Incidence and risk factors for moderate/severe COVID-19 in rheumatic diseases patients on hydroxychloroquine: a 24-week prospective cohort

被引:0
作者
Pinheiro, M. M. [1 ,25 ]
Pileggi, G. S. [1 ]
Kakehasi, A. M. [2 ]
Reis, A. P. M. Gomides [3 ]
Reis-Neto, E. T. [1 ]
Abreu, M. M. [4 ]
Albuquerque, C. P. [3 ]
Araujo, N. C. [5 ]
Bacchiega, A. B. [6 ]
Bianchi, D. V. [7 ]
Bica, B. [4 ]
Bonfa, E. [8 ]
Borba, E. F. [8 ]
Brito, D. C. S. Egypto [9 ]
Calderaro, D. C. [2 ]
Duarte, A. L. B. Pinto [10 ]
Santo, R. O. Espirito [11 ]
Fernandes, P. R. [12 ]
Guimaraes, M. P. [13 ]
Gomes, K. W. Poti [4 ,14 ]
Ilana, G. G. Faustino [15 ]
Klumb, E. M. [16 ]
Marques, C. D. L. [10 ]
de Melo, A. K. Guedes [9 ]
Monticielo, O. A. [11 ]
Mota, L. M. H. [3 ]
Munhoz, G. A. [17 ]
Paiva, E. S. [18 ]
Pereira, H. L. A. [9 ,19 ]
Provenza, J. R. [20 ]
Ribeiro, S. L. E. [19 ]
Rocha Jr, L. F. [21 ]
Sato, E. I. [1 ]
Skare, T. [22 ]
de Souza, V. A. [12 ]
Valim, V. [23 ]
Lacerda, M. V. G. [24 ]
Xavier, R. M. [11 ]
Ferreira, G. A. [2 ]
机构
[1] Univ Fed Sao Paulo, Escola Paulista Med Unifesp EPM, Hosp Sao Paulo, Sao Paulo, SP, Brazil
[2] Univ Fed Minas Gerais UFMG, Hosp Clin, Belo Horizonte MG, Belo Horizonte, MG, Brazil
[3] Univ Brasilia, EBSERH HUB UnB, Hosp Univ Brasilia, Brasilia, DF, Brazil
[4] Univ Fed Rio de Janeiro UFRJ, Hosp Univ Clementino Fraga Filho, Rio De Janeiro, RJ, Brazil
[5] Hosp Serv Publ Estadu al, Inst Assistencia Med ao Servidor Publ Estadual IAM, Sao Paulo, AL, Brazil
[6] Educ & Res Inst Canc Hosp Barretos, Fac Med Barretos FACISB, Barretos, SP, Brazil
[7] Santa Casa Misericordia Rio de Janeiro HGSCMRJ, Rio De Janeiro, RJ, Brazil
[8] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Rheumatol Div, Sao Paulo, SP, Brazil
[9] Univ Fed Paraiba UFPB, Hosp Univ Lauro Wan derley, Joao Pessoa, PB, Brazil
[10] Univ Fed Pernambuco UFPE, Hosp Clin, Recife, Brazil
[11] Univ Fed Rio de Grande UFRGS, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
[12] Univ Fed Juiz de Fora UFJF, Hosp Univ, Juiz De Fora, MG, Brazil
[13] Santa Casa Misericordia Belo Horizonte, Belo Horizonte, MG, Brazil
[14] Hosp Geral Fortaleza HGF, Fortaleza, CE, Brazil
[15] Ctr Med Ribeirao shopping, Ctr Avancado Pesquisa, Estu dos & Diagnost CAPED, Ribeirao Preto, SP, Brazil
[16] Univ Estado Rio de Janeiro UERJ, Hosp Univ Pedro Ernes to, Rio De Janeiro, RJ, Brazil
[17] Irmandade Santa Casa Misericordia Sao Paulo ISCMSP, Sao Paulo, SP, Brazil
[18] Univ Federal Parana UFPR, Curitiba, PR, Brazil
[19] Univ Fed Amazonas, Hosp Univ Getulio Vargas, Manaus, AM, Brazil
[20] Pontificia Univ Catol Campinas PUC CAMP, Campinas, SP, Brazil
[21] Inst Med Integral Prof Fernando Figueira IMIP PE, Recife, PE, Brazil
[22] Hosp Univ Evangel Mackenzie HUEM, Curitiba, PR, Brazil
[23] Univ Fed Espirito St, Hosp Univ Cassiano Antonio Moraes, Vitoria, ES, Brazil
[24] Fiocruz MS, Inst Leonidas & Maria Deane, Manaus, AM, Brazil
[25] Ave Jandira 610-81, BR-04080004 Sao Paulo, SP, Brazil
关键词
rheumatic disease; hydroxychloroquine; COVID-19; SARS-CoV-2; prospective observational cohort; comorbidities; risk factors; SYSTEMIC-LUPUS-ERYTHEMATOSUS; CHALLENGE; MANAGEMENT; OUTCOMES;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To evaluate the incidence of COVID-19 and its main outcomes in rheumatic disease (RD) patients on hydroxychloroquine (HCQ) compared to household cohabitants (HC).Methods This is a 24-week nationwide prospective multi-centre cohort with a control group without RD and not using HCQ. All participants were monitored through scheduled phone interviews performed by health professionals. Details regarding COVID-19 symptoms, and epidemiological, clinical, and demographic data were recorded on a specific web-based platform. COVID-19 was defined according to the Brazilian Ministry of Health criteria and classified as mild, moderate or severe.Results A total of 9,585 participants, 5,164 (53.9%) RD patients on HCQ and 4,421 (46.1%) HC were enrolled from March 29th, 2020 to September 30th, 2020, according to the eligibility criteria. COVID-19 confirmed cases were higher in RD patients than in cohabitants [728 (14.1%) vs. 427 (9.7%), p<0.001] in a 24-week follow-up. However, there was no significant difference regarding outcomes related to moderate/ severe COVID-19 (7.1% and 7.3%, respectively, p=0.896). After multiple adjustments, risk factors associated with hospitalisation were age over 65 (HR=4.5; 95%CI 1.35-15.04, p=0.014) and cardiopathy (HR=2.57; 95%CI 1.12-5.91, p=0.026). The final survival analysis demonstrated the probability of dying in 180 days after a COVID-19 diagnosis was significantly higher in patients over 65 years (HR=20.8; 95%CI 4.5-96.1) and with 2 or more comorbidities (HR=10.8; 95%CI 1.1-107.9 and HR=24.8; 95%CI 2.5-249.3, p=0.006, respectively).Conclusion Although RD patients have had a higher COVID-19 incidence than individuals from the same epidemiological background, the COVID-19 severity was related to traditional risk factors, particularly multiple comorbidities and age, and not to underlying RD and HCQ.
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页码:1258 / 1266
页数:9
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