tetano
Editor, Senior Moderator
Isr Med Assoc J
. 2022 May;24(5):299-305.
Risk Factors and Outcomes for COVID-19 in Autoimmune Inflammatory Diseases during the SARS-CoV-2 Pandemic: A Comparative Study
Olga Vera-Lastra[SUP] 1 2 3 [/SUP], Erik Cimé-Aké[SUP] 1 2 [/SUP], Alberto Ordinola Navarro[SUP] 1 2 [/SUP], Joel Eduardo Morales-Gutiérrez[SUP] 1 2 4 [/SUP], Orestes de Jesús Cobos-Quevedo[SUP] 1 2 [/SUP], Jorge Hurtado-Díaz[SUP] 1 2 [/SUP], María Lucero Espinoza-Sánchez[SUP] 1 2 5 [/SUP], Ana Lilia Peralta-Amaro[SUP] 1 2 3 [/SUP], María Pilar Cruz-Domínguez[SUP] 3 6 [/SUP], Gabriela Medina[SUP] 3 7 [/SUP], Antonio Fraga-Mouret[SUP] 8 [/SUP], Jesus Sepulveda-Delgado[SUP] 9 [/SUP], Luis J Jara[SUP] 3 6 [/SUP]
Affiliations
Abstract
Background: Patients with autoimmune disease (AID) and coronavirus disease 2019 (COVID-19) could have higher mortality due to the co-morbidity and the use of immunosuppressive therapy.
Objectives: To analyze the risk factors and outcomes of patients with AID and COVID-19 versus a control group.
Methods: A prospective cohort study included patients with and without AID and COVID-19. Patients were paired by age and sex. Clinical, biochemical, immunological treatments, and outcomes (days of hospital stay, invasive mechanical ventilation [IMV], oxygen at discharge, and death) were collected.
Results: We included 226 COVID-19 patients: 113 with AID (51.15 ± 14.3 years) and 113 controls (53.45 ± 13.3 years). The most frequent AIDs were Rheumatoid arthritis (26.5%), systemic lupus erythematosus (21%), and systemic sclerosis (14%). AID patients had lower lactate dehydrogenas, C-reactive protein, fibrinogen, IMV (P = 0.027), and oxygen levels at discharge (P ≤ 0.0001) and lower death rates (P ≤ 0.0001). Oxygen saturation (SaO2) ≤ 88% at hospitalization provided risk for IMV (RR [relative risk] 3.83, 95% confidence interval [95%CI] 1.1-13.6, P = 0.038). Higher creatinine and LDH levels were associated with death in the AID group. SaO2 ≤ 88% and CO-RADS ≥ 4 were risk factors for in-hospital mortality (RR 4.90, 95%CI 1.8-13.0, P = 0.001 and RR 7.60, 95%CI 1.4-39.7, P = 0.016, respectively). Anticoagulant therapy was protective (RR 0.36, 95%CI 0.1-0.9, P = 0.041).
Conclusions: Patients with AID had better outcomes with COVID-19 than controls. Anticoagulation was associated with a lower death in patients with AID.
. 2022 May;24(5):299-305.
Risk Factors and Outcomes for COVID-19 in Autoimmune Inflammatory Diseases during the SARS-CoV-2 Pandemic: A Comparative Study
Olga Vera-Lastra[SUP] 1 2 3 [/SUP], Erik Cimé-Aké[SUP] 1 2 [/SUP], Alberto Ordinola Navarro[SUP] 1 2 [/SUP], Joel Eduardo Morales-Gutiérrez[SUP] 1 2 4 [/SUP], Orestes de Jesús Cobos-Quevedo[SUP] 1 2 [/SUP], Jorge Hurtado-Díaz[SUP] 1 2 [/SUP], María Lucero Espinoza-Sánchez[SUP] 1 2 5 [/SUP], Ana Lilia Peralta-Amaro[SUP] 1 2 3 [/SUP], María Pilar Cruz-Domínguez[SUP] 3 6 [/SUP], Gabriela Medina[SUP] 3 7 [/SUP], Antonio Fraga-Mouret[SUP] 8 [/SUP], Jesus Sepulveda-Delgado[SUP] 9 [/SUP], Luis J Jara[SUP] 3 6 [/SUP]
Affiliations
- PMID: 35598053
Abstract
Background: Patients with autoimmune disease (AID) and coronavirus disease 2019 (COVID-19) could have higher mortality due to the co-morbidity and the use of immunosuppressive therapy.
Objectives: To analyze the risk factors and outcomes of patients with AID and COVID-19 versus a control group.
Methods: A prospective cohort study included patients with and without AID and COVID-19. Patients were paired by age and sex. Clinical, biochemical, immunological treatments, and outcomes (days of hospital stay, invasive mechanical ventilation [IMV], oxygen at discharge, and death) were collected.
Results: We included 226 COVID-19 patients: 113 with AID (51.15 ± 14.3 years) and 113 controls (53.45 ± 13.3 years). The most frequent AIDs were Rheumatoid arthritis (26.5%), systemic lupus erythematosus (21%), and systemic sclerosis (14%). AID patients had lower lactate dehydrogenas, C-reactive protein, fibrinogen, IMV (P = 0.027), and oxygen levels at discharge (P ≤ 0.0001) and lower death rates (P ≤ 0.0001). Oxygen saturation (SaO2) ≤ 88% at hospitalization provided risk for IMV (RR [relative risk] 3.83, 95% confidence interval [95%CI] 1.1-13.6, P = 0.038). Higher creatinine and LDH levels were associated with death in the AID group. SaO2 ≤ 88% and CO-RADS ≥ 4 were risk factors for in-hospital mortality (RR 4.90, 95%CI 1.8-13.0, P = 0.001 and RR 7.60, 95%CI 1.4-39.7, P = 0.016, respectively). Anticoagulant therapy was protective (RR 0.36, 95%CI 0.1-0.9, P = 0.041).
Conclusions: Patients with AID had better outcomes with COVID-19 than controls. Anticoagulation was associated with a lower death in patients with AID.