A multidisciplinary registry of patients with autoimmune and immune-mediated diseases with symptomatic COVID-19 from a single center

被引：21

作者：

Sarmiento-Monroy, Juan C. ^{[1
]}

Espinosa, Gerard ^{[2
]}

Londono, Maria-Carlota ^{[3
,4
]}

Meira, Fernanda ^{[5
]}

Caballol, Berta ^{[6
]}

Llufriu, Sara ^{[7
]}

Carrasco, Josep Lluis ^{[8
]}

Moll-Udina, Aina ^{[9
]}

Quintana, Luis F. ^{[10
]}

Giavedoni, Priscila ^{[11
]}

Ramirez, Julio ^{[12
]}

Inciarte-Mundo, Jose ^{[1
]}

Solana, Elisabeth ^{[7
]}

Blanco, Yolanda ^{[7
]}

Martinez-Hernandez, Eugenia ^{[7
]}

Sepulveda, Maria ^{[7
]}

Llorenc, Victor ^{[9
]}

Prieto-Gonzalez, Sergio ^{[2
]}

Espigol-Frigole, Georgina ^{[2
]}

Milisenda, Jose C. ^{[12
]}

Cid, Maria C. ^{[2
]}

Mascaro, Jose M., Jr. ^{[11
]}

Blanco, Isabel ^{[13
]}

Barbera, Joan Albert ^{[13
]}

Sibila, Oriol ^{[13
]}

Gratacos-Gines, Jordi ^{[6
]}

Adan, Alfredo ^{[9
]}

Agusti, Alvaro ^{[13
]}

Sanmarti, Raimon ^{[1
]}

Panes, Julian ^{[6
]}

Cervera, Ricard ^{[2
]}

Vila, Jordi ^{[14
]}

Soriano, Alex ^{[5
]}

Gomez-Puerta, Jose A. ^{[1
]}

机构：

[1] Hosp Clin Barcelona, Rheumatol Dept, Villarroel 170, Barcelona 08036, Catalonia, Spain

[2] Univ Barcelona, Hosp Clin, IDIBAPS, Dept Autoimmune Dis, Barcelona, Catalonia, Spain

[3] Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Liver Unit, Barcelona, Catalonia, Spain

[4] Univ Barcelona, Ctr Invest Red Enfermedades Hepat & Digest CIBERe, Barcelona, Catalonia, Spain

[5] Hosp Clin Barcelona, IDIBAPS, Dept Infect Dis, Barcelona, Spain

[6] Hosp Clin Barcelona, Dept Gastroenterol, Barcelona, Catalonia, Spain

[7] Hosp Clin Barcelona, Dept Neurol, Barcelona, Catalonia, Spain

[8] Univ Barcelona, Dept Basic Clin Practice, Biostat, Barcelona, Catalonia, Spain

[9] Hosp Clin Barcelona, Inst Invest Biomed Agusti Pi & Sunyer IDIBAPS, Grp Ocular Inflammat Clin & Expt Studies, Barcelona, Catalonia, Spain

[10] Univ Barcelona, Ctr Referencia Enfermedad Glomerular Compleja Sis, Hosp Clin, Dept Nephrol & Renal Transplantat,Dept Med,IDIBAP, Barcelona, Catalonia, Spain

[11] Univ Barcelona, Hosp Clin, Dept Dermatol, Barcelona, Catalonia, Spain

[12] Univ Barcelona, CIBERER, Hosp Clin, Muscle Res Unit,Dept Internal Med, Barcelona, Catalonia, Spain

[13] Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Dept Pulm Med, Barcelona, Catalonia, Spain

[14] Univ Barcelona, Barcelona Inst Global Hlth, Hosp Clin, Dept Clin Microbiol,Biomed Diagnost Ctr, Barcelona, Catalonia, Spain

来源：

JOURNAL OF AUTOIMMUNITY | 2021年 / 117卷

关键词：

Autoimmune diseases; Severe acute respiratory syndrome coronavirus 2; COVID-19; Immunosuppression; Adverse outcome; RHEUMATIC-DISEASES; EPIDEMIOLOGY;

D O I：

10.1016/j.jaut.2020.102580

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background and aim: There is increasing interest regarding SARS-CoV-2 infection in patients with autoimmune and immune-mediated inflammatory diseases (AI/IMID) with some discrepancies in different cohorts about their risk and outcomes. The aim was to describe a multidisciplinary cohort of patients with AI/IMID and symptomatic SARS-CoV-2 infection in a single tertiary center and analyze sociodemographic, clinical, and therapeutic factors associated with poor outcomes. Methods: A retrospective observational study was conducted from the 1st of March until May 29th, 2020 in a University tertiary hospital in Barcelona, Spain. Patients with an underlying AI/IMID and symptomatic SARSCoV-2 infection were identified in our local SARS-CoV-2 infection database. Controls (2:1) were selected from the same database and matched by age and gender. The primary outcome was severe SARS-CoV-2 infection, which was a composite endpoint including admission to the intensive care unit (ICU), need for mechanical ventilation (MV), and/or death. Several covariates including age, sex, and comorbidities among others were combined into a multivariate model having severe SARS-CoV-2 as the dependent variable. Also, a sensitivity analysis was performed evaluating AID and IMID separately. Results: The prevalence of symptomatic SARS-CoV-2 infection in a cohort of AI/IMID patients was 1.3%. Eightyfive patients with AI/IMID and symptomatic SARS-CoV-2 were identified, requiring hospitalization in 58 (68%) cases. A total of 175 patients admitted for SARS-CoV-2 (58 with AI/IMID and 117 matched-controls) were analyzed. In logistic regression analysis, a significant inverse association between AI/IMID group and severe SARS-CoV-2 (OR 0.28; 95% CI 0.12-0.61; p = 0.001), need of MV (OR 0.20; IC 95% 0.05-0.71; p = 0.014), and ICU admission (OR 0.25; IC 95% 0.10-0.62; p = 0.003) was found. Conclusions: Patients with AI/IMID who require admission for SARS-CoV-2 infection have a lower risk of developing severe disease, including the need to stay in the ICU and MV.

引用

页数：9

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