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1. Inflammatory rheumatic diseases with onset after SARS-CoV-2 infection or COVID-19 vaccination: a report of 267 cases from the COVID-19 and ASD group.

Author

Ursini F, Ruscitti P, Addimanda O, Foti R, Raimondo V, Murdaca G, Caira V, Pigatto E, Cuomo G, Lo Gullo A, Cavazzana I, Campochiaro C, Naclerio C, De Angelis R, Ciaffi J, Mancarella L, Brusi V, Marchetti E, Motta F, Visentini M, Lorusso S, De Santis M, De Luca G, Massaro L, Olivo D, Pellegrini R, Francioso F, Luppino J, Di Cola I, Foti R, Varcasia G, Caso F, Reta M, Dagna L, Selmi C, Iagnocco A, Giacomelli R, Iannone F, and Ferri C

Subjects
Humans, COVID-19 Vaccines adverse effects, SARS-CoV-2, Vaccination, COVID-19 epidemiology, COVID-19 prevention & control, Polymyalgia Rheumatica, Giant Cell Arteritis, Autism Spectrum Disorder
Abstract

Objectives: To better define the spectrum of new-onset post-COVID-19 and post-COVID-19 vaccine inflammatory rheumatic diseases (IRD) from a large multicentric observational study., Methods: Consecutive cases of IRD encountered during a 12-month period and satisfying one of the following inclusion criteria: (a) onset of the rheumatic manifestations within 4 weeks from SARS-CoV-2 infection or (b) onset of the rheumatic manifestations within 4 weeks from the administration of one of the COVID-19 vaccines ws recruited., Results: The final analysis cohort comprised 267 patients, of which 122 (45.2%) in the post-COVID-19 and 145 (54.8%) in the postvaccine cohort. Distribution of IRD categories differed between the two cohorts: the post-COVID-19 cohort had a higher percentage of patients classified as having inflammatory joint diseases (IJD, 52.5% vs 37.2%, p=0.013) while the post-vaccine cohort had a higher prevalence of patients classified as polymyalgia rheumatica (PMR, 33.1% vs 21.3%, p=0.032). No differences were detected in the percentage of patients diagnosed with connective tissue diseases (CTD 19.7% vs 20.7%, p=0.837) or vasculitis (6.6% vs 9.0%, p=0.467). Despite the short follow-up period, IJD and PMR patients' response to first-line therapy was favourable, with both groups achieving a drop in baseline disease activity scores of ~30% and ~70% respectively., Conclusion: Our article reports the largest cohort published to date of new-onset IRD following SARS-CoV-2 infection or COVID-19 vaccines. Although causality cannot be ascertained, the spectrum of possible clinical manifestations is broad and includes IJD, PMR, CTD and vasculitis., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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2. Higher risk of short term COVID-19 vaccine adverse events in myositis patients with autoimmune comorbidities: results from the COVAD study.

Author

Dey M, R N, Nikiphorou E, Sen P, Saha S, Lilleker JB, Agarwal V, Kardes S, Day J, Milchert M, Joshi M, Gheita T, Salim B, Velikova T, Gracia-Ramos AE, Parodis I, Selva O'Callaghan A, Kim M, Chatterjee T, Tan AL, Makol A, Nune A, Cavagna L, Saavedra MA, Shinjo SK, Ziade N, Knitza J, Kuwana M, Distler O, Barman B, Singh YP, Ranjan R, Jain A, Pandya SC, Pilania RK, Sharma A, Manoj MM, Gupta V, Kavadichanda CG, Patro PS, Ajmani S, Phatak S, Goswami RP, Chowdhury AC, Mathew AJ, Shenoy P, Asranna A, Bommakanti KT, Shukla A, Pande AR, Chandwar K, Pauling JD, Wincup C, Üsküdar Cansu D, Zamora Tehozol EA, Rojas Serrano J, García-De La Torre I, Del Papa N, Sambataro G, Fabiola A, Govoni M, Parisi S, Bartoloni Bocci E, Sebastiani GD, Fusaro E, Sebastiani M, Quartuccio L, Franceschini F, Sainaghi PP, Orsolini G, De Angelis R, Danielli MG, Venerito V, Traboco LS, Hoff LS, Kusumo Wibowo SA, Tomaras S, Langguth D, Limaye V, Needham M, Srivastav N, Yoshida A, Nakashima R, Sato S, Kimura N, Kaneko Y, Loarce-Martos J, Prieto-González S, Gil-Vila A, Gonzalez RA, Chinoy H, Agarwal V, Aggarwal R, and Gupta L

