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

来源：

CLINICAL AND EXPERIMENTAL RHEUMATOLOGY | 2022年 / 40卷 / 07期

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.

引用

页码：1258 / 1266

页数：9

共 53 条

[1] Comorbidities in rheumatic diseases need special consideration during the COVID-19 pandemic [J].

Ahmed, Sakir ;

Gasparyan, Armen Yuri ;

Zimba, Olena .

RHEUMATOLOGY INTERNATIONAL, 2021, 41 (02) :243-256

[2] Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis [J].

Akiyama, Shintaro ;

Hamdeh, Shadi ;

Micic, Dejan ;

Sakuraba, Atsushi .

ANNALS OF THE RHEUMATIC DISEASES, 2021, 80 (03) :384-391

[3] Outcomes of Systemic Lupus Erythematosus in Patients who Discontinue Hydroxychloroquine [J].

Aouhab, Z. ;

Hong, H. ;

Felicelli, C. ;

Tarplin, S. ;

Ostrowski, R. A. .

ACR OPEN RHEUMATOLOGY, 2019, 1 (09) :593-599

[4] COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study [J].

Avouac, Jerome ;

Drumez, Elodie ;

Hachulla, Eric ;

Seror, Raphaele ;

Georgin-Lavialle, Sophie ;

El Mahou, Soumaya ;

Pertuiset, Edouard ;

Thao Pham ;

Marotte, Hubert ;

Servettaz, Amelie ;

Domont, Fanny ;

Chazerain, Pascal ;

Devaux, Mathilde ;

Claudepierre, Pascal ;

Langlois, Vincent ;

Mekinian, Arsene ;

Maria, Alexandre Thibault Jacques ;

Banneville, Beatrice ;

Fautrel, Bruno ;

Pouchot, Jacques ;

Thomas, Thierry ;

Flipo, Rene-Marc ;

Richez, Christophe .

LANCET RHEUMATOLOGY, 2021, 3 (06) :E419-E426

[5] Science unites a troubled world: Lessons from the pandemic [J].

Booz, George W. ;

Zouein, Fouad A. .

EUROPEAN JOURNAL OF PHARMACOLOGY, 2021, 890

[6] Severe COVID-19: what have we learned with the immunopathogenesis? [J].

Bordallo, Bruno ;

Bellas, Mozart ;

Cortez, Arthur Fernandes ;

Vieira, Matheus ;

Pinheiro, Marcelo .

ADVANCES IN RHEUMATOLOGY, 2020, 60 (01)

[7] Evolution and epidemic spread of SARS-CoV-2 in Brazil [J].

Candido, Darlan S. ;

Claro, Ingra M. ;

de Jesus, Jaqueline G. ;

Souza, William M. ;

Moreira, Filipe R. R. ;

Dellicour, Simon ;

Mellan, Thomas A. ;

du Plessis, Louis ;

Pereira, Rafael H. M. ;

Sales, Flavia C. S. ;

Manuli, Erika R. ;

Theze, Julien ;

Almeida, Luiz ;

Menezes, Mariane T. ;

Voloch, Carolina M. ;

Fumagalli, Marcilio J. ;

Coletti, Thais M. ;

Silva, Camila A. M. ;

Ramundo, Mariana S. ;

Amorim, Mariene R. ;

Hoeltgebaum, Henrique H. ;

Mishra, Swapnil ;

Gill, Mandev S. ;

Carvalho, Luiz M. ;

Buss, Lewis F. ;

Prete Jr, Carlos A. ;

Ashworth, Jordan ;

Nakaya, Helder, I ;

Peixoto, Pedro S. ;

Brady, Oliver J. ;

Nicholls, Samuel M. ;

Tanuri, Amilcar ;

Rossi, Atila D. ;

Braga, Carlos K., V ;

Gerber, Alexandra L. ;

Guimaraes, Ana Paula de C. ;

Gaburo Jr, Nelson ;

Alencar, Cecila Salete ;

Ferreira, Alessandro C. S. ;

Lima, Cristiano X. ;

Levi, Jose Eduardo ;

Granato, Celso ;

Ferreira, Giulia M. ;

Francisco Jr, Ronaldo S. ;

Granja, Fabiana ;

Garcia, Marcia T. ;

Moretti, Maria Luiza ;

Perroud Jr, Mauricio W. ;

Castineiras, Terezinha M. P. P. ;

Lazari, Carolina S. .

SCIENCE, 2020, 369 (6508) :1255-+

[8] Hydroxychloroquine with or without Azithromycin in Covid-19 [J].

Choudhary, Rahul ;

Bohra, Gopal K. ;

Kumar, Deepak .

NEW ENGLAND JOURNAL OF MEDICINE, 2021, 384 (02) :190-191

[9] Prevalence of Diabetes by Race and Ethnicity in the United States, 2011-2016 [J].

Cheng, Yiling J. ;

Kanaya, Alka M. ;

Araneta, Maria Rosario G. ;

Saydah, Sharon H. ;

Kahn, Henry S. ;

Gregg, Edward W. ;

Fujimoto, Wilfred Y. ;

Imperatore, Giuseppina .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2019, 322 (24) :2389-2398

[10] Charlson Comorbidity Index Score and Risk of Severe Outcome and Death in Danish COVID-19 Patients [J].

Christensen, Daniel Molager ;

Strange, Jarl Emanuel ;

Gislason, Gunnar ;

Torp-Pedersen, Christian ;

Gerds, Thomas ;

Fosbol, Emil ;

Phelps, Matthew .

JOURNAL OF GENERAL INTERNAL MEDICINE, 2020, 35 (09) :2801-2803

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