학술논문
Sociodemographic and clinical factors associated with poor COVID-19 outcomes in patients with rheumatic diseases: data from the SAR-COVID Registry.
Document Type
Article
Author
Isnardi, Carolina A.; Roberts, Karen; Saurit, Verónica; Petkovic, Ingrid; Báez, Roberto M.; Quintana, Rosana; Tissera, Yohana; Ornella, Sofía; D.Angelo Exeni, Maria Eugenia; Pisoni, Cecilia N.; Castro Coello, Vanessa V.; Berbotto, Guillermo; Haye Salinas, María J.; Velozo, Edson; Reyes Torres, Álvaro A.; Tanten, Romina; Zelaya, Marcos D.; Gobbi, Carla; Alonso, Carla G.; de los Ángeles Severina, María
Source
Subject
*RHEUMATISM
*COVID-19
*SOCIODEMOGRAPHIC factors
*PROGNOSIS
*TREATMENT effectiveness
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Language
ISSN
0770-3198
Abstract
Background/objective: This study aims to describe the course and to identify poor prognostic factors of SARS-CoV-2 infection in patients with rheumatic diseases. Methods: Patients ≥ 18 years of age, with a rheumatic disease, who had confirmed SARS-CoV-2 infection were consecutively included by major rheumatology centers from Argentina, in the national, observational SAR-COVID registry between August 13, 2020 and July 31, 2021. Hospitalization, oxygen requirement, and death were considered poor COVID-19 outcomes. Results: A total of 1915 patients were included. The most frequent rheumatic diseases were rheumatoid arthritis (42%) and systemic lupus erythematosus (16%). Comorbidities were reported in half of them (48%). Symptoms were reported by 95% of the patients, 28% were hospitalized, 8% were admitted to the intensive care unit (ICU), and 4% died due to COVID-19. During hospitalization, 9% required non-invasive mechanical ventilation (NIMV) or high flow oxygen devices and 17% invasive mechanical ventilation (IMV). In multivariate analysis models, using poor COVID-19 outcomes as dependent variables, older age, male gender, higher disease activity, treatment with glucocorticoids or rituximab, and the presence of at least one comorbidity and a greater number of them were associated with worse prognosis. In addition, patients with public health insurance and Mestizos were more likely to require hospitalization. Conclusions: In addition to the known poor prognostic factors, in this cohort of patients with rheumatic diseases, high disease activity, and treatment with glucocorticoids and rituximab were associated with worse COVID-19 outcomes. Furthermore, patients with public health insurance and Mestizos were 44% and 39% more likely to be hospitalized, respectively. Study registration: This study has been registered in ClinicalTrials.gov under the number NCT04568421. Key Points • High disease activity, and treatment with glucocorticoids and rituximab were associated with poor COVID-19 outcome in patients with rheumatic diseases. • Some socioeconomic factors related to social inequality, including non-Caucasian ethnicity and public health insurance, were associated with hospitalization due to COVID-19. [ABSTRACT FROM AUTHOR]