Subjects
Humans, COVID-19 Vaccines, Vaccination, COVID-19, Myositis, Autoimmune Diseases
Published
2023
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3. Systemic syndromes of rheumatological interest with onset after COVID-19 vaccine administration: a report of 30 cases.

Author

Ursini F, Ruscitti P, Raimondo V, De Angelis R, Cacciapaglia F, Pigatto E, Olivo D, Di Cola I, Galluccio F, Francioso F, Foti R, Tavoni AG, D'Angelo S, Campochiaro C, Motta F, De Santis M, Bilia S, Bruno C, De Luca G, Visentini M, Ciaffi J, Mancarella L, Brusi V, D'Onghia M, Cuomo G, Fusaro E, Cipriani P, Dagna L, Guiducci S, Meliconi R, Iannone F, Iagnocco A, Giacomelli R, and Ferri C

Subjects
COVID-19 Vaccines adverse effects, Humans, Immunotherapy, Syndrome, COVID-19 prevention & control, Rheumatic Diseases
Published
2022
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4. Spectrum of short-term inflammatory musculoskeletal manifestations after COVID-19 vaccine administration: a report of 66 cases.

Author

Ursini F, Ruscitti P, Raimondo V, De Angelis R, Cacciapaglia F, Pigatto E, Olivo D, Di Cola I, Galluccio F, Francioso F, Foti R, Tavoni A, D'Angelo S, Campochiaro C, Motta F, De Santis M, Bilia S, Bruno C, De Luca G, Visentini M, Ciaffi J, Mancarella L, Brusi V, D'Onghia M, Cuomo G, Fusaro E, Dagna L, Guiducci S, Meliconi R, Iannone F, Iagnocco A, Giacomelli R, and Ferri C

Subjects
Female, Humans, Male, Middle Aged, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Musculoskeletal Diseases chemically induced, Rheumatic Diseases chemically induced, SARS-CoV-2 immunology
Abstract

Competing Interests: Competing interests: None declared.

Published
2022
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5. Prevalence and Death Rate of COVID-19 in Autoimmune Systemic Diseases in the First Three Pandemic Waves. Relationship with Disease Subgroups and Ongoing Therapies.

Author

Ferri C, Raimondo V, Gragnani L, Giuggioli D, Dagna L, Tavoni A, Ursini F, L'Andolina M, Caso F, Ruscitti P, Caminiti M, Foti R, Riccieri V, Guiducci S, Pellegrini R, Zanatta E, Varcasia G, Olivo D, Gigliotti P, Cuomo G, Murdaca G, Cecchetti R, De Angelis R, Romeo N, Ingegnoli F, Cozzi F, Codullo V, Cavazzana I, Colaci M, Abignano G, De Santis M, Lubrano E, Fusaro E, Spinella A, Lumetti F, De Luca G, Bellando-Randone S, Visalli E, Bosco YD, Amato G, Giannini D, Bilia S, Masini F, Pellegrino G, Pigatto E, Generali E, Mariano GP, Pettiti G, Zanframundo G, Brittelli R, Aiello V, Caminiti R, Scorpiniti D, Ferrari T, Campochiaro C, Brusi V, Fredi M, Moschetti L, Cacciapaglia F, Paparo SR, Ragusa F, Mazzi V, Elia G, Ferrari SM, Di Cola I, Vadacca M, Lorusso S, Monti M, Lorini S, Aprile ML, Tasso M, Miccoli M, Bosello S, D'Angelo S, Doria A, Franceschini F, Meliconi R, Matucci-Cerinic M, Iannone F, Giacomelli R, Salvarani C, Zignego AL, Fallahi P, and Antonelli A

