학술논문
COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data
Document Type
article
Author
Claudia Diniz Lopes Marques; Sandra Lúcia Euzébio Ribeiro; Cleandro P. Albuquerque; Samia Araujo de Sousa Studart; Aline Ranzolin; Nicole Pamplona Bueno de Andrade; Andrea T. Dantas; Guilherme D. Mota; Gustavo G. Resende; Adriana O. Marinho; Danielle Angelieri; Danieli Andrade; Francinne M. Ribeiro; Felipe Omura; Nilzio A. Silva; Laurindo Rocha Junior; Danielle E. Brito; Diana C. Fernandino; Michel A. Yazbek; Mariana P. G. Souza; Antonio Carlos Ximenes; Ana Silvia S. Martins; Glaucio Ricardo W. Castro; Lívia C. Oliveira; Ana Beatriz S. B. Freitas; Adriana M. Kakehasi; Ana Paula M. Gomides; Edgard Torres Reis Neto; Gecilmara S. Pileggi; Gilda A. Ferreira; Licia Maria H. Mota; Ricardo M. Xavier; Marcelo de Medeiros Pinheiro; the ReumaCoV-Brasil Registry
Source
Advances in Rheumatology, Vol 62, Iss 1, Pp 1-13 (2022)
Subject
Language
English
ISSN
2523-3106
Abstract
Abstract Objectives To evaluate the disease activity before and after COVID-19 and risk factors associated with outcomes, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV) and death in patients with spondylarthritis (SpA). Methods ReumaCoV Brazil is a multicenter prospective cohort of immune-mediated rheumatic diseases (IMRD) patients with COVID-19 (case group), compared to a control group of IMRD patients without COVID-19. SpA patients enrolled were grouped as axial SpA (axSpA), psoriatic arthritis (PsA) and enteropathic arthritis, according to usual classification criteria. Results 353 SpA patients were included, of whom 229 (64.9%) were axSpA, 118 (33.4%) PsA and 6 enteropathic arthritis (1.7%). No significant difference was observed in disease activity before the study inclusion comparing cases and controls, as well no worsening of disease activity after COVID-19. The risk factors associated with hospitalization were age over 60 years (OR = 3.71; 95% CI 1.62–8.47, p = 0.001); one or more comorbidities (OR = 2.28; 95% CI 1.02–5.08, p = 0.001) and leflunomide treatment (OR = 4.46; 95% CI 1.33–24.9, p = 0.008). Not having comorbidities (OR = 0.11; 95% CI 0.02–0.50, p = 0.001) played a protective role for hospitalization. In multivariate analysis, leflunomide treatment (OR = 8.69; CI = 95% 1.41–53.64; p = 0.023) was associated with hospitalization; teleconsultation (OR = 0.14; CI = 95% 0.03–0.71; p = 0.01) and no comorbidities (OR = 0.14; CI = 95% 0.02–0.76; p = 0.02) remained at final model as protective factor. Conclusions Our results showed no association between pre-COVID disease activity or that SARS-CoV-2 infection could trigger disease activity in patients with SpA. Teleconsultation and no comorbidities were associated with a lower hospitalization risk. Leflunomide remained significantly associated with higher risk of hospitalization after multiple adjustments.