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Armağan B, Atalar E, Güven SC, Özdemir B, Konak HE, Akyüz Dağlı P, Erden A, Gök K, Maraş Y, Doğan İ, Küçükşahin O, Erten Ş, Omma A. Effects of sulfasalazine in axial spondyloarthritis on COVID-19 outcomes: real-life data from a single center. Immunopharmacol Immunotoxicol 2022:1-7. [PMID: 36537308 DOI: 10.1080/08923973.2022.2160729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Compared to biological agents, little is known about the impact of sulfasalazine therapy on COVID-19 outcomes in patients with Axial Spondyloarthritis (AxSpA). Therefore, we aimed to evaluate the COVID-19 severity in AxSpAs receiving sulfasalazine and biologic-agent. MATERIALS AND METHODS A total of 219 SARS-CoV-2 positive AxSpA patients were retrospectively analyzed. COVID-19 pneumonia, hospitalization rate, and length of stay were used to determine COVID-19 severity. AxSpA patients were mainly grouped and compared as sulfasalazine and non-sulfasalazine. Afterward, we excluded no-treatment patients to reveal the drug's effects more clearly and regrouped AxSpA patients as sulfasalazine-monotherapy (34.3%), biologic-monotherapy (33.7%), and sulfasalazine + biologic (7.3%). RESULTS Fifty-nine percent of the patients were male and the mean age was 45.0 years. Peripheral arthritis was 35% and uveitis 15%. In total, 41.5% of them have received sulfasalazine and 41.0% biologic agents, and the remaining patients with no AxSpA-specific treatment. In the first comparison, the sulfasalazine group had a higher age, more frequent COVID-19 pneumonia, hospitalization, and longer hospitalization than a non-sulfasalazine group. In the pairwise comparison of 3 treatment groups, the demographic and clinical features, the hospitalization rate and the length of hospital stay were similar but the sulfasalazine-monotherapy group had a higher frequency of COVID-19 pneumonia than the biologic-monotherapy group (23% vs. 7%, p = 0.008). CONCLUSION Our results imply sulfasalazine may be related to more severe COVID-19 in AxSpA patients. These patients should be followed more carefully in the presence of COVID-19, regardless of reasons such as age, comorbidity, and extra-axial disease, and consideration of discontinuing sulfasalazine maybe even thought.
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Affiliation(s)
- Berkan Armağan
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Ebru Atalar
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | | | - Bahar Özdemir
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | | | | | | | - Kevser Gök
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Yüksel Maraş
- Division of Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - İsmail Doğan
- Division of Rheumatology, Department of Internal Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Orhan Küçükşahin
- Division of Rheumatology, Department of Internal Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Şükran Erten
- Division of Rheumatology, Department of Internal Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ahmet Omma
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
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Zabana Y, Marín-Jiménez I, Rodríguez-Lago I, Vera I, Martín-Arranz MD, Guerra I, Gisbert JP, Mesonero F, Benítez O, Taxonera C, Ponferrada-Díaz Á, Piqueras M, Lucendo AJ, Caballol B, Mañosa M, Martínez-Montiel P, Bosca-Watts M, Gordillo J, Bujanda L, Manceñido N, Martínez-Pérez T, López A, Rodríguez-Gutiérrez C, García-López S, Vega P, Rivero M, Melcarne L, Calvo M, Iborra M, Barreiro de-Acosta M, Sicilia B, Barrio J, Pérez JL, Busquets D, Pérez-Martínez I, Navarro-Llavat M, Hernández V, Argüelles-Arias F, Ramírez Esteso F, Meijide S, Ramos L, Gomollón F, Muñoz F, Suris G, de Zarate JO, Huguet JM, Llaó J, García-Sepulcre MF, Sierra M, Durà M, Estrecha S, Fuentes Coronel A, Hinojosa E, Olivan L, Iglesias E, Gutiérrez A, Varela P, Rull N, Gilabert P, Hernández-Camba A, Brotons A, Ginard D, Sesé E, Carpio D, Aceituno M, Cabriada JL, González-Lama Y, Jiménez L, Chaparro M, López-San Román A, Alba C, Plaza-Santos R, Mena R, Tamarit-Sebastián S, Ricart E, Calafat M, Olivares S, Navarro P, Bertoletti F, Alonso-Galán H, Pajares R, Olcina P, Manzano P, Domènech E, Esteve M. Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry. J Clin Med 2022; 11:421. [PMID: 35054116 PMCID: PMC8781643 DOI: 10.3390/jcm11020421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/23/2021] [Accepted: 01/06/2022] [Indexed: 02/04/2023] Open
Abstract
We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD.