Subjects
Aged, Humans, Male, Middle Aged, Pandemics, Prevalence, Prospective Studies, Antirheumatic Agents therapeutic use, Autoimmune Diseases drug therapy, Autoimmune Diseases epidemiology, COVID-19 epidemiology, Lung Diseases, Interstitial drug therapy, Lung Diseases, Interstitial epidemiology, Scleroderma, Systemic, COVID-19 Drug Treatment
Abstract

Objective: Autoimmune systemic diseases (ASD) represent a predisposing condition to COVID-19. Our prospective, observational multicenter telephone survey study aimed to investigate the prevalence, prognostic factors, and outcomes of COVID-19 in Italian ASD patients., Methods: The study included 3,918 ASD pts (815 M, 3103 F; mean age 59±12SD years) consecutively recruited between March 2020 and May 2021 at the 36 referral centers of COVID-19 and ASD Italian Study Group. The possible development of COVID-19 was recorded by means of a telephone survey using a standardized symptom assessment questionnaire., Results: ASD patients showed a significantly higher prevalence of COVID-19 (8.37% vs. 6.49%; p<0.0001) but a death rate statistically comparable to the Italian general population (3.65% vs. 2.95%). Among the 328 ASD patients developing COVID-19, 17% needed hospitalization, while mild-moderate manifestations were observed in 83% of cases. Moreover, 12/57 hospitalized patients died due to severe interstitial pneumonia and/or cardiovascular events; systemic sclerosis (SSc) patients showed a significantly higher COVID-19-related death rate compared to the general population (6.29% vs. 2.95%; p=0.018). Major adverse prognostic factors to develop COVID-19 were: older age, male gender, SSc, pre-existing ASD-related interstitial lung involvement, and long-term steroid treatment. Of note, patients treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) showed a significantly lower prevalence of COVID-19 compared to those without (3.58% vs. 46.99%; p=0.000), as well as the SSc patients treated with low dose aspirin (with 5.57% vs. without 27.84%; p=0.000)., Conclusion: During the first three pandemic waves, ASD patients showed a death rate comparable to the general population despite the significantly higher prevalence of COVID-19. A significantly increased COVID-19- related mortality was recorded in only SSc patients' subgroup, possibly favored by preexisting lung fibrosis. Moreover, ongoing long-term treatment with csDMARDs in ASD might usefully contribute to the generally positive outcomes of this frail patients' population., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Published
2022
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6. Broad clinical spectrum of SARS-CoV-2-associated inflammatory joint disease in adults: a report of 35 cases from the COVID-19 & Autoimmune Systemic Disease Italian study group.

Author

Ursini F, Ruscitti P, D'Angelo S, Cacciapaglia F, De Angelis R, Campochiaro C, Caso F, De Santis M, Di Cola I, Parisi S, Raimondo V, Abignano G, Costa L, Ciaffi J, Dagna L, Iagnocco A, Iannone F, Meliconi R, Giacomelli R, and Ferri C

Subjects
Adult, Aged, Female, Humans, Italy, Male, Middle Aged, SARS-CoV-2, Arthritis epidemiology, Arthritis virology, COVID-19 complications
Abstract

Competing Interests: Competing interests: None declared.

Published
2021
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7. Correspondence on 'SARS-CoV-2 vaccine hesitancy among patients with rheumatic and musculoskeletal diseases: a message for rheumatologists'.

