tetano
Editor, Senior Moderator
Ann Rheum Dis
. 2020 May 22;annrheumdis-2020-217627.
doi: 10.1136/annrheumdis-2020-217627. Online ahead of print.
Clinical Features of Rheumatic Patients Infected With COVID-19 in Wuhan, China
Cong Ye[SUP] #[/SUP][SUP] 1 [/SUP], Shaozhe Cai[SUP] #[/SUP][SUP] 1 [/SUP], Guifen Shen[SUP] 1 [/SUP], Hanxiong Guan[SUP] 2 [/SUP], Liling Zhou[SUP] 1 [/SUP], Yangyang Hu[SUP] 1 [/SUP], Wei Tu[SUP] 1 [/SUP], Yu Chen[SUP] 1 [/SUP], Yikai Yu[SUP] 1 [/SUP], Xuefen Wu[SUP] 1 [/SUP], Yuxue Chen[SUP] 1 [/SUP], Jixin Zhong[SUP] 3 [/SUP], Lingli Dong[SUP] 3 [/SUP]
Affiliations
Abstract
Objective: The clinical features of rheumatic patients with coronavirus disease 2019 (COVID-19) have not been reported. This study aimed to describe the clinical features of COVID-19 in rheumatic patients and provide information for handling this situation in clinical practice.
Methods: This is a retrospective case series study. Deidentified data, including gender, age, laboratory and radiological results, symptoms, signs, and medication history, were collected from 2326 patients diagnosed with COVID-19, including 21 cases in combination with rheumatic disease, in Tongji Hospital between 13 January and 15 March 2020.
Results: Length of hospital stay and mortality rate were similar between rheumatic and non-rheumatic groups, while the presence of respiratory failure was more common in rheumatic cases (38% vs 10%, p<0.001). Symptoms of fever, fatigue and diarrhoea were seen in 76%, 43% and 23% of patients, respectively. There were four rheumatic patients who experienced a flare of rheumatic disease during hospital stay, with symptoms of muscle aches, back pain, joint pain or rash. While lymphocytopaenia was seen in 57% of rheumatic patients, only one patient (5%) presented with leucopenia in rheumatic cases. Rheumatic patients presented with similar radiological features of ground-glass opacity and consolidation. Patients with pre-existing interstitial lung disease showed massive fibrous stripes and crazy-paving signs at an early stage. Five rheumatic cases used hydroxychloroquine before the diagnosis of COVID-19 and none progressed to critically ill stage.
Conclusions: Respiratory failure was more common in rheumatic patients infected with COVID-19. Differential diagnosis between COVID-19 and a flare of rheumatic disease should be considered.
Trial registration number: ChiCTR2000030795.
Keywords: autoimmune diseases; autoimmunity; inflammation.
. 2020 May 22;annrheumdis-2020-217627.
doi: 10.1136/annrheumdis-2020-217627. Online ahead of print.
Clinical Features of Rheumatic Patients Infected With COVID-19 in Wuhan, China
Cong Ye[SUP] #[/SUP][SUP] 1 [/SUP], Shaozhe Cai[SUP] #[/SUP][SUP] 1 [/SUP], Guifen Shen[SUP] 1 [/SUP], Hanxiong Guan[SUP] 2 [/SUP], Liling Zhou[SUP] 1 [/SUP], Yangyang Hu[SUP] 1 [/SUP], Wei Tu[SUP] 1 [/SUP], Yu Chen[SUP] 1 [/SUP], Yikai Yu[SUP] 1 [/SUP], Xuefen Wu[SUP] 1 [/SUP], Yuxue Chen[SUP] 1 [/SUP], Jixin Zhong[SUP] 3 [/SUP], Lingli Dong[SUP] 3 [/SUP]
Affiliations
- PMID: 32444415
- DOI: 10.1136/annrheumdis-2020-217627
Abstract
Objective: The clinical features of rheumatic patients with coronavirus disease 2019 (COVID-19) have not been reported. This study aimed to describe the clinical features of COVID-19 in rheumatic patients and provide information for handling this situation in clinical practice.
Methods: This is a retrospective case series study. Deidentified data, including gender, age, laboratory and radiological results, symptoms, signs, and medication history, were collected from 2326 patients diagnosed with COVID-19, including 21 cases in combination with rheumatic disease, in Tongji Hospital between 13 January and 15 March 2020.
Results: Length of hospital stay and mortality rate were similar between rheumatic and non-rheumatic groups, while the presence of respiratory failure was more common in rheumatic cases (38% vs 10%, p<0.001). Symptoms of fever, fatigue and diarrhoea were seen in 76%, 43% and 23% of patients, respectively. There were four rheumatic patients who experienced a flare of rheumatic disease during hospital stay, with symptoms of muscle aches, back pain, joint pain or rash. While lymphocytopaenia was seen in 57% of rheumatic patients, only one patient (5%) presented with leucopenia in rheumatic cases. Rheumatic patients presented with similar radiological features of ground-glass opacity and consolidation. Patients with pre-existing interstitial lung disease showed massive fibrous stripes and crazy-paving signs at an early stage. Five rheumatic cases used hydroxychloroquine before the diagnosis of COVID-19 and none progressed to critically ill stage.
Conclusions: Respiratory failure was more common in rheumatic patients infected with COVID-19. Differential diagnosis between COVID-19 and a flare of rheumatic disease should be considered.
Trial registration number: ChiCTR2000030795.
Keywords: autoimmune diseases; autoimmunity; inflammation.