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Affiliation(s)
- Yamile Zabana
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
| | | | - Iago Rodríguez-Lago
- Gastroenterology Department, Hospital Universitario de Galdakao, 48960 Galdakao, Spain; (I.R.-L.); (J.L.C.)
- Biocruces Bizkaia Health Research Institute, 48960 Galdakao, Spain
| | - Isabel Vera
- Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain; (I.V.); (Y.G.-L.)
| | | | - Iván Guerra
- Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain; (I.G.); (L.J.)
- Instituto de Investigación Hospital Universitario La Paz (IdiPaz), 28046 Madrid, Spain
| | - Javier P. Gisbert
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Department of Gastroenterology, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, Spain
| | - Francisco Mesonero
- Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (F.M.); (A.L.-S.R.)
| | - Olga Benítez
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
| | - Carlos Taxonera
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (C.T.); (C.A.)
- Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], 28040 Madrid, Spain
| | | | - Marta Piqueras
- Consorci Sanitari de Terrassa, 08227 Terrassa, Spain; (M.P.); (R.M.)
| | - Alfredo J. Lucendo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, Spain
- Hospital General de Tomelloso, 13700 Tomelloso, Spain;
| | - Berta Caballol
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Clínic de Barcelona-IDIBAPS, 08036 Barcelona, Spain
| | - Míriam Mañosa
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
| | - Pilar Martínez-Montiel
- Fundación Hospital Universitario Doce de Octubre, 28041 Madrid, Spain; (P.M.-M.); (S.O.)
| | - Maia Bosca-Watts
- Hospital Clinic Universitari de Valencia, 46010 Valencia, Spain; (M.B.-W.); (P.N.)
| | - Jordi Gordillo
- Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (J.G.); (F.B.)
| | - Luis Bujanda
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitario Donostia, Instituto Biodonostia, 20014 San Sebastián, Spain;
- Universidad del País Vasco (UPV/EHU), 48940 Leioua, Spain
| | - Noemí Manceñido
- Hospital Universitario Infanta Sofía, 28703 San Sebastián de los Reyes, Spain; (N.M.); (R.P.)
