tetano
Editor, Senior Moderator
J Autoimmun
. 2020 Nov 30;117:102580.
doi: 10.1016/j.jaut.2020.102580. Online ahead of print.
A multidisciplinary registry of patients with autoimmune and immune-mediated diseases with symptomatic COVID-19 from a single center
Juan C Sarmiento-Monroy[SUP] 1 [/SUP], Gerard Espinosa[SUP] 2 [/SUP], Maria-Carlota Londo?o[SUP] 3 [/SUP], Fernanda Meira[SUP] 4 [/SUP], Berta Caballol[SUP] 5 [/SUP], Sara Llufriu[SUP] 6 [/SUP], Josep Lluis Carrasco[SUP] 7 [/SUP], Aina Moll-Udina[SUP] 8 [/SUP], Luis F Quintana[SUP] 9 [/SUP], Priscila Giavedoni[SUP] 10 [/SUP], Julio Ram?rez[SUP] 11 [/SUP], Jose Inciarte-Mundo[SUP] 1 [/SUP], Elisabeth Solana[SUP] 6 [/SUP], Yolanda Blanco[SUP] 6 [/SUP], Eugenia Martinez-Hernandez[SUP] 6 [/SUP], Maria Sep?lveda[SUP] 6 [/SUP], Victor Lloren?[SUP] 8 [/SUP], Sergio Prieto-Gonz?lez[SUP] 2 [/SUP], Georgina Esp?gol-Frigol?[SUP] 2 [/SUP], Jose C Milisenda[SUP] 11 [/SUP], Maria C Cid[SUP] 2 [/SUP], Jose M Mascar? Jr[SUP] 10 [/SUP], Isabel Blanco[SUP] 12 [/SUP], Joan Albert Barber?[SUP] 12 [/SUP], Oriol Sibila[SUP] 12 [/SUP], Jordi Gratacos-Gin?s[SUP] 5 [/SUP], Alfredo Ad?n[SUP] 8 [/SUP], Alvaro Agust?[SUP] 12 [/SUP], Raimon Sanmart?[SUP] 1 [/SUP], Julian Pan?s[SUP] 5 [/SUP], Ricard Cervera[SUP] 2 [/SUP], Jordi Vila[SUP] 13 [/SUP], Alex Soriano[SUP] 4 [/SUP], Jos? A G?mez-Puerta[SUP] 14 [/SUP], Immunocovid Clinic
Affiliations
Abstract
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 SARS-CoV-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%. Eighty-five 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.
Keywords: Adverse outcome; Autoimmune diseases; COVID-19; Immunosuppression; Severe acute respiratory syndrome coronavirus 2.
. 2020 Nov 30;117:102580.
doi: 10.1016/j.jaut.2020.102580. Online ahead of print.
A multidisciplinary registry of patients with autoimmune and immune-mediated diseases with symptomatic COVID-19 from a single center
Juan C Sarmiento-Monroy[SUP] 1 [/SUP], Gerard Espinosa[SUP] 2 [/SUP], Maria-Carlota Londo?o[SUP] 3 [/SUP], Fernanda Meira[SUP] 4 [/SUP], Berta Caballol[SUP] 5 [/SUP], Sara Llufriu[SUP] 6 [/SUP], Josep Lluis Carrasco[SUP] 7 [/SUP], Aina Moll-Udina[SUP] 8 [/SUP], Luis F Quintana[SUP] 9 [/SUP], Priscila Giavedoni[SUP] 10 [/SUP], Julio Ram?rez[SUP] 11 [/SUP], Jose Inciarte-Mundo[SUP] 1 [/SUP], Elisabeth Solana[SUP] 6 [/SUP], Yolanda Blanco[SUP] 6 [/SUP], Eugenia Martinez-Hernandez[SUP] 6 [/SUP], Maria Sep?lveda[SUP] 6 [/SUP], Victor Lloren?[SUP] 8 [/SUP], Sergio Prieto-Gonz?lez[SUP] 2 [/SUP], Georgina Esp?gol-Frigol?[SUP] 2 [/SUP], Jose C Milisenda[SUP] 11 [/SUP], Maria C Cid[SUP] 2 [/SUP], Jose M Mascar? Jr[SUP] 10 [/SUP], Isabel Blanco[SUP] 12 [/SUP], Joan Albert Barber?[SUP] 12 [/SUP], Oriol Sibila[SUP] 12 [/SUP], Jordi Gratacos-Gin?s[SUP] 5 [/SUP], Alfredo Ad?n[SUP] 8 [/SUP], Alvaro Agust?[SUP] 12 [/SUP], Raimon Sanmart?[SUP] 1 [/SUP], Julian Pan?s[SUP] 5 [/SUP], Ricard Cervera[SUP] 2 [/SUP], Jordi Vila[SUP] 13 [/SUP], Alex Soriano[SUP] 4 [/SUP], Jos? A G?mez-Puerta[SUP] 14 [/SUP], Immunocovid Clinic
Affiliations
- PMID: 33338707
- DOI: 10.1016/j.jaut.2020.102580
Abstract
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 SARS-CoV-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%. Eighty-five 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.
Keywords: Adverse outcome; Autoimmune diseases; COVID-19; Immunosuppression; Severe acute respiratory syndrome coronavirus 2.