Details

Autor(en) / Beteiligte

• Marques, Claudia Diniz Lopes
• Kakehasi, Adriana Maria
• Pinheiro, Marcelo Medeiros
• Mota, Licia Maria Henrique
• Albuquerque, Cleandro Pires
• Silva, Carolina Rocha
• Santos, Gabriela Porfirio Jardim
• Reis-Neto, Edgard Torres
• Matos, Pedro
• Devide, Guilherme
• Dantas, Andrea
• Giorgi, Rina Dalva
• Omura, Felipe
• Marinho, Adriana de Oliveira
• Valadares, Lilian David Azevedo
• Melo, Ana Karla G
• Ribeiro, Francinne Machado
• Ferreira, Gilda Aparecida
• Santos, Flavia Patricia de Sena
• Ribeiro, Sandra Lucia Euzebio
• Andrade, Nicole Pamplona Bueno
• Yazbek, Michel Alexandre
• Souza, Viviane Angelina de
• Paiva, Eduardo S
• Azevedo, Valderilio Feijo
• Freitas, Ana Beatriz Santos Bacchiega de
• Provenza, José Roberto
• Toledo, Ricardo Acayaba de
• Fontenelle, Sheilla
• Carneiro, Sueli
• Xavier, Ricardo
• Pileggi, Gecilmara Cristina Salviato
• Reis, Ana Paula Monteiro Gomides

Titel

High levels of immunosuppression are related to unfavourable outcomes in hospitalised patients with rheumatic diseases and COVID-19: first results of ReumaCoV Brasil registry

Ist Teil von

• Rheumatic & musculoskeletal diseases open, 2021-01, Vol.7 (1), p.e001461

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• ObjectivesTo evaluate risk factors associated with unfavourable outcomes: emergency care, hospitalisation, admission to intensive care unit (ICU), mechanical ventilation and death in patients with immune-mediated rheumatic disease (IMRD) and COVID-19.MethodsAnalysis of the first 8 weeks of observational multicentre prospective cohort study (ReumaCoV Brasil register). Patients with IMRD and COVID-19 according to the Ministry of Health criteria were classified as eligible for the study.Results334 participants were enrolled, a majority of them women, with a median age of 45 years; systemic lupus erythematosus (32.9%) was the most frequent IMRD. Emergency care was required in 160 patients, 33.0% were hospitalised, 15.0% were admitted to the ICU and 10.5% underwent mechanical ventilation; 28 patients (8.4%) died. In the multivariate adjustment model for emergency care, diabetes (prevalence ratio, PR 1.38; 95% CI 1.11 to 1.73; p=0.004), kidney disease (PR 1.36; 95% CI 1.05 to 1.77; p=0.020), oral glucocorticoids (GC) (PR 1.49; 95% CI 1.21 to 1.85; p<0.001) and pulse therapy with methylprednisolone (PR 1.38; 95% CI 1.14 to 1.67; p=0.001) remained significant; for hospitalisation, age >50 years (PR 1.89; 95% CI 1.26 to 2.85; p=0.002), no use of tumour necrosis factor inhibitor (TNFi) (PR 2.51;95% CI 1.16 to 5.45; p=0.004) and methylprednisolone pulse therapy (PR 2.50; 95% CI 1.59 to 3.92; p<0.001); for ICU admission, oral GC (PR 2.24; 95% CI 1.36 to 3.71; p<0.001) and pulse therapy with methylprednisolone (PR 1.65; 95% CI 1.00 to 2.68; p<0.043); the two variables associated with death were pulse therapy with methylprednisolone or cyclophosphamide (PR 2.86; 95% CI 1.59 to 5.14; p<0.018).ConclusionsAge >50 years and immunosuppression with GC and cyclophosphamide were associated with unfavourable outcomes of COVID-19. Treatment with TNFi may have been protective, perhaps leading to the COVID-19 inflammatory process.