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Boteanu A, Leon L, Pérez Esteban S, Rabadán Rubio E, Pavía Pascual M, Bonilla G, Bonilla González-Laganá C, García Fernandez A, Recuero Diaz S, Ruiz Gutierrez L, Sanmartín Martínez JJ, de la Torre-Rubio N, Nuño L, Sánchez Pernaute O, Del Bosque I, Lojo Oliveira L, Rodríguez Heredia JM, Clemente D, Abasolo L, Bachiller-Corral J. Severe COVID-19 in patients with immune-mediated rheumatic diseases: A stratified analysis from the SORCOM multicentre registry. Mod Rheumatol 2023; 34:97-105. [PMID: 36516217 DOI: 10.1093/mr/roac148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/11/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The aim of this study is to evaluate risk factors for severe coronavirus disease 2019 (COVID-19) in patients with immune-mediated rheumatic diseases, stratified by systemic autoimmune conditions and chronic inflammatory arthritis. METHODS An observational, cross-sectional multicentre study was performed. Patients from 10 rheumatology departments in Madrid who presented with severe acute respiratory syndrome coronavirus-2 infection between February 2020 and May 2021 were included. The main outcome was COVID-19 severity (hospital admission or mortality). Risk factors for severity were estimated, adjusting for covariates (socio-demographic, clinical, and treatments), using logistic regression analyses. RESULTS In total, 523 patients with COVID-19 were included, among whom 192 (35.6%) patients required hospital admission and 38 (7.3%) died. Male gender, older age, and comorbidities such as diabetes mellitus, hypertension, and obesity were associated with severe COVID-19. Corticosteroid doses >10 mg/day, rituximab, sulfasalazine, and mycophenolate use, were independently associated with worse outcomes. COVID-19 severity decreased over the different pandemic waves. Mortality was higher in the systemic autoimmune conditions (univariate analysis, P < .001), although there were no differences in the overall severity in the multivariate analysis. CONCLUSIONS This study confirms and provides new insights regarding the harmful effects of corticosteroids, rituximab, and other therapies (mycophenolate and sulfasalazine) in COVID-19. Methotrexate and anti-tumour necrosis factor therapy were not associated with worse outcomes.
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Affiliation(s)
- Alina Boteanu
- Rheumatology Department and IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Leticia Leon
- Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain
- Health Sciences, Universidad Camilo José Cela, Madrid, Spain
| | - Silvia Pérez Esteban
- Rheumatology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Elena Rabadán Rubio
- Rheumatology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Marina Pavía Pascual
- Rheumatology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Gema Bonilla
- Rheumatology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Sheila Recuero Diaz
- Rheumatology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Lucia Ruiz Gutierrez
- Rheumatology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | | | - Laura Nuño
- Rheumatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Olga Sánchez Pernaute
- Rheumatology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Iván Del Bosque
- Rheumatology Department and IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | - Daniel Clemente
- Rheumatology Department, Hospital Universitario Infantil Niño Jesus, Madrid, Spain
| | - Lydia Abasolo
- Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Javier Bachiller-Corral
- Rheumatology Department and IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Universidad de Alcalá, Madrid, Spain
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