Rising incidence of systemic autoimmune inflammatory rheumatic diseases during the COVID-19 pandemic: a geographical cohort study.

IF 5.1 2区医学 Q1 RHEUMATOLOGY

RMD Open Pub Date : 2025-06-12 DOI:10.1136/rmdopen-2024-005227

Enrico De Lorenzis, Paolo Parente, Salvatore Soldati, Andrea Barbara, Gerlando Natalello, Marina Davoli, Silvia Laura Bosello, Maria Antonietta D'Agostino, Mirko Di Martino

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引用次数: 0

Abstract

Objective: The natural infection with SARS-CoV-2, or vaccination against it, has been postulated to directly contribute to an increase in the incidence of autoimmune inflammatory rheumatic diseases (AIIRDs). Conversely, preventive measures limiting access to healthcare services could have resulted in missed or delayed AIIRD diagnoses or have reduced the infection rate of any triggering infections. We aimed to define real-life trends in AIIRD diagnoses from the prepandemic period through 2023 in a large and geographically circumscribed population of 6.5 million inhabitants.

Methods: AIIRDs' annual diagnosis rates from 2017 to 2023 were derived from the registration of disease-specific exemption codes of the resident population of Lazio, a highly populated region in central Italy. Incidence rate ratios (IRRs) were calculated to compare pandemic and average prepandemic rates (2017-2019). Poisson regression was used to define statistically significant changes.

Results: A total of 16 254 AIIRD diagnoses were registered over the 7-year period. The average prepandemic incidence of AIIRDs was 4.81 per 10 000 inhabitants (95% CI 4.69 to 4.92). Compared with the prepandemic period, the diagnosis rate decreased in 2020 (IRR 0.68, 95% CI 0.64 to 0.72) but remained above prepandemic levels in 2021, 2022 and 2023. In 2023, there was a 22% increase in AIIRD incidence compared with prepandemic levels (IRR 1.22, 95% CI 1.17 to 1.28, p<0.001). This excess incidence was primarily driven by increases in both primary arthritides and systemic rheumatic diseases.

Conclusions: We observed a temporary decline in diagnosis in 2020, followed by a substantial increase from 2021 to 2023. This trend (decline and increase) may be linked to COVID-19 infection or to the reduction and subsequently potential increase of other infectious triggers following the use of preventive measures, such as facial masks and social distancing.

查看原文本刊更多论文

2019冠状病毒病大流行期间系统性自身免疫性炎症性风湿病发病率上升：一项地理队列研究

目的：自然感染SARS-CoV-2或接种疫苗被认为是自身免疫性炎症性风湿性疾病（AIIRDs）发病率增加的直接原因。相反，限制获得保健服务的预防措施可能会导致错过或延迟AIIRD诊断，或降低任何触发性感染的感染率。我们的目标是确定从大流行前到2023年AIIRD诊断的现实趋势，在650万人口的大型地理限制人口中。方法：2017 - 2023年AIIRDs的年诊出率来源于意大利中部人口稠密地区拉齐奥常住人口的疾病特异性豁免代码登记。计算发病率比（IRRs），以比较大流行和大流行前的平均发病率（2017-2019年）。使用泊松回归来定义具有统计学意义的变化。结果：7年期间共登记了16 254例AIIRD诊断。禽流感大流行前的平均发病率为每1万居民4.81例（95%可信区间4.69至4.92）。与大流行前相比，诊断率在2020年有所下降（IRR 0.68, 95% CI 0.64至0.72），但在2021年、2022年和2023年仍高于大流行前的水平。2023年，与大流行前水平相比，AIIRD发病率增加了22% （IRR 1.22, 95% CI 1.17至1.28）。结论：我们观察到2020年诊断暂时下降，随后从2021年到2023年大幅增加。这一趋势（下降和增加）可能与COVID-19感染有关，也可能与采取口罩和保持社交距离等预防措施后其他感染诱因减少并随后可能增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

RMD Open RHEUMATOLOGY-

CiteScore

7.30

自引率

6.50%

发文量

205

审稿时长

14 weeks

期刊介绍： RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.