Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave.
Covid-19 and rheumatic autoimmune systemic diseases: Role of pre-existing lung involvement and ongoing treatments / Ferri C.; Giuggioli D.; Raimondo V.; L'andolina M.; Dagna L.; Tavoni A.; Caso F.; Ursini F.; Ruscitti P.; Caminiti M.; Foti R.; Riccieri V.; Guiducci S.; Pellegrini R.; Zanatta E.; Varcasia G.; Olivo D.; Gigliotti P.; Cuomo G.; Murdaca G.; Cecchetti R.; De Angelis R.; Romeo N.; Ingegnoli F.; Cozzi F.; Codullo V.; Cavazzana I.; Colaci M.; Abignano G.; De Santis M.; Lubrano E.; Fusaro E.; Della Rossa A.; Spinella A.; Lumetti F.; De Luca G.; Bellando-Randone S.; Visalli E.; Dal Bosco Y.; Amato G.; Giannini D.; Bilia S.; Masini F.; Pellegrino G.; Pigatto E.; Generali E.; Mariano G.P.; Pettiti G.; Zanframundo G.; Brittelli R.; Aiello V.; Caminiti R.; Scorpiniti D.; Ferrari T.; Campochiaro C.; Brusi V.; Fredi M.; Moschetti L.; Cacciapaglia F.; Gragnani L.; Monti M.; Lorini S.; Paparo S.R.; Ragusa F.; Mazzi V.; Elia G.; Ferrari S.M.; Di Cola I.; Vadacca M.; Lorusso S.; Barsotti S.; Aprile M.L.; Marco T.; Miccoli M.; Bosello S.; Matucci-Cerinic M.; D'angelo S.; Doria A.; Franceschini F.; Meliconi R.; Iannone F.; Giacomelli R.; Zignego A.L.; Fallahi P.; Antonelli A.. - In: CURRENT PHARMACEUTICAL DESIGN. - ISSN 1381-6128. - STAMPA. - 27:(2021), pp. 4245-4252. [10.2174/1381612827666210903103935]
Covid-19 and rheumatic autoimmune systemic diseases: Role of pre-existing lung involvement and ongoing treatments
Raimondo V.;Caso F.;Guiducci S.;Bellando-Randone S.;Giannini D.;Generali E.;Aiello V.;Lorini S.;Ragusa F.;Matucci-Cerinic M.;D'angelo S.;Doria A.;Zignego A. L.;
2021
Abstract
Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave.
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