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Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and COVID-19: The Clinical Course and Prognosis of 15 Patients From a Tertiary Care Center.
Ince, Burak; Bektas, Murat; Koca, Nevzat; Agargün, Besim Fazil; Zarali, Sibel; Güzey, Damla Yenersu; Durak, Görkem; Yalçinkaya, Yasemin; Artim-Esen, Bahar; Gül, Ahmet; Inanç, Murat.
  • Ince B; From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Bektas M; From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Koca N; From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Agargün BF; Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Zarali S; Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Güzey DY; Istanbul Faculty of Medicine.
  • Durak G; Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Yalçinkaya Y; From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Artim-Esen B; From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Gül A; From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine.
  • Inanç M; From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine.
J Clin Rheumatol ; 28(6): 300-304, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-1865041
ABSTRACT

OBJECTIVE:

The aim of this study was to evaluate incidence rates, prognoses, and disease-related factors associated with poor outcomes in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) who had coronavirus disease (COVID-19).

METHODS:

Patients with AAV were questioned for a history of COVID-19 in the outpatient setting. Cumulative clinical findings and treatment history were obtained from the patients' medical records. The clinical, laboratory, and imaging findings of inpatients with COVID-19 were recorded. The data of patients who developed symptomatic COVID-19 and/or died of the disease were used for comparison.

RESULTS:

Eighty-nine patients (47.2% female; mean age, 56 ± 12.5 years) were included. The diagnosis was granulomatosis with polyangiitis in 56 patients (62.9%) and microscopic polyangiitis in 33 (37.1%). Sixty-one (68.2%) and 21 patients (23.6%) had renal and peripheral nerve involvement, respectively. Ten patients had a history of diffuse alveolar hemorrhage. Fifteen patients (16.9%) had COVID-19, including 9 (60%) with severe pneumonia. Twelve patients (85.7%) were hospitalized, 6 (42.9%) were admitted to the intensive care unit, and 5 (35.7%) died. All deceased patients had hypogammaglobulinemia (IgG levels <700 mg/dL) during hospital admission. Symptomatic COVID-19 was associated with higher disease activity, glucocorticoid and rituximab treatments, and glomerular filtration rate <30 mL/min. A history of peripheral nerve involvement, higher organ damage scores, and hypogammaglobulinemia was associated with mortality.

CONCLUSIONS:

The prognosis was poor in our patients with AAV who had COVID-19, especially those with severe multisystem involvement. Hypogammaglobulinemia was associated with mortality. Serum IgG level monitoring in patients with AAV would be beneficial during the COVID-19 pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Granulomatosis with Polyangiitis / Agammaglobulinemia / Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Clin Rheumatol Journal subject: Physiology / Orthopedics / Rheumatology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Granulomatosis with Polyangiitis / Agammaglobulinemia / Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Clin Rheumatol Journal subject: Physiology / Orthopedics / Rheumatology Year: 2022 Document Type: Article