Author

Smerilli G, Cipolletta E, Moscioni E, Francioso F, Risa AM, Maccarrone V, Zompa D, Di Matteo A, Di Carlo M, De Angelis R, Salaffi F, Filippucci E, and Grassi W

Subjects
COVID-19 Vaccines, Humans, Rheumatologists, SARS-CoV-2, COVID-19, Musculoskeletal Diseases prevention & control, Rheumatic Diseases
Abstract

Competing Interests: Competing interests: MDC has received speaking fees from AbbVie and Novartis. FS has received speaking fees from Roche, AbbVie, Novartis, Bristol-Myers-Squibb, Pfizer and Merck Sharp and Dohme Italia. EF has received speaking fees from AbbVie, BMS, Janssen, Lilly, MSD, Novartis, Roche, Pfizer and UCB Pharma. WG has received speaking fees from AbbVie, Celgene, Grünenthal, Pfizer and UCB Pharma. All other authors disclose no conflict of interest.

Published
2021
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8. Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments.

Author

Ferri C, Giuggioli D, Raimondo V, L'Andolina M, Dagna L, Tavoni A, Caso F, Ursini F, Ruscitti P, Caminiti M, Foti R, Riccieri V, Guiducci S, Pellegrini R, Zanatta E, Varcasia G, Olivo D, Gigliotti P, Cuomo G, Murdaca G, Cecchetti R, De Angelis R, Romeo N, Ingegnoli F, Cozzi F, Codullo V, Cavazzana I, Colaci M, Abignano G, De Santis M, Lubrano E, Fusaro E, Rossa AD, Spinella A, Lumetti F, De Luca G, Bellando-Randone S, Visalli E, Dal Bosco Y, Amato G, Giannini D, Bilia S, Masini F, Pellegrino G, Pigatto E, Generali E, Mariano GP, Pettiti G, Zanframundo G, Brittelli R, Aiello V, Caminiti R, Scorpiniti D, Ferrari T, Campochiaro C, Brusi V, Fredi M, Moschetti L, Cacciapaglia F, Gragnani L, Monti M, Lorini S, Paparo SR, Ragusa F, Mazzi V, Elia G, Ferrari SM, Di Cola I, Vadacca M, Lorusso S, Barsotti S, Aprile ML, Marco T, Miccoli M, Bosello S, Matucci-Cerinic M, D'Angelo S, Doria A, Franceschini F, Meliconi R, Iannone F, Giacomelli R, Zignego AL, Fallahi P, and Antonelli A

Subjects
Humans, Lung, Pandemics, SARS-CoV-2, Autoimmune Diseases drug therapy, Autoimmune Diseases epidemiology, COVID-19, Rheumatic Diseases drug therapy, Rheumatic Diseases epidemiology
Abstract

Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations., Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic., Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing)., Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003)., Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Published
2021
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9. Inflammatory rheumatic diseases with onset after SARS-CoV-2 infection or COVID-19 vaccination: a report of 267 cases from the COVID-19 and ASD group

Author

Ursini, Francesco, Ruscitti, Piero, Addimanda, Olga, Foti, Rosario, Raimondo, Vincenzo, Murdaca, Giuseppe, Caira, Virginia, Pigatto, Erika, Cuomo, Giovanna, Lo Gullo, Alberto, Cavazzana, Ilaria, Campochiaro, Corrado, Naclerio, Caterina, De Angelis, Rossella, Ciaffi, Jacopo, Mancarella, Luana, Brusi, Veronica, Marchetti, Elena, Motta, Francesca, Visentini, Marcella, Lorusso, Sebastiano, De Santis, Maria, De Luca, Giacomo, Massaro, Laura, Olivo, Domenico, Pellegrini, Roberta, Francioso, Francesca, Luppino, Jessica, Di Cola, Ilenia, Foti, Roberta, Varcasia, Giuseppe, Caso, Francesco, Reta, Massimo, Dagna, Lorenzo, Selmi, Carlo, Iagnocco, Annamaria, Giacomelli, Roberto, Iannone, Florenzo, and Ferri, Clodoveo

Subjects
Arthritis, Autoimmune Diseases, COVID-19, Polymyalgia Rheumatica, Vaccination
Published
2023

10. Spectrum of short-term inflammatory musculoskeletal manifestations after COVID-19 vaccine administration: a report of 66 cases

