SEVERITY of COVID-19 in PATIENTS with RHEUMATOID ARTHRITIS RECEIVING BIOLOGICAL DMARDS

ABSTRACT

Background: The safety of biological DMARDs for rheumatic diseases in the context of the covid 19 pandemic is one of the key aspects of modern rheumatology Objectives: assess the severity of the course of COVID-19 infection in patients with rheumatoid arthritis receiving various biological disease-modifying antirheu-matic drugs. Methods: to assess the severity of the course of SARS-CoV-2, discharged epic-risis from hospitals or the conclusion of computed tomography were used. Since March 2020 to November 2021, among the 1389 patients with rheumatic diseases observed at the of the anticytokine therapy center of the North-Western State Medical University Named after I.I. Mechnikov 105 cases of COVID-19 infection of patients with rheumatoid arthritis were registered, of which 53 patients received outpatient treatment, and 52 patients received inpatient treatment. In 76% of cases, patients received biological DMARDs in combination with synthetic DMARDs. Results: In patients treated on an outpatient basis, only 17% (9 patients) underwent chest X-ray examination, according to which grade 2 CT was observed in three patients. Among hospitalized patients, multispiral computed tomography was performed in all cases (n=8;15.3%) of this group of interstitial lung lesions consistent with CT-1. At the same time, CT-2 was determined in 25 (48,1%), CT-3-in 16 (30.8%), CT-4-in 3 (5.8%) (2 lethal cases) patients. The most severe cases of COVID-19 (CT-3 and CT-4) were observed most often in patients (12 and 3, respectively) treated with rituximab (Table 1). Conclusion: Previous rituximab therapy in patients with rheumatoid arthritis is the most unfavorable prognostic factor during COVID-19 infection.