| | | | - Alicia López
- Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Hospital del Mar, 08003 Barcelona, Spain;
| | | | | | - Pablo Vega
- Complexo Hospitalario Universitario de Ourense, 32005 Ourense, Spain;
| | - Montserrat Rivero
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Luigi Melcarne
- Hospital Universitari Parc Taulí, 08208 Sabadell, Spain;
| | - Maria Calvo
- Hospital San Pedro-Logroño, 26006 Logroño, Spain;
| | - Marisa Iborra
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitario y Politécnico de la Fe de Valencia, 46026 Valencia, Spain
| | | | | | - Jesús Barrio
- Hospital Universitario Río Hortega (HURH), 47012 Valladolid, Spain;
| | - José Lázaro Pérez
- Hospital Universitario Fundación de Alcorcón, 28922 Alcorcón, Spain;
| | - David Busquets
- Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Spain;
| | - Isabel Pérez-Martínez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | | | | | | | | | - Susana Meijide
- Hospital Universitario de Cruces, 48903 Barakaldo, Spain;
| | - Laura Ramos
- Hospital Universitario de Canarias, 38320 San Cristobal de la Laguna, Spain;
| | - Fernando Gomollón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Clínico Universitario “Lozano Blesa” and IIS Aragón, 50009 Zaragoza, Spain
| | - Fernando Muñoz
- Hospital Universitario de Salamanca, 37007 Salamanca, Spain;
| | - Gerard Suris
- Hospital Universitari de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain;
| | | | - José María Huguet
- Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain;
| | - Jordina Llaó
- Althaia Xarxa Assistencial Universitària de Manresa, 08243 Manresa, Spain;
| | | | - Mónica Sierra
- Complejo Asistencial Universitario de León, 24071 León, Spain;
| | - Miguel Durà
- Hospital Clínico de Valladolid, 47003 Valladolid, Spain;
| | | | | | | | | | - Eva Iglesias
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía de Córdoba, 14004 Cordoba, Spain;
| | - Ana Gutiérrez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital General Universitario de Alicante, 03010 Alicante, Spain
| | - Pilar Varela
- Hospital Universitario de Cabueñes, 33394 Gijón, Spain;
| | - Núria Rull
- Hospital Universitario Son Llàtzer, 07198 Palma, Spain;
| | - Pau Gilabert
- Hospital de Viladecans, 08840 Viladecans, Spain;
| | | | | | - Daniel Ginard
- Hospital Universitario Son Espases, 07120 Palma, Spain;
| | - Eva Sesé
- Hospital Universitari Arnau de Vilanova de Lleida, 25198 Lleida, Spain;
| | - Daniel Carpio
- Complexo Hospitalario de Pontevedra, 36071 Pontevedra, Spain;
| | - Montserrat Aceituno
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
| | - José Luis Cabriada
- Gastroenterology Department, Hospital Universitario de Galdakao, 48960 Galdakao, Spain; (I.R.-L.); (J.L.C.)
- Biocruces Bizkaia Health Research Institute, 48960 Galdakao, Spain
| | - Yago González-Lama
- Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain; (I.V.); (Y.G.-L.)
| | - Laura Jiménez
- Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain; (I.G.); (L.J.)
- Instituto de Investigación Hospital Universitario La Paz (IdiPaz), 28046 Madrid, Spain
| | - María Chaparro
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Department of Gastroenterology, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, Spain
| | | | - Cristina Alba
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (C.T.); (C.A.)
- Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], 28040 Madrid, Spain
| | - Rocío Plaza-Santos
- Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (Á.P.-D.); (R.P.-S.)
| | - Raquel Mena
- Consorci Sanitari de Terrassa, 08227 Terrassa, Spain; (M.P.); (R.M.)
| | | | - Elena Ricart
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Clínic de Barcelona-IDIBAPS, 08036 Barcelona, Spain
| | - Margalida Calafat
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
| | - Sonsoles Olivares
- Fundación Hospital Universitario Doce de Octubre, 28041 Madrid, Spain; (P.M.-M.); (S.O.)
| | - Pablo Navarro
- Hospital Clinic Universitari de Valencia, 46010 Valencia, Spain; (M.B.-W.); (P.N.)
| | - Federico Bertoletti
- Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (J.G.); (F.B.)
| | - Horacio Alonso-Galán
- Hospital Universitario Donostia, Instituto Biodonostia, 20014 San Sebastián, Spain;
- Universidad del País Vasco (UPV/EHU), 48940 Leioua, Spain
| | - Ramón Pajares
- Hospital Universitario Infanta Sofía, 28703 San Sebastián de los Reyes, Spain; (N.M.); (R.P.)
| | - Pablo Olcina
- Hospital Virgen de la Luz, 16002 Cuenca, Spain; (T.M.-P.); (P.O.)
| | - Pamela Manzano
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
| | - Eugeni Domènech
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
| | - Maria Esteve
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
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