Author

Francesca Motta, Veronica Brusi, Corrado Campochiaro, Lorenzo Dagna, Enrico Fusaro, Ilenia Di Cola, Clodoveo Ferri, Fabio Cacciapaglia, Caterina Bruno, Rosario Foti, Riccardo Meliconi, Francesca Francioso, Felice Galluccio, Serena Guiducci, Vincenzo Raimondo, Jacopo Ciaffi, Annamaria Iagnocco, Giovanna Cuomo, Giacomo De Luca, Antonio Tavoni, Francesco Ursini, Roberto Giacomelli, Maria De Santis, Silvia Bilia, Piero Ruscitti, Salvatore D'Angelo, Florenzo Iannone, Domenico Olivo, Martina D'Onghia, Rossella De Angelis, Marcella Visentini, Luana Mancarella, E. Pigatto, Ursini, F., Ruscitti, P., Raimondo, V., De Angelis, R., Cacciapaglia, F., Pigatto, E., Olivo, D., Di Cola, I., Galluccio, F., Francioso, F., Foti, R., Tavoni, A., D'Angelo, S., Campochiaro, C., Motta, F., De Santis, M., Bilia, S., Bruno, C., DE LUCA, Giacomo, Visentini, M., Ciaffi, J., Mancarella, L., Brusi, V., D'Onghia, M., Cuomo, G., Fusaro, E., Dagna, L., Guiducci, S., Meliconi, R., Iannone, F., Iagnocco, A., Giacomelli, R., Ferri, C., Ursini, Francesco, Ruscitti, Piero, Raimondo, Vincenzo, De Angelis, Rossella, Cacciapaglia, Fabio, Pigatto, Erika, Olivo, Domenico, Di Cola, Ilenia, Galluccio, Felice, Francioso, Francesca, Foti, Rosario, Tavoni, Antonio, D'Angelo, Salvatore, Campochiaro, Corrado, Motta, Francesca, De Santis, Maria, Bilia, Silvia, Bruno, Caterina, De Luca, Giacomo, Visentini, Marcella, Ciaffi, Jacopo, Mancarella, Luana, Brusi, Veronica, D'Onghia, Martina, Cuomo, Giovanna, Fusaro, Enrico, Dagna, Lorenzo, Guiducci, Serena, Meliconi, Riccardo, Iannone, Florenzo, Iagnocco, Annamaria, Giacomelli, Roberto, Ferri, Clodoveo, Ursini, F, Ruscitti, P, Raimondo, V, De Angelis, R, Cacciapaglia, F, Pigatto, E, Olivo, D, Di Cola, I, Galluccio, F, Francioso, F, Foti, R, Tavoni, A, D'Angelo, S, Campochiaro, C, Motta, F, De Santis, M, Bilia, S, Bruno, C, De Luca, G, Visentini, M, Ciaffi, J, Mancarella, L, Brusi, V, D'Onghia, M, Cuomo, G, Fusaro, E, Dagna, L, Guiducci, S, Meliconi, R, Iannone, F, Iagnocco, A, Giacomelli, R, and Ferri, C

Subjects
Male, medicine.medical_specialty, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Immunology, Population, Arthritis, medicine.disease_cause, General Biochemistry, Genetics and Molecular Biology, polymyalgia rheumatica, Immune system, Rheumatology, Rheumatic Diseases, Pandemic, medicine, Immunology and Allergy, Humans, Musculoskeletal Diseases, Covid-19, arthritis, vaccination, Intensive care medicine, Adverse effect, education, education.field_of_study, business.industry, SARS-CoV-2, COVID-19, Female, Middle Aged, medicine.disease, Vaccination, arthriti, Molecular mimicry, business
Abstract

