Factors associated with severe infection in rheumatoid arthritis patients: lessons learned from the COVID-19 pandemic.

IF 5.4 2区 医学 Q1 INFECTIOUS DISEASES
Infection Pub Date : 2024-08-01 Epub Date: 2024-02-21 DOI:10.1007/s15010-024-02187-z
Aya Embaby, Lobna A Maged, Hoda M Abdel-Hamid, Khaled T El Hadidi
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引用次数: 0

Abstract

Purpose: This aimed to identify the factors associated with severe/critical coronavirus disease 2019 (COVID-19) infection in rheumatoid arthritis (RA) patients.

Methods: Two-hundred RA patients diagnosed according to the American College of Rheumatology/ European League Against Rheumatism (ACR/EULAR) classification criteria with proven COVID-19 infection were recruited and categorized according to the world health organization (WHO) COVID-19 severity grading into 2 groups: patients with mild/moderate COVID-19 (n = 164) and patients with severe/critical COVID-19 (n = 36). Comparison between both groups was done to identify the risk factors associated with severe/critical infection. Incidence of RA disease activity flare defined as increase in clinical disease activity index (CDAI) more than 10 points following infection was calculated.

Results: Multivariate analysis identified history of previous serious infection, age > 60 years, and diabetes as factors positively associated, whereas COVID-19 vaccination was negatively associated with severe/critical infection. Following COVID-19 infection, the number of patients with severe/critical COVID-19 who had high RA disease activity and the incidence of flares was significantly higher in comparison to patients with mild/moderate COVID-19 (P < 0.001 and 0.003; respectively).

Conclusion: Age > 60 years, diabetes, and history of previous serious infections are risk factors for severe/critical COVID-19, while vaccination has a protective role in RA patients. Infection particularly when severe is associated with risk of disease flare.

类风湿性关节炎患者严重感染的相关因素:从 COVID-19 大流行中汲取的教训。
目的:旨在确定类风湿关节炎(RA)患者感染严重/危重冠状病毒病2019(COVID-19)的相关因素:招募了200名根据美国风湿病学会/欧洲抗风湿病联盟(ACR/EULAR)分类标准确诊并证实感染了COVID-19的RA患者,并根据世界卫生组织(WHO)的COVID-19严重程度分级分为两组:轻度/中度COVID-19患者(n = 164)和重度/危重COVID-19患者(n = 36)。对两组患者进行比较,以确定与重度/危重感染相关的风险因素。计算了感染后RA疾病活动复发(定义为临床疾病活动指数(CDAI)增加超过10点)的发生率:多变量分析发现,既往严重感染史、年龄大于60岁和糖尿病与严重/危重感染呈正相关,而接种COVID-19疫苗与严重/危重感染呈负相关。感染COVID-19后,与轻度/中度COVID-19患者相比,重度/危重COVID-19患者中出现高度RA疾病活动和复发的人数明显增多(P 结语:COVID-19疫苗接种与RA疾病活动和复发密切相关):年龄大于 60 岁、糖尿病和既往严重感染史是重度/危重 COVID-19 的风险因素,而接种疫苗对 RA 患者有保护作用。感染尤其是严重感染与疾病复发的风险有关。
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来源期刊
Infection
Infection 医学-传染病学
CiteScore
12.50
自引率
1.30%
发文量
224
审稿时长
6-12 weeks
期刊介绍: Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.
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