PERSISTENT POST-DISCHARGE SYMPTOMS after COVID-19 in RHEUMATIC and MUSCULOSKELETAL DISEASES

ABSTRACT

Background: The COVID-19 pandemic continues worldwide and has had a strong impact on public health. As the pandemic evolves, efforts have been inten-sifed to identify persistent symptoms associated with the infection once resolved have intensifed. Objectives: We aimed to describe persistent symptoms and sequelae in patients with rheumatic and musculoskeletal diseases (RMD) after admission due to Covid-19. We also compared the role of autoimmune rheumatic diseases (ARD) with that of non-autoimmune rheumatic and musculoskeletal diseases (NARD) in persistent symptoms and sequelae. Methods: We performed an observational study of patients with RMD who attended a rheumatology outpatient clinic in Madrid and required admission to hospital due to Covid-19 (1st March-30th May 2020) and survived. The study began at discharge and ran until 1st October 2020. The main outcomes were persistence of symptoms and sequelae related to Covid19. The independent variable was the RMD group (ARD and NARD). The covariates were sociode-mographic data, clinical fndings, and treatment. We ran a multivariate logistic regression model to assess the risk of the main outcomes by RMD group. Results: We included 105 patients, of whom 51.5% had ARD and 68.57% reported at least 1 persistent symptom. The most frequent were dyspnea, fatigue, and chest pain. Sequelae were recorded in 31 patients. These included lung damage in 10.4% of patients, lymphopenia in 10%, central retinal vein occlusion (1 patient), and optic neuritis (1 patient). Two patients died. Eleven patients required readmission owing to Covid-19 problems (16.7% ARD vs 3.9% NARD;p=0.053). No statistically signifcant differences were found between RMD groups in the fnal models. Conclusion: Many RMD patients have persistent symptoms, as in other populations. Lung damage is the most frequent sequela. Compared to NARD patients, ARD patients do not seem to differ in terms of persistent symptoms or sequelae, although ARD patients might generate more readmissions due to Covid-19.