In the past months, mass vaccination represented the turning point of the global battle against the COVID-19 pandemic, an unprecedented challenge for physicians, healthcare professionals, health systems and pharmaceutical companies. More than 6 billion doses of vaccine have been administered to date, covering nearly 50% of the world’s population. Although the vaccination campaign is still thwarted by spread of fake news disseminated by a ubiquitous antivaxxer movement, accumulating real-life data1 confirm the favourable safety profile already demonstrated in phase III clinical trials.2 Despite the lack of a steady literature evidence,3 the potential role of vaccines in promoting autoimmunity continues to intrigue many researchers. The theoretical basis of this association relies on the possible molecular mimicry between macromolecular components of the vaccine and specific human proteins and the exuberant immune response elicited by adjuvants contained in vaccines.4 Adverse events (AEs) associated with COVID-19 vaccines are usually mild and mainly restricted to injection site reactions. Interestingly, among systemic AEs, arthralgia is one of the most common.2 To the best of our knowledge, only isolated cases5 of arthritis developed after COVID-19 …

Published
2022

11. Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments

Author

M. L. Aprile, Rosario Foti, Ruscitti Piero, Giuseppe Varcasia, Ilaria Cavazzana, Nicoletta Romeo, Riccardo Meliconi, Serena Lorini, Serena Guiducci, Amelia Spinella, Roberto Giacomelli, Vincenzo Aiello, Alessandra Della Rossa, Giorgio Amato, Daiana Giannini, Vincenzo Raimondo, Francesco Caso, Ennio Lubrano, Silvia Bosello, Maurizio Caminiti, Monica Monti, Tasso Marco, Francesca Ingegnoli, Giorgio Pettiti, Massimo L'Andolina, Salvatore D'Angelo, Francesca Ragusa, Elisabetta Zanatta, Giacomo De Luca, Riccardo Cecchetti, Franco Franceschini, Greta Pellegrino, Silvia Bellando-Randone, Silvia Martina Ferrari, Micaela Fredi, Veronica Brusi, Lorenzo Dagna, Giusy Elia, Fabio Cacciapaglia, Francesco Ursini, Giuseppina Abignano, Sebastiano Lorusso, Clodoveo Ferri, Anna Linda Zignego, Rodolfo Caminiti, Sabrina Rosaria Paparo, Raffaele Brittelli, Liala Moschetti, Elena Generali, Marco Matucci-Cerinic, Roberta Pellegrini, Ylenia Dal Bosco, Giovanni Zanframundo, Domenico Olivo, Tommaso Ferrari, Alessandro Antonelli, M. Vadacca, Andrea Doria, Pietro Gigliotti, Poupak Varcasia, Enrico Fusaro, Elisa Visalli, Simone Barsotti, Giuseppa Pagano Mariano, Giovanna Cuomo, Florenzo Iannone, Maria De Santis, Valeria Mazzi, Giuseppe Murdaca, Michele Colaci, Silvia Bilia, Franco Cozzi, Dilia Giuggioli, Corrado Campochiaro, Valeria Riccieri, Erika Pigatto, Laura Gragnani, Ilenia Di Cola, Daniela Scorpiniti, Mario Miccoli, Francesco Masini, Veronica Codullo, Rossella De Angelis, Federica Lumetti, Antonio Tavoni, Ferri, Clodoveo, Giuggioli, Dilia, Raimondo, Vincenzo, L’Andolina, Massimo, Dagna, Lorenzo, Tavoni, Antonio, Caso, Francesco, Ursini, Francesco, Piero, Ruscitti, Caminiti, Maurizio, Foti, Rosario, Riccieri, Valeria, Guiducci, Serena, Pellegrini, Roberta, Zanatta, Elisabetta, Varcasia, Giuseppe, Olivo, Domenico, Gigliotti, Pietro, Cuomo, Giovanna, Murdaca, Giuseppe, Cecchetti, Riccardo, De