COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology
Introduction Data concerning SARS-CoV-2 in patients affected by SLE are contradicting.The aim of this study was to investigate disease-related differences in COVID-19 prognosis of patients affected by rheumatic diseases before vaccination; we tested the hypothesis that patients with SLE may have a d...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/10/2/e000945.full |
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| author | Carlo Alberto Scirè Micaela Fredi Marta Mosca Greta Carrara Chiara Scirocco Laura Andreoli Anna Zanetti Luca Moroni Gianpiero Landolfi Bernd Raffeiner Gian Domenico Sebastiani Davide Rozza Claudia Lomater Sara Ferrigno |
| author_facet | Carlo Alberto Scirè Micaela Fredi Marta Mosca Greta Carrara Chiara Scirocco Laura Andreoli Anna Zanetti Luca Moroni Gianpiero Landolfi Bernd Raffeiner Gian Domenico Sebastiani Davide Rozza Claudia Lomater Sara Ferrigno |
| author_sort | Carlo Alberto Scirè |
| collection | DOAJ |
| description | Introduction Data concerning SARS-CoV-2 in patients affected by SLE are contradicting.The aim of this study was to investigate disease-related differences in COVID-19 prognosis of patients affected by rheumatic diseases before vaccination; we tested the hypothesis that patients with SLE may have a different outcome compared with those with rheumatoid arthritis (RA) or spondyloarthritis (SPA).Methods We analysed data from the national CONTROL-19 Database with a retrospective, observational design, including rheumatic patients affected by COVID-19. The principal outcome measure was hospitalisation with death or mechanical ventilation. Differences between SLE, RA and SPA were analysed by univariable and multivariable logistic regression models.Results We included 103 patients with SLE (88.2% female, mean age 48.9 years, 50.4% active disease), 524 patients with RA (74.4% female, mean age 60.6 years, 59.7% active disease) and 486 patients with SPA (58.1% female, mean age 53.2 years, 58% active disease).Outcome prevalence was not different between patients with SLE and those with RA (SLE 24.5%, RA 25.6%), while patients with SPA showed a more favourable outcome compared with those with SLE (SPA 15.9%); data from the multivariable analysis confirmed this result.In SLE, age >65 years (OR 17.3, CI 5.51 to 63.16, p<0.001), hypertension (OR 6.2, CI 2.37 to 17.04, p<0.001) and prednisone (PDN) use (OR 3.8, CI 1.43 to 11.39, p=0.01) were associated with severe outcomes, whereas hydroxychloroquine use was found to be protective (OR 0.3, CI 0.14 to 0.91, p=0.03).Conclusion Our data suggest that patients with SLE and RA do not show a different COVID-19 outcome, while patients with SPA have a more favourable disease course compared with those with SLE. Risk of hospitalisation with ventilation or death was associated with age >65 years, hypertension and PDN use in patients with SLE. |
| first_indexed | 2024-03-08T17:03:43Z |
| format | Article |
| id | doaj.art-30f195f60d2d47039b5fdf331e8a6ece |
| institution | Directory Open Access Journal |
| issn | 2053-8790 |
| language | English |
| last_indexed | 2024-03-08T17:03:43Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj.art-30f195f60d2d47039b5fdf331e8a6ece2024-01-04T07:15:08ZengBMJ Publishing GroupLupus Science and Medicine2053-87902023-11-0110210.1136/lupus-2023-000945COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for RheumatologyCarlo Alberto Scirè0Micaela Fredi1Marta Mosca2Greta Carrara3Chiara Scirocco4Laura Andreoli5Anna Zanetti6Luca Moroni7Gianpiero Landolfi8Bernd Raffeiner9Gian Domenico Sebastiani10Davide Rozza11Claudia Lomater12Sara Ferrigno1310 School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy3 Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy7 Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy9 Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy1 Rheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy4 Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy9 Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy6 Unit of Immunology, Rheumatology, Allergy and Rare Diseases, San Raffaele Hospital IRCCS, Vita-Salute San Raffaele University, Milan, Italy9 Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy8 Rheumatology Unit, Department of Medicine, Bolzano Hospital, Bolzano, ItalyUOC di Reumatologia, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy9 Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy5 Rheumatology Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy2 Rheumatology, Allergology and Clinical Immunology, Department of ‘Systems Medicine’, University of Rome Tor Vergata, Rome, ItalyIntroduction Data concerning SARS-CoV-2 in patients affected by SLE are contradicting.The aim of this study was to investigate disease-related differences in COVID-19 prognosis of patients affected by rheumatic diseases before vaccination; we tested the hypothesis that patients with SLE may have a different outcome compared with those with rheumatoid arthritis (RA) or spondyloarthritis (SPA).Methods We analysed data from the national CONTROL-19 Database with a retrospective, observational design, including rheumatic patients affected by COVID-19. The principal outcome measure was hospitalisation with death or mechanical ventilation. Differences between SLE, RA and SPA were analysed by univariable and multivariable logistic regression models.Results We included 103 patients with SLE (88.2% female, mean age 48.9 years, 50.4% active disease), 524 patients with RA (74.4% female, mean age 60.6 years, 59.7% active disease) and 486 patients with SPA (58.1% female, mean age 53.2 years, 58% active disease).Outcome prevalence was not different between patients with SLE and those with RA (SLE 24.5%, RA 25.6%), while patients with SPA showed a more favourable outcome compared with those with SLE (SPA 15.9%); data from the multivariable analysis confirmed this result.In SLE, age >65 years (OR 17.3, CI 5.51 to 63.16, p<0.001), hypertension (OR 6.2, CI 2.37 to 17.04, p<0.001) and prednisone (PDN) use (OR 3.8, CI 1.43 to 11.39, p=0.01) were associated with severe outcomes, whereas hydroxychloroquine use was found to be protective (OR 0.3, CI 0.14 to 0.91, p=0.03).Conclusion Our data suggest that patients with SLE and RA do not show a different COVID-19 outcome, while patients with SPA have a more favourable disease course compared with those with SLE. Risk of hospitalisation with ventilation or death was associated with age >65 years, hypertension and PDN use in patients with SLE.https://lupus.bmj.com/content/10/2/e000945.full |
| spellingShingle | Carlo Alberto Scirè Micaela Fredi Marta Mosca Greta Carrara Chiara Scirocco Laura Andreoli Anna Zanetti Luca Moroni Gianpiero Landolfi Bernd Raffeiner Gian Domenico Sebastiani Davide Rozza Claudia Lomater Sara Ferrigno COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology Lupus Science and Medicine |
| title | COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology |
| title_full | COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology |
| title_fullStr | COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology |
| title_full_unstemmed | COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology |
| title_short | COVID-19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis: results from the CONTROL-19 Study by the Italian Society for Rheumatology |
| title_sort | covid 19 prognosis in systemic lupus erythematosus compared with rheumatoid arthritis and spondyloarthritis results from the control 19 study by the italian society for rheumatology |
| url | https://lupus.bmj.com/content/10/2/e000945.full |
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