Predictors of hospitalization for COVID-19 in patients with autoimmune rheumatic diseases : results from a community cohort follow-up
© 2021. International League of Associations for Rheumatology (ILAR)..
OBJECTIVE: The identification of risk factors for COVID-19 adverse course in autoimmune rheumatic diseases (ARDs) is of the utmost importance when approaching patient management; however, data are scarce in relation to the Latin American population. The objective of this study was to determine predictors of hospitalization for COVID-19 patients from an ARD community cohort.
METHODS: A real setting longitudinal study (March to November 2020) in an ARD community cohort was carried out. Potential predictors of hospitalization for COVID-19 examined included (1) sociodemographic variables (age, gender, education, tobacco use, socioeconomic status, and co-inhabitants), (2) comorbidities, (3) time to COVID-19 diagnosis, and (4) ARD's features: clinical (disease type, disease duration, activity), treatment [corticosteroids use/doses, use of synthetic DMARDs (cDMARDs, tsDMARDs, and bDMARDs)], treatment schedule and non-adherence, and the Multidimensional Health Assessment Questionnaire (MDHAQ). Univariable and multivariable regression analysis were conducted; OR and 95% CI (p < 0.05) were determined.
RESULTS: One thousand and one hundred forty-eight patients with ARDs were included; 154 had COVID-19; of these 139 (90.3%) were women, aged 52.5 (13.7) years; 33.1% had hypertension and 61.0% an affected organ by ARD. Infection was detected 8.4 (10.1) days after symptoms started; there were 33 hospitalized patients (rate 21.4%). Predictors of hospitalization by multivariable analysis were age (OR: 1.06; CI: 1.01-1.10; p: 0.01), comorbidities: hypertension (OR: 3.95; 95% CI: 1.40-10.95, p: 0.01) and neoplasm (OR: 9.0; 95% CI: 1.6-52.3; p: 0.01), number of organs involved by ARD (OR: 2.26; 95% CI: 1.16-4.41; p: 0.02), and infection diagnosis delay (OR: 1.36; 95% CI: 1.03-1.80; p: 0.01).
CONCLUSIONS: In our ARD patients with COVID-19, older age, comorbidities (neoplasