Clinical outcomes and risk factors in patients with COVID-19 and autoimmune rheumatic diseases: insights from a major Australian hospital study

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Internal Medicine Journal Pub Date : 2024-08-13 DOI:10.1111/imj.16488

Zhi Ling, Stephen Guy, Christopher Fong

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引用次数: 0

Abstract

Background and Aim

Patients with autoimmune inflammatory rheumatic disease (AIIRD) are at higher risk of severe infections because of their underlying diseases and immunosuppression. Our objective was to elucidate the epidemiological and clinical characteristics of patients with AIIRD presenting with COVID-19 and their relation to disease severity. We explored whether variables, including underlying diagnosis, disease-modifying antirheumatic drugs (DMARDs) and COVID-19 vaccine status, were associated with more severe forms of COVID-19 infection.

Methods

Between 1 January 2020 and 30 June 2022, 151 patients with AIIRD and COVID-19 infection were analysed using a binary regression model and a multinomial regression model.

Results

The average age was 61.5 years, and average Charlson Comorbidity Index (CCI) was 2.1; 106 (70.2%) patients were diagnosed with rheumatoid arthritis (RA), and 70 (46.4%) patients were receiving prednisolone. In the multivariable logistic regression model, ages between 50 and 69 years (odds ratio (OR) = 5.85; 95% confidence interval (CI) = 1.35–25.25) and older than 70 years (OR = 5.29; 95% CI = 1.21–23.14), prior prednisolone treatment (OR = 7.09; 95% CI = 2.63–19.11) and vaccination status including one and two doses (OR = 0.19; 95% CI = 0.05–0.69) and three and four doses (OR = 0.09; 95% CI = 0.02–0.35) were all statistically significant factors related to changes in the severity level of COVID-19.

Conclusion

Severity of COVID-19 infection in patients with AIIRD is affected by age, background steroid use and vaccination status. Factors including sex, comorbidity, diagnosis of AIIRDs and use of DMARDs, including conventional synthetic, biologics and targeted DMARDs, were not significantly associated with COVID-19 severity.

查看原文本刊更多论文

COVID-19 和自身免疫性风湿病患者的临床疗效和风险因素：澳大利亚一家大型医院研究的启示。

背景和目的：自身免疫性炎症性风湿病（AIIRD）患者由于其基础疾病和免疫抑制，发生严重感染的风险较高。我们的目的是阐明出现 COVID-19 的自身免疫性炎症性风湿病患者的流行病学和临床特征及其与疾病严重程度的关系。我们探讨了包括基础诊断、改善病情抗风湿药物（DMARDs）和COVID-19疫苗接种情况在内的变量是否与更严重的COVID-19感染形式有关：方法：采用二元回归模型和多项式回归模型对2020年1月1日至2022年6月30日期间151例AIIRD和COVID-19感染患者进行了分析：平均年龄为61.5岁，平均夏尔森合并症指数（CCI）为2.1；106名（70.2%）患者被诊断为类风湿性关节炎（RA），70名（46.4%）患者正在接受泼尼松龙治疗。在多变量逻辑回归模型中，年龄在 50 至 69 岁之间（比值比 (OR) = 5.85；95% 置信区间 (CI) = 1.35-25.25）和 70 岁以上（OR = 5.29；95% CI = 1.21-23.14）、曾接受过强的松龙治疗（OR = 7.09；95% CI = 2.63-19.11）和疫苗接种情况，包括一剂和两剂（OR = 0.19; 95% CI = 0.05-0.69）以及三剂和四剂（OR = 0.09; 95% CI = 0.02-0.35），都是与COVID-19严重程度变化相关的具有统计学意义的因素：结论：AIIRD患者感染COVID-19的严重程度受年龄、类固醇使用背景和疫苗接种情况的影响。性别、合并症、AIIRD诊断以及使用DMARDs（包括传统合成药物、生物制剂和靶向DMARDs）等因素与COVID-19严重程度无显著相关性。

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来源期刊

Internal Medicine Journal 医学-医学：内科

CiteScore

3.50

自引率

4.80%

发文量

600

审稿时长

3-6 weeks

期刊介绍： The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.