Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern Italy
Rheumatic disease patients are at greater risk of infection due to their disease, comorbidities, and immunosuppressive therapy. COVID-19 outcomes in this patient setting appeared to be similar to those of the general population. However, data on this topic were mainly related to small studies on a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2023-07-01
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| Series: | Reumatismo |
| Subjects: | |
| Online Access: | https://www.reumatismo.org/index.php/reuma/article/view/1542 |
| _version_ | 1797778123726520320 |
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| author | N. Ughi D.P. Bernasconi C. Gagliardi F. Del Gaudio A. Dicuonzo A. Maloberti C. Giannattasio C. Rossetti M.G. Valsecchi O.M. Epis |
| author_facet | N. Ughi D.P. Bernasconi C. Gagliardi F. Del Gaudio A. Dicuonzo A. Maloberti C. Giannattasio C. Rossetti M.G. Valsecchi O.M. Epis |
| author_sort | N. Ughi |
| collection | DOAJ |
| description |
Rheumatic disease patients are at greater risk of infection due to their disease, comorbidities, and immunosuppressive therapy. COVID-19 outcomes in this patient setting appeared to be similar to those of the general population. However, data on this topic were mainly related to small studies on a limited number of patients. Consequently, to date, this field remains poorly explored, particularly in the pre-vaccine era. This monocentric study aimed to describe the intrahospital mortality in rheumatic patients with SARS-CoV-2 consecutively hospitalized from 21 February to 31 December 2020, before anti-SARS-CoV-2 vaccine administration spread, compared with non-rheumatic patients. Of 2491 included patients, 65 [3%, median (interquartile range) age 75 (64.76-82.239 years, 65% women] were suffering from rheumatic diseases. A total of 20 deaths were reported [case fatality rate 31%, 95% confidence interval (CI): 19-42] compared with 433 deaths (19%, 95% CI: 17-20) in patients without rheumatic diseases (p=0.024). However, the rheumatic disease was not associated with a significant increase in univariate mortality hazards (hazard ratio 1.374, 95% CI: 0.876-2.154), and after adjustment (hazard ratio 1.199, 95% CI: 0.759-1.894) by age, sex and Charlson comorbidity index. The incidence of intensive care unit admission, death, and discharge in the case-control study was comparable between rheumatic and non-rheumatic patients. The presence of rheumatic diseases in SARS-CoV-2-hospitalized patients did not represent an independent risk factor for severe disease or mortality.
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| first_indexed | 2024-03-12T23:12:46Z |
| format | Article |
| id | doaj.art-bc741dd2efd5467aad166cc247bf9c14 |
| institution | Directory Open Access Journal |
| issn | 0048-7449 2240-2683 |
| language | English |
| last_indexed | 2024-03-12T23:12:46Z |
| publishDate | 2023-07-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Reumatismo |
| spelling | doaj.art-bc741dd2efd5467aad166cc247bf9c142023-07-17T19:26:32ZengPAGEPress PublicationsReumatismo0048-74492240-26832023-07-0175210.4081/reumatismo.2023.1542Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern ItalyN. Ughi0D.P. Bernasconi1C. Gagliardi2F. Del Gaudio3A. Dicuonzo4A. Maloberti5C. Giannattasio6C. Rossetti7M.G. Valsecchi8O.M. Epis9Division of Rheumatology, Multispecialist Medical Department, Niguarda Hospital, MilanBicocca Bioinformatics Biostatistics and Bioimaging Center-B4, School of Medicine and Surgery, Milano-Bicocca University, MilanDivision of Rheumatology, Multispecialist Medical Department, Niguarda Hospital, MilanFunctional Department for Higher Education, Research, and Development, Niguarda Hospital, MilanFunctional Department for Higher Education, Research, and Development, Niguarda Hospital, MilanDivision of Cardiology 4, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan; School of Medicine and Surgery, Milano-Bicocca University, Milan Division of Cardiology 4, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan; School of Medicine and Surgery, Milano-Bicocca University, Milan Functional Department for Higher Education, Research, and Development, Niguarda Hospital, MilanBicocca Bioinformatics Biostatistics and Bioimaging Center-B4, School of Medicine and Surgery, Milano-Bicocca University, MilanDivision of Rheumatology, Multispecialist Medical Department, Niguarda Hospital, Milan Rheumatic disease patients are at greater risk of infection due to their disease, comorbidities, and immunosuppressive therapy. COVID-19 outcomes in this patient setting appeared to be similar to those of the general population. However, data on this topic were mainly related to small studies on a limited number of patients. Consequently, to date, this field remains poorly explored, particularly in the pre-vaccine era. This monocentric study aimed to describe the intrahospital mortality in rheumatic patients with SARS-CoV-2 consecutively hospitalized from 21 February to 31 December 2020, before anti-SARS-CoV-2 vaccine administration spread, compared with non-rheumatic patients. Of 2491 included patients, 65 [3%, median (interquartile range) age 75 (64.76-82.239 years, 65% women] were suffering from rheumatic diseases. A total of 20 deaths were reported [case fatality rate 31%, 95% confidence interval (CI): 19-42] compared with 433 deaths (19%, 95% CI: 17-20) in patients without rheumatic diseases (p=0.024). However, the rheumatic disease was not associated with a significant increase in univariate mortality hazards (hazard ratio 1.374, 95% CI: 0.876-2.154), and after adjustment (hazard ratio 1.199, 95% CI: 0.759-1.894) by age, sex and Charlson comorbidity index. The incidence of intensive care unit admission, death, and discharge in the case-control study was comparable between rheumatic and non-rheumatic patients. The presence of rheumatic diseases in SARS-CoV-2-hospitalized patients did not represent an independent risk factor for severe disease or mortality. https://www.reumatismo.org/index.php/reuma/article/view/1542SARS-CoV-2rheumatic diseasessevere outcomesintrahospital mortality |
| spellingShingle | N. Ughi D.P. Bernasconi C. Gagliardi F. Del Gaudio A. Dicuonzo A. Maloberti C. Giannattasio C. Rossetti M.G. Valsecchi O.M. Epis Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern Italy Reumatismo SARS-CoV-2 rheumatic diseases severe outcomes intrahospital mortality |
| title | Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern Italy |
| title_full | Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern Italy |
| title_fullStr | Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern Italy |
| title_full_unstemmed | Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern Italy |
| title_short | Trends in severe outcomes in SARS-CoV-2-positive hospitalized patients with rheumatic diseases: a monocentric observational and case-control study in northern Italy |
| title_sort | trends in severe outcomes in sars cov 2 positive hospitalized patients with rheumatic diseases a monocentric observational and case control study in northern italy |
| topic | SARS-CoV-2 rheumatic diseases severe outcomes intrahospital mortality |
| url | https://www.reumatismo.org/index.php/reuma/article/view/1542 |
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