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Kong X, Wang J, Fan G, Huang H, Sun Y, Chen H, Ma L, Li Y, Jiang L. COVID-19 infection characteristics, risk factors and its potential impacts on Takayasu arteritis: a web-based survey in a large cohort. Front Immunol 2024; 14:1284168. [PMID: 38259433 PMCID: PMC10800358 DOI: 10.3389/fimmu.2023.1284168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Objectives To investigate the characteristics of COVID-19 and its impact on patients with Takayasu's arteritis (TAK). Methods A web-based survey was administered to a TAK cohort and their co-residents in China during January 2023. Infection symptoms, post-acute sequelae of COVID-19 (PASC), potential impacts of COVID-19 on patients' disease condition, treatment and immune-related parameters were analyzed. In addition, risk factors for COVID-19 and disease relapse after infection were explored. Results The infection rate was significantly lower in patients with TAK than in co-residents (79.13% vs 90.67%, p=0.025). TAK patients were more prone to gastrointestinal symptoms (17.78% vs 5.88%, p=0.024), sleep problems (25.15% vs 10.29%, p=0.011), and symptoms involving more than 2 organs (58.90% vs 35.29%, p=0.001) after infection. Although only 2.45% of TAK patients were hospitalized and none progressed to life-threatening conditions, they were more likely to suffer from PASC (26.38% vs 13.24%, p=0.029), especially active patients. Active disease after the pandemic was significantly lower in infected patients than uninfected patients (21/163, 12.88% vs. 11/43, 25.58%, p=0.041). The presence of multiple system symptoms was a risk factor for active TAK after infection [OR: 3.62 (95% CI 1.06-12.31), p=0.040]. Moreover, csDMARDs treatment was a risk factor for COVID-19 infection [OR: 3.68 (95% CI 1.56-8.66), p=0.002]. Conclusion Although TAK patients with COVID-19 have more acute and post-acute symptoms, there is no adverse outcome and the risk of disease relapse does not increase. Patients treated with csDMARDs may be at higher risk of infection and deserve more clinical attention.
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Affiliation(s)
- Xiufang Kong
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jinghua Wang
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guihua Fan
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huijing Huang
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ying Sun
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huiyong Chen
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lili Ma
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
- Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China
| | - Yanshan Li
- Department of Rheumatology and Immunology, Linyi People's Hospital, Linyi, Shandong, China
| | - Lindi Jiang
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
- Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China
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Marinkov A, Dimova R, Karalilova R, Keskinova D, Bahariev D, Batalov K, Popova V, Batalov Z, Batalov A. The COVID-19 pandemic's impact on rheumatic disease patients' satisfaction with access to medical services. Rheumatol Int 2024; 44:157-164. [PMID: 37776498 DOI: 10.1007/s00296-023-05413-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 10/02/2023]
Abstract
The COVID-19 hurt various lifestyle aspects, especially the treatment and follow-up of patients with chronic diseases such as autoimmune inflammatory rheumatic diseases (RD). The new circumstances changed the frequency of medical examinations and the way patients with rheumatic diseases are followed up. The objective is to study the impact of COVID-19 on RD patients' satisfaction with access to medical services. A national multicenter observational cross-sectional anonymous online survey was conducted on patients with RD using a specially developed web-based platform and structured questionnaire https://rheumatologycovid19.bg/ . The study was carried out with the support of intra-university project №6/2022 MU-Plovdiv. 1288 patients participated, with an average age of 47.03 (SD ± 12.80 years), of whom 992 (81.6%) were women. The questionnaire contained 41 questions grouped into 5 panels. Descriptive statistics were used-mean, alternative analysis, logistic regression and Decision Tree using the CRT (classification and regression trees) method. The study found that RD patients' satisfaction with access to medical services was influenced by communication type and the frequency of visits to the rheumatologist, difficulties in prescribing and finding medicines and the presence of comorbidities. The likelihood of patients' satisfaction with their rheumatologist was 5.5 and 3 times higher for in-person and other means of communication, respectively, compared to those without any communication. The relative share of patients who communicated by phone was larger (59%) compared to pre-pandemic (41%), where direct contact with the physician prevailed (80%). The results of the study confirmed the need to optimize remote access to medical care for patients with RD during the pandemic.
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Affiliation(s)
- Aleksandar Marinkov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Rositsa Dimova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, 4002, Bulgaria.
| | - Rositsa Karalilova
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Donka Keskinova
- Department of Applied and Institutional Sociology, Faculty of Philosophy and History, University of Plovdiv Paisiy Hilendarski, Plovdiv, Bulgaria
| | - Dimitar Bahariev
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
- Medical University of Plovdiv, Plovdiv, 4002, Bulgaria
| | - Konstantin Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Velichka Popova
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Zguro Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Anastas Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
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Afzali A, Lukanova R, Hennessy F, Kakehi S, Knight H, Milligan G, Gupte-Singh K. Unmet Needs in Real-World Advanced Therapy-Naïve and -Experienced Patients with Moderately to Severely Active Ulcerative Colitis in the United States. Adv Ther 2023; 40:4321-4338. [PMID: 37458875 PMCID: PMC10499754 DOI: 10.1007/s12325-023-02605-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/28/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Despite availability of advanced therapies (ATs) for ulcerative colitis (UC), many patients fail to respond to treatment. This study examined real-world clinical and humanistic outcomes associated with current treatments in patients with UC. METHODS This cross-sectional study used US data from the Adelphi Real World Disease Specific Programme for inflammatory bowel disease from before (2017-2018) and during the COVID-19 pandemic (2020-2021). Physicians (gastroenterologists) seeing > 5 patients/month reported patients' disease characteristics, current symptoms and treatments, and reasons for treatment choices for their next seven consecutive patients aged ≥ 18 years with moderately to severely active UC before current treatment. Patients were asked to complete the EQ-5D-5L health-related quality of life (HRQoL) measure. ATs included tumor necrosis factor inhibitors (TNFis), integrin receptor antagonists, interleukin-12/23 antagonists, and Janus kinase inhibitors. Patients were classified as AT-naïve or AT-experienced based on current treatment received for ≥ 8 weeks and further classified as responders or non-responders based on symptoms, disease flare status, and remission. Descriptive analyses are presented. RESULTS The 2017-2018 cohort included 92 physicians and 539 patients (208 [38.6%] AT-experienced). The 2020-2021 cohort included 73 physicians and 448 patients (349 [77.9%] AT-experienced). TNFis were the most common ATs. In 2017-2018, 195 (58.9%) AT-naïve and 113 (54.3%) AT-experienced patients were non-responders; in 2020-2021 this was 57 (57.6%) and 182 (52.1%). Efficacy and induction of remission were physicians' most common reasons for AT choice. Dislike of injections/infusions was the most common reason for eligible patients not receiving biologic therapy. Numerically, non-responders (both AT-naïve and AT-experienced) had more symptoms, overall pain and fatigue, and lower HRQoL scores than responders. CONCLUSIONS Before (2017-2018) and during the pandemic (2020-2021), over half of patients with UC did not respond to AT. Non-responders carried a high burden of disease. Alternative therapies are urgently needed to treat UC.
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Affiliation(s)
- Anita Afzali
- Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, ML 0551, Room 6065, Cincinnati, OH, 45267, USA.
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