COVID-19在类风湿性关节炎中的发病率、住院率和COVID-19大流行前后的全因死亡风险

IF 3.4 4区 医学 Q2 RHEUMATOLOGY
Mohammad Movahedi, Xiuying Li, Angela Cesta, Claire Bombardier, Elliot Hepworth, Sibel Zehra Aydin
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引用次数: 0

摘要

目的:COVID-19感染可引发细胞因子风暴,可通过类似于类风湿性关节炎(RA)的免疫调节疗法进行治疗。本研究调查了2019冠状病毒病(COVID-19)的患病率、住院率、急诊科(ED)就诊情况,以及RA治疗和基线特征对RA患者死亡率的影响。方法:将安大略省最佳实践研究计划(obi)的RA患者与临床评估科学研究所(ICES)保存的安大略省医疗记录相关联。该研究调查了2020年1月1日至2022年3月31日期间COVID-19感染、急诊科就诊、住院和重症监护病房(ICU)入院情况,以及大流行前后的全因死亡率风险。结果:2969例RA患者中,596例(20.1%)感染COVID-19。在COVID-19患者中,108人(18.1%)住院或去急诊室。女性更容易被感染(81.9% vs. 76.5%;比值比:1.30;95% CI: 1.01-1.66)。COVID-19患者更有可能使用生物制剂(52.5%比46.1%;adj or:1.28; 95% CI: 1.04-1.57)或Janus激酶抑制剂(JAKi)(13.4%比9.5%;adj or:1.44; 95% CI: 1.08-1.93)。年龄较大(bb0 ~ 80岁)(相对危险度:10.9;95% CI:6.49 ~ 18.2)、吸烟(相对危险度:1.85;95% CI:1.41 ~ 2.42)和较高的疾病活动度评分(相对危险度:1.09;95% CI:1.00 ~ 1.18)与COVID-19大流行前后较高的全因死亡率相关,后者相关性更强。大流行前,JAKi与死亡率增加呈负相关(相对比:0.55;95% CI: 0.34-0.91)。结论:2019冠状病毒病在女性、年轻患者、合并症患者和接受先进治疗的患者中较高。与大流行前相比,大流行期间较高的死亡率与年龄较大、口服类固醇使用、吸烟和较高的疾病活动性有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19 in rheumatoid arthritis: prevalence, hospital admission, and risk of all-cause mortality before and after COVID-19 pandemic.

Objectives: COVID-19 infection can trigger a cytokine storm, treatable with immunomodulating therapies similar to those used in rheumatoid arthritis (RA). This study investigated COVID-19 prevalence, hospitalisation, emergency department (ED) visits, and the impact of RA treatment and baseline characteristics on mortality in RA patients.

Methods: RA patients from the Ontario Best Practices Research Initiative (OBRI) were linked to Ontario healthcare records held at the Institute for Clinical Evaluative Sciences (ICES). The study examined COVID-19 infection, ED visits, hospitalisation, and intensive care unit (ICU) admissions between January 1st 2020, and March 31st 2022, and the risk of all-cause mortality before and after the pandemic.

Results: Among 2,969 RA patients, 596 (20.1%) had COVID-19. Of those with COVID-19, 108 (18.1%) were hospitalised or visited ED. Females were more likely to be infected (81.9% vs. 76.5%; adj ORs:1.30; 95% CI: 1.01-1.66). COVID-19 patients were more likely to use biologics (52.5% vs. 46.1%; adj ORs:1.28; 95% CI: 1.04-1.57) or Janus Kinase inhibitors (JAKi) (13.4% vs. 9.5%; adj ORs:1.44; 95% CI: 1.08-1.93). Older age (>80 years) (adj HR: 10.9; 95% CI:6.49-18.2), smoking (adj HR: 1.85; 95% CI:1.41-2.42), and higher disease activity score (adj HR: 1.09; 95% CI:1.00-1.18) were associated with higher all-cause mortality both before and after the COVID-19 pandemic, with stronger associations in the latter. JAKi were negatively associated with increased death before the pandemic (adj HR: 0.55; 95% CI: 0.34-0.91).

Conclusions: COVID-19 was higher in females, younger patients, those with comorbidities, and those using advanced therapies. Compared to pre-pandemic, higher death rates during the pandemic were associated with older age, oral steroid use, smoking, and higher disease activity.

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来源期刊
CiteScore
6.10
自引率
18.90%
发文量
377
审稿时长
3-6 weeks
期刊介绍: Clinical and Experimental Rheumatology is a bi-monthly international peer-reviewed journal which has been covering all clinical, experimental and translational aspects of musculoskeletal, arthritic and connective tissue diseases since 1983.
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