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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Impact of Corticosteroids and Immunosuppressive Therapies on Symptomatic SARS-CoV-2 Infection MESHD in a Large Cohort of Patients with Chronic Inflammatory Arthritis MESHD Arthritis HP

    Authors: Ennio Giulio Favalli; Serena Bugatti; Catherine Klersy; Martina Biggioggero; Silvia Rossi; Orazio De Lucia; Francesca Bobbio-Pallavicini; Antonella Murgo; Silvia Balduzzi; Roberto Caporali; Carlomaurizio Montecucco

    doi:10.21203/rs.3.rs-51667/v1 Date: 2020-07-31 Source: ResearchSquare

    Background: Prevalence SERO and outcomes of Coronavirus Disease MESHD ( COVID MESHD)-19 in relation to immunomodulatory medications are still unknown. The aim of the study is to investigate the impact of glucocorticoids and immunosuppressive agents on COVID MESHD-19 in a large cohort of patients with chronic immune-mediated inflammatory arthritis MESHD arthritis HP.Methods: The study was conducted in the arthritis HP arthritis MESHD outpatient clinic at two large Academic Hospitals in the COVID MESHD-19 most endemic area of Northern Italy (Lombardy). We circulated a cross-sectional survey exploring the prevalence SERO of Severe Acute Respiratory Syndrome-Coronavirus-2 MESHD nasopharyngeal swab positivity and the occurrence of acute respiratory illness MESHD ( fever HP and/or cough HP and/or dyspnea HP dyspnea MESHD), administered face-to-face or by phone to consecutive patients from 25th February to 20th April 2020. COVID MESHD-19 cases were defined as confirmed or highly suspicious according to the World Health Organization criteria. The impact of medications on COVID MESHD-19 incidence was evaluated. Results: The study population included 2050 adults TRANS with chronic inflammatory arthritis MESHD arthritis HP receiving glucocorticoids, conventional-synthetic (cs), or targeted-synthetic/biological (ts/b) disease-modifying drugs (DMARDs). Laboratory-confirmed COVID MESHD-19 and highly suspicious infection MESHD were recorded in 1.1% and 1.4% of the population, respectively. Treatment with glucocorticoids was independently associated with increased risk of COVID MESHD-19 (adjusted OR [95% CI] ranging from 1.23 [1.04-1.44] to 3.20 [1.97-5.18] depending on the definition used). Conversely, patients treated with ts/bDMARDs were at reduced risk (adjusted OR ranging from 0.46 [0.18-1.21] to 0.47 [0.46-0.48]). No independent effects of csDMARDs were observed.Conclusions: During the COVID MESHD-19 outbreak, treatment with immunomodulatory medications appears safe. Conversely, glucocorticoids, even at low-dose, may confer increased risk of infection TRANS risk of infection TRANS.Trial registration:  retrospectively registered

    Prevalence SERO of Hospital PCR Confirmed Covid-19 Cases in Patients with Chronic Inflammatory and Autoimmune Rheumatic Diseases MESHD

    Authors: José L. Pablos; Lydia Abasolo-Alcázar; José M. Álvaro-Gracia; Francisco J. Blanco; Ricardo Blanco; Isabel Castrejón; David Fernández-Fernández; Benjamín Fernández-Gutierrez; María Galindo; Miguel A. González-Gay; Sara Manrique-Arija; Natalia Mena-Vázquez; Antonio Mera-Varela; Miriam Retuerto; Álvaro Seijas-Lopez; - RIER investigators group

    doi:10.1101/2020.05.11.20097808 Date: 2020-05-14 Source: medRxiv

    ABSTRACT Background. The susceptibility of patients with rheumatic diseases MESHD, and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown. Methods. We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with SARS-CoV-2 positive PCR tests performed in the hospital to the same reference populations. Incidences of PCR+ confirmed COVID-19 were compared among groups. Results. Patients with chronic inflammatory diseases had 1.32-fold higher prevalence SERO of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Systemic autoimmune or immune mediated diseases (AI/IMID) patients showed a significant increase, whereas inflammatory arthritis (IA) or systemic lupus erythematosus MESHD arthritis HP (IA) or systemic lupus erythematosus HP ( SLE MESHD) patients did not. COVID-19 cases in some but not all diagnostic groups had older ages TRANS than cases in the reference population. IA patients on targeted-synthetic or biological disease-modifying antirheumatic drugs (ts/bDMARD), but not those on conventional-synthetic (csDMARD), had a greater prevalence SERO despite a similar age TRANS distribution. Conclusion. Patients with AI/IMID show a variable risk of hospital diagnosed COVID-19. Interplay of aging, therapies, and disease specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic MESHD patients and to analyze the specific factors involved in COVID-19 susceptibility.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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