Angelis, Rossella, Romeo, Nicoletta, Ingegnoli, Francesca, Cozzi, Franco, Codullo, Veronica, Cavazzana, Ilaria, Colaci, Michele, Abignano, Giuseppina, De Santis, Maria, Lubrano, Ennio, Fusaro, Enrico, Rossa, Alessandra Della, Spinella, Amelia, Lumetti, Federica, De Luca, Giacomo, Bellando-Randone, Silvia, Visalli, Elisa, Dal Bosco, Ylenia, Amato, Giorgio, Giannini, Daiana, Bilia, Silvia, Masini, Francesco, Pellegrino, Greta, Pigatto, Erika, Generali, Elena, Mariano, Giuseppa Pagano, Pettiti, Giorgio, Zanframundo, Giovanni, Brittelli, Raffaele, Aiello, Vincenzo, Caminiti, Rodolfo, Scorpiniti, Daniela, Ferrari, Tommaso, Campochiaro, Corrado, Brusi, Veronica, Fredi, Micaela, Moschetti, Liala, Cacciapaglia, Fabio, Gragnani, Laura, Monti, Monica, Lorini, Serena, Paparo, Sabrina Rosaria, Ragusa, Francesca, Mazzi, Valeria, Elia, Giusy, Ferrari, Silvia Martina, Di Cola, Ilenia, Vadacca, Marta, Lorusso, Sebastiano, Barsotti, Simone, Aprile, Maria Letizia, Marco, Tasso, Miccoli, Mario, Bosello, Silvia, Matucci-Cerinic, Marco, D'Angelo, Salvatore, Doria, Andrea, Franceschini, Franco, Meliconi, Riccardo, Iannone, Florenzo, Giacomelli, Roberto, Zignego, Anna Linda, Varcasia, Poupak, Antonelli, Alessandro, L'Andolina, Massimo, Della Rossa, Alessandra, Pagano Mariano, Giuseppa, Rosaria Paparo, Sabrina, Martina Ferrari, Silvia, Letizia Aprile, Maria, Linda Zignego, Anna, Ferri C., Giuggioli D., Raimondo V., L'andolina M., Dagna L., Tavoni A., Caso F., Ursini F., Ruscitti P., Caminiti M., Foti R., Riccieri V., Guiducci S., Pellegrini R., Zanatta E., Varcasia G., Olivo D., Gigliotti P., Cuomo G., Murdaca G., Cecchetti R., De Angelis R., Romeo N., Ingegnoli F., Cozzi F., Codullo V., Cavazzana I., Colaci M., Abignano G., De Santis M., Lubrano E., Fusaro E., Della Rossa A., Spinella A., Lumetti F., De Luca G., Bellando-Randone S., Visalli E., Dal Bosco Y., Amato G., Giannini D., Bilia S., Masini F., Pellegrino G., Pigatto E., Generali E., Mariano G.P., Pettiti G., Zanframundo G., Brittelli R., Aiello V., Caminiti R., Scorpiniti D., Ferrari T., Campochiaro C., Brusi V., Fredi M., Moschetti L., Cacciapaglia F., Gragnani L., Monti M., Lorini S., Paparo S.R., Ragusa F., Mazzi V., Elia G., Ferrari S.M., Di Cola I., Vadacca M., Lorusso S., Barsotti S., Aprile M.L., Marco T., Miccoli M., Bosello S., Matucci-Cerinic M., D'angelo S., Doria A., Franceschini F., Meliconi R., Iannone F., Giacomelli R., Zignego A.L., Fallahi P., and Antonelli A.

Subjects
medicine.medical_specialty, Settore MED/16 - REUMATOLOGIA, Referral, Coronavirus disease 2019 (COVID-19), autoimmune systemic disease, systemic sclerosis, Population, COVID-19, SARS-CoV-2, arthritis, autoimmune systemic diseases, connective tissue diseases, interstitial lung disease, rheumatic diseases, Arthritis, Keywords: COVID-19, Scleroderma, Autoimmune Diseases, Covid-19, Autoimmune systemic diseases, Connective tissue diseases, Interstitial lung disease, Rheumatic diseases, Systemic sclerosis, Internal medicine, Rheumatic Diseases, Drug Discovery, Pandemic, medicine, Humans, education, rheumatic disease, Lung, Pandemics, Pharmacology, education.field_of_study, Aspirin, business.industry, covid 19, medicine.disease, arthriti, connective tissue disease, business, medicine.drug
Abstract

Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave.

Published
2021

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