POS0203 PREDICTIVE SEVERITY FACTORS OF COVID-19 IN PATIENTS WITH RHEUMATIC IMMUNE MEDIATED DISEASES

Autor: D. Martínez-López, I. Ferraz-Amaro, D. Prieto-Peña, F. Benavides-Villanueva, C. Corrales-Selaya, L. Sanchez-Bilbao, A. Herrero-Morant, C. Álvarez-Reguera, M. Trigueros-Vazquez, M. A. González-Gay, R. Blanco
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:337.1-337
ISSN: 1468-2060
0003-4967
Popis: BackgroundCOVID-19 has become a common disease in patients with rheumatic immune-mediated diseases (R-IMID). A risk stratification of the patients at COVID-19 onset is important to predict possible unfavorable results.ObjectivesTo identify predictive severity factors in patients with COVID-19 with R-IMID.MethodsCross-sectional study in a single University Hospital. We included all consecutive patients with a R-IMID and COVID-19 up to November 6th, 2020. Confirmed infection was defined if the patient had a positive nasopharyngeal swab for SARS-CoV-2.COVID-19 case severity was divided into mild, moderate, severe and critical according to the United States National Institute of Health (NIH) COVID-19 guidelines (1).We performed a multivariable analysis and calculated de odds ratio of critical COVID in patients with R-IMID, adjusting by age, sex and comorbidities.ResultsWe included 274 patients with R-IMID complicated with COVID-19. At COVID-19 onset, the main comorbidities, analytical values, underlying R-IMID and treatments received are shown in Table 1.Table 1.General features patients with R-IMID and COVID-19General featuresOverall patients (n=274)Critical COVID (n=21)General features (continuation)Patients (n=274)Critical COVID (n=21)Age, years59 ±1876.32 ± 13.4Analytical values, mean ± SDFemale, n (%)185 (67)11 (52.4)-CRP (mg/dl)4.7 ± 5.2511.7 ± 8.6CV risk factors, n (%)-Creatinine (mg/dl)0.91 ± 0.41.4 ± 0.7-Current smoker27 (10)2 (9.5)-Platelets (x103/ul)179 ± 78163 ± 72-Obesity49 (18)5 (23.8)-Hemoglobina (g/l)13.0 ± 1.812.5 ± 2.1-Hypertension119 (43)18 (85.7)-Neutrophils (x103/ul)4.5 ± 2.54.9 ± 3.2-Diabetes Mellitus36 (13)5 (23.8)-Lymphocytes (x103/ul)1.1 ± 10.7 ± 0.5-Dyslipidemia119 (43)15 (71.4)-Ferritin (ug/L)426 ± 417664 ± 469Comorbidities, n (%)-LDH (U/L)257 ± 92314 ± 143-Chronic pulmonary disease12 (4.4)3 (14.3)-D-Dimer (ng/ml)999±12561890 ± 1893-Established cardiovascular disease45 (16.4)10 (47.6)Underlying R-IMID, n (%)-Cancer21 (8)6 (28.6)-RA79 (28.8)9 (42.9)-Chronic kidney disease27 (10)6 (28.6)-PsA55 (20.1)3 (14.3)-Chronic liver disease11 (4)3 (14.3)-SpA34 (12.4)0Treatments received, n (%)-PMR22 (8)6 (28.6)-Methotrexate // Hydroxychloroquine62 (23) // 50 (18)3 (14.3) // 2 (9.5)-SLE22 (8)0-TNFi31 (11.3)0-Vasculitis8 (2.9)1 (4.8)-Anti-CD208 (2.9)3 (14.3)-Sjogren’s syndrome8 (2.9)2 (9.5)-Other biologic DMARDs // JAKINIBs16 (5.8) // 6 (2.2)1 (4.8) // (4.8)-Others46 (16.8)0CRP: C-reactive protein; ILD: Interstitial lung disease; LDH: Lactate dehydrogenase; PMR: Polymyalgia rheumatica¸PsA: Psoriatic arthritis, RA: Rheumatoid arthritis; SLE: Systemic lupus erythematosus; SpA: Axial spondyloarthritis*Adjusted by age, cardiovascular risk factors and comorbiditiesAccording to COVID-19 severity, patients were mild (n=209; 76.3%), moderate (n=35; 12.8%), severe (n=9; 3.3%) and critical (n=21; 7.7%).The predictive variables at COVID-19 onset related statistically to critical COVID were older patients, hypertension, dyslipidemia, previous cardiovascular disease, cancer, chronic kidney disease, and chronic liver disease. The only underlying R-IMID and treatment was polymyalgia rheumatica and Rituximab, respectively. Regarding analytical values were higher values of C-reactive protein, LDH, platelets and lymphopenia (Figure 1).Figure 1.Predictive factors for critical COVID-19 in R-IMID (Multivariable analysis)COPD: Chronic obstructive pulmonary disease; CRP: C-reactive protein; CV: Cardiovascular; HCQ: Hydroxychloroquine; ILD: Interstitial lung disease; LDH: Lactate dehydrogenase; MTX: Methotrexate; PsA: Psoriatic arthritis; RA: Rheumatoid arthritis; SLE: Systemic lupus erythematosus; TNFi: TNF inhibitors.*p< 0.005Data in graphic are presented in a logarithmic scale.ConclusionWe identified various factors associated with a worse prognosis of COVID-19 in patients with R-IMID. This can help to identify which patients can present a worse course of the disease at the moment of the diagnosis.Disclosure of InterestsDavid Martínez-López: None declared, Iván Ferraz-Amaro: None declared, Diana Prieto-Peña: None declared, Fabricio Benavides-Villanueva: None declared, Cristina Corrales-Selaya: None declared, Lara Sanchez-Bilbao: None declared, Alba Herrero-Morant: None declared, Carmen Álvarez-Reguera: None declared, Martin Trigueros-Vazquez: None declared, Miguel A González-Gay Speakers bureau: Consultation fees/participation in company-sponsored speaker´s bureau from Abbvie, Pfizer, Roche, and MSD, Grant/research support from: Dr. Miguel A. Gonzalez-Gay received grants/research supports from Abbvie, MSD, and Roche, Ricardo Blanco Speakers bureau: Consultation fees/participation in company-sponsored speaker´s bureau from Abbvie, Lilly, Pfizer, Roche, Bristol-Myers, Janssen, and MSD., Grant/research support from: Dr. Ricardo Blanco received grants/research supports from Abbvie, MSD, and Roche
Databáze: OpenAIRE
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