina, Gabriela; Fraga-Mouret, Antonio; Sepulveda-Delgado, Jesus; Jara, Luis J.
  • Vera-Lastra O; Department of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Cimé-Aké E; Department of High Specialty Medical Unit, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Ordinola Navarro A; Department of Postgraduate Studies, Faculty of Medicine, National University Autonomous of Mexico, México City, México.
  • Morales-Gutiérrez JE; Department of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Cobos-Quevedo OJ; Department of High Specialty Medical Unit, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Hurtado-Díaz J; Department of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Lucero Espinoza-Sánchez M; Department of High Specialty Medical Unit, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Peralta-Amaro AL; Department of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Cruz-Domínguez MP; Department of High Specialty Medical Unit, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Medina G; Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico.
  • Fraga-Mouret A; Department of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Sepulveda-Delgado J; Department of High Specialty Medical Unit, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
  • Jara LJ; Department of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
Isr Med Assoc J ; 24(5): 299-305, 2022 May.
Article in English | MEDLINE | ID: covidwho-1857838
ABSTRACT

BACKGROUND:

Patients with autoimmune disease (AID) and coronavirus disease 2019 (COVID-19) could have higher mortality due to the co-morbidity and the use of immunosuppressive therapy.

OBJECTIVES:

To analyze the risk factors and outcomes of patients with AID and COVID-19 versus a control group.

METHODS:

A prospective cohort study included patients with and without AID and COVID-19. Patients were paired by age and sex. Clinical, biochemical, immunological treatments, and outcomes (days of hospital stay, invasive mechanical ventilation [IMV], oxygen at discharge, and death) were collected.

RESULTS:

We included 226 COVID-19 patients 113 with AID (51.15 ± 14.3 years) and 113 controls (53.45 ± 13.3 years). The most frequent AIDs were Rheumatoid arthritis (26.5%), systemic lupus erythematosus (21%), and systemic sclerosis (14%). AID patients had lower lactate dehydrogenas, C-reactive protein, fibrinogen, IMV (P = 0.027), and oxygen levels at discharge (P ≤ 0.0001) and lower death rates (P ≤ 0.0001). Oxygen saturation (SaO2) ≤ 88% at hospitalization provided risk for IMV (RR [relative risk] 3.83, 95% confidence interval [95%CI] 1.1-13.6, P = 0.038). Higher creatinine and LDH levels were associated with death in the AID group. SaO2 ≤ 88% and CO-RADS ≥ 4 were risk factors for in-hospital mortality (RR 4.90, 95%CI 1.8-13.0, P = 0.001 and RR 7.60, 95%CI 1.4-39.7, P = 0.016, respectively). Anticoagulant therapy was protective (RR 0.36, 95%CI 0.1-0.9, P = 0.041).

CONCLUSIONS:

Patients with AID had better outcomes with COVID-19 than controls. Anticoagulation was associated with a lower death in patients with AID.
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Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Isr Med Assoc J Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Mexico

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Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Isr Med Assoc J Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Mexico