Objective: Autoimmune systemic diseases (ASD) represent a predisposing condition to COVID-19. Our prospective, observational multicenter telephone survey study aimed to investigate the prevalence, prognostic factors, and outcomes of COVID-19 in Italian ASD patients. Methods: The study included 3,918 ASD pts (815 M, 3103 F; mean age 59±12SD years) consecutively recruit-ed between March 2020 and May 2021 at the 36 referral centers of COVID-19 and ASD Italian Study Group. The possible development of COVID-19 was recorded by means of a telephone survey using a standardized symptom assessment questionnaire. Results: ASD patients showed a significantly higher prevalence of COVID-19 (8.37% vs. 6.49%; p<0.0001) but a death rate statistically comparable to the Italian general population (3.65% vs. 2.95%). Among the 328 ASD patients developing COVID-19, 17% needed hospitalization, while mild-moderate manifestations were observed in 83% of cases. Moreover, 12/57 hospitalized patients died due to severe interstitial pneumonia and/or cardiovascular events; systemic sclerosis (SSc) patients showed a significantly higher COVID-19-related death rate compared to the general population (6.29% vs. 2.95%; p=0.018). Major adverse prognostic factors to develop COVID-19 were: older age, male gender, SSc, pre-existing ASD-related interstitial lung involvement, and long-term steroid treatment. Of note, patients treated with conventional synthetic disease-modifying an-tirheumatic drugs (csDMARDs) showed a significantly lower prevalence of COVID-19 compared to those without (3.58% vs. 46.99%; p=0.000), as well as the SSc patients treated with low dose aspirin (with 5.57% vs. without 27.84%; p=0.000). Conclusion: During the first three pandemic waves, ASD patients showed a death rate comparable to the general population despite the significantly higher prevalence of COVID-19. A significantly increased COVID-19-related mortality was recorded in only SSc patients’ subgroup, possibly favored by preexisting lung fibrosis. Moreover, ongoing long-term treatment with csDMARDs in ASD might usefully contribute to the generally positive outcomes of this frail patients’ population.

Prevalence and Death Rate of COVID-19 in Autoimmune Systemic Diseases in the First Three Pandemic Waves. Relationship with Disease Subgroups and Ongoing Therapies / Ferri, C.; Raimondo, V.; Gragnani, L.; Giuggioli, D.; Dagna, L.; Tavoni, A.; Ursini, F.; L'Andolina, M.; Caso, 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.; 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.; Paparo, S. R.; Ragusa, F.; Mazzi, V.; Elia, G.; Ferrari, S. M.; Di Cola, I.; Vadacca, M.; Lorusso, S.; Monti, M.; Lorini, S.; Aprile, M. L.; Tasso, M.; Miccoli, M.; Bosello, S.; D'Angelo, S.; Doria, A.; Franceschini, F.; Meliconi, R.; Matucci-Cerinic, M.; Iannone, F.; Giacomelli, R.; Salvarani, C.; Zignego, A. L.; Fallahi, P.; Antonelli, A.. - In: CURRENT PHARMACEUTICAL DESIGN. - ISSN 1381-6128. - 28:24(2022), pp. 2022-2028. [10.2174/1381612828666220614151732]

Prevalence and Death Rate of COVID-19 in Autoimmune Systemic Diseases in the First Three Pandemic Waves. Relationship with Disease Subgroups and Ongoing Therapies

Dagna L.;De Luca G.;
2022-01-01

Abstract

Objective: Autoimmune systemic diseases (ASD) represent a predisposing condition to COVID-19. Our prospective, observational multicenter telephone survey study aimed to investigate the prevalence, prognostic factors, and outcomes of COVID-19 in Italian ASD patients. Methods: The study included 3,918 ASD pts (815 M, 3103 F; mean age 59±12SD years) consecutively recruit-ed between March 2020 and May 2021 at the 36 referral centers of COVID-19 and ASD Italian Study Group. The possible development of COVID-19 was recorded by means of a telephone survey using a standardized symptom assessment questionnaire. Results: ASD patients showed a significantly higher prevalence of COVID-19 (8.37% vs. 6.49%; p<0.0001) but a death rate statistically comparable to the Italian general population (3.65% vs. 2.95%). Among the 328 ASD patients developing COVID-19, 17% needed hospitalization, while mild-moderate manifestations were observed in 83% of cases. Moreover, 12/57 hospitalized patients died due to severe interstitial pneumonia and/or cardiovascular events; systemic sclerosis (SSc) patients showed a significantly higher COVID-19-related death rate compared to the general population (6.29% vs. 2.95%; p=0.018). Major adverse prognostic factors to develop COVID-19 were: older age, male gender, SSc, pre-existing ASD-related interstitial lung involvement, and long-term steroid treatment. Of note, patients treated with conventional synthetic disease-modifying an-tirheumatic drugs (csDMARDs) showed a significantly lower prevalence of COVID-19 compared to those without (3.58% vs. 46.99%; p=0.000), as well as the SSc patients treated with low dose aspirin (with 5.57% vs. without 27.84%; p=0.000). Conclusion: During the first three pandemic waves, ASD patients showed a death rate comparable to the general population despite the significantly higher prevalence of COVID-19. A significantly increased COVID-19-related mortality was recorded in only SSc patients’ subgroup, possibly favored by preexisting lung fibrosis. Moreover, ongoing long-term treatment with csDMARDs in ASD might usefully contribute to the generally positive outcomes of this frail patients’ population.
2022
aspirin
autoimmune systemic diseases
COVID-19
DMARD
interstitial lung involvement
steroids
systemic sclerosis
vasculitis
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/135793
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