CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases

被引:7
作者
Chevalier, Kevin [1 ]
Genin, Michael [2 ]
Jean, Thomas Petit [3 ]
Avouac, Jerome [4 ]
Flipo, Rene-Marc [5 ]
Georgin-Lavialle, Sophie [6 ]
El Mahou, Soumaya [7 ]
Pertuiset, Edouard [8 ]
Pham, Thao [9 ]
Servettaz, Amelie [10 ]
Marotte, Hubert [11 ]
Domont, Fanny [12 ]
Chazerain, Pascal [13 ]
Devaux, Mathilde [14 ]
Mekinian, Arsene [15 ]
Sellam, Jeremie [16 ]
Fautrel, Bruno [17 ]
Rouzaud, Diane [18 ]
Ebstein, Esther [19 ]
Costedoat-Chalumeau, Nathalie [20 ]
Richez, Christophe [21 ]
Hachulla, Eric [22 ]
Mariette, Xavier [1 ]
Seror, Raphaele [1 ]
机构
[1] Univ Paris Saclay, Hop Bicetre, Ctr Immunol Viral Infect & Autoimmune Dis, INSERM,UMR 1184,Dept Rheumatol,AP HP, Le Kremlin Bicetre, France
[2] Univ Lille, CHU Lille, ULR METRICS Evaluat Technol St & Prat Med 2694, Lille, France
[3] AP HP, Dept Innovat & Donnees, Paris, France
[4] Cochin Hosp, Rheumatol A, Paris, France
[5] Univ Lille, Rheumatol, Lille, France
[6] Tenon Hosp, Internal Med, Paris, France
[7] Hosp Ctr Tourcoing, Rheumatol, Tourcoing, France
[8] Hosp Rene Dubos, Rheumatol, Pontoise, France
[9] Hosp St Marguerite, Rheumatol, Marseille, France
[10] Hosp Robert Debre, Internal Med, Infect Dis & Clin Immunol, Reims, France
[11] Univ Hosp St Etienne, Rheumatol, St Priest En Jarez, France
[12] Univ Hosp Pitie Salpetriere Charles Foix, Internal Med & Clin Immunol, Paris, France
[13] Hop Croix St Simon, Rheumatol & Internal Med, Paris, France
[14] St Germain En Laye Intercommunal Hosp Ctr, Internal Med, Poissy, France
[15] Hosp St Antoine, AP HP, Internal Med, Paris, France
[16] Hosp St Antoine, AP HP, Rheumatol, Paris, France
[17] Sorbonne Univ, Pitie Salpetriere Hosp, Pierre Louis Inst Epidemiol & Publ Hlth, Dept Rheumatol,AP HP,INSERM,UMRS 1136, Paris, France
[18] Bichat Claude Bernard Hosp, Internal Med, Paris, France
[19] Bichat Claude Bernard Hosp, Rheumatol, Paris, France
[20] Cochin Hosp, Internal Med, Paris, France
[21] Chu Bordeaux, Site Pellegrin, Rheumatol, Bordeaux, France
[22] Univ Lille, Inst Translat Res Inflammat, Referral Ctr Ctr Rare Syst Autoimmune Dis North &, Dept Internal Med & Clin Immunol,CHU Lille,INSERM, Lille, France
关键词
COVID-19; auto-immune diseases; inflammatory rheumatic diseases; rituximab; lupus; vasculitis; rheumatic and musculoskeletal diseases; CLINICAL CHARACTERISTICS; HOSPITALIZED-PATIENTS; OUTCOMES; PNEUMONIA; THERAPY;
D O I
10.3389/fmed.2023.1152587
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
IntroductionAutoimmune/inflammatory rheumatic diseases (AIRDs) patients might be at-risk of severe COVID-19. However, whether this is linked to the disease or to its treatment is difficult to determine. This study aimed to identify factors associated with occurrence of severe COVID-19 in AIRD patients and to evaluate whether having an AIRD was associated with increased risk of severe COVID-19 or death. Materials and methodsTwo databases were analyzed: the EDS (Entrepot des Donnees de Sante, Clinical Data Warehouse), including all patients followed in Paris university hospitals and the French multi-center COVID-19 cohort [French rheumatic and musculoskeletal diseases (RMD)]. First, in a combined analysis we compared patients with severe and non-severe COVID-19 to identify factors associated with severity. Then, we performed a propensity matched score case-control study within the EDS database to compare AIRD cases and non-AIRD controls. ResultsAmong 1,213 patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher risk of severe COVID-19 [aOR = 1.43 (1.08-1.87), p = 0.01] but analysis restricted to rheumatoid arthritis and spondyloarthritis found no increased risk of severe COVID-19 [aOR = 1.11 (0.68-1.81)]. ConclusionIn this multicenter study, we confirmed that AIRD patients treated with rituximab or corticosteroids and/or having vasculitis, auto-inflammatory disease, and sarcoidosis had increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of severe COVID-19 compares general population.
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页数:15
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