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Hospital admissions in inflammatory rheumatic diseases during the peak of COVID-19 pandemic: incidence and role of disease-modifying agents
- Source :
- Therapeutic Advances in Musculoskeletal Disease, Therapeutic Advances in Musculoskeletal Disease, Vol 13 (2021)
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Aims: In this pandemic, it is essential for rheumatologists and patients to know the relationship between COVID-19 and inflammatory rheumatic diseases (IRDs). We wanted to assess the role of targeted synthetic or biologic disease-modifying antirheumatic drugs (ts/bDMARDs) and other variables in the development of moderate-severe COVID-19 disease in IRD. Methods: An observational longitudinal study was conducted during the epidemic peak in Madrid (1 March to 15 April 2020). All patients attended at the rheumatology outpatient clinic of a tertiary hospital in Madrid with a medical diagnosis of IRD were included. Main outcome: hospital admission related to COVID-19. Independent variable: ts/bDMARDs. Covariates: sociodemographic, comorbidities, type of IRD diagnosis, glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Incidence rate (IR) of hospital admission related to COVID-19 was expressed per 1000 patient-months. Cox multiple regression analysis was run to examine the influence of ts/bDMARDs and other covariates on IR of hospital admission related to COVID-19. Results: A total of 3951 IRD patients were included (5896 patient-months). Methotrexate was the csDMARD most used. Eight hundred and two patients were on ts/bDMARDs, mainly anti-TNF agents, and Rtx. Hospital admissions related to COVID-19 occurred in 54 patients (1.36%) with an IR of 9.15 (95% confidence interval: 7–11.9). In the multivariate analysis, older, male, comorbidities, and specific systemic autoimmune conditions (Sjögren, polychondritis, Raynaud, and mixed connective tissue disease) had more risk of hospital admissions. Exposition to ts/bDMARDs did not achieve statistical significance. Use of glucocorticoids, NSAIDs, and csDMARDs dropped from the final model. Conclusion: This study provides additional evidence in IRD patients regarding susceptibility to moderate–severe infection related to COVID-19.
- Subjects :
- 030203 arthritis & rheumatology
2019-20 coronavirus outbreak
medicine.medical_specialty
When Rheumatology and Infectious Disease Come Together
Coronavirus disease 2019 (COVID-19)
business.industry
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Incidence (epidemiology)
COVID-19
Diseases of the musculoskeletal system
Disease
03 medical and health sciences
0302 clinical medicine
RC925-935
Rheumatology
Internal medicine
Pandemic
medicine
disease-modifying antirheumatic drugs
rheumatic diseases
Orthopedics and Sports Medicine
autoimmune diseases
030212 general & internal medicine
business
Original Research
Subjects
Details
- Language :
- English
- ISSN :
- 17597218 and 1759720X
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Therapeutic Advances in Musculoskeletal Disease
- Accession number :
- edsair.doi.dedup.....2b32c4fc6dba8e0f4a775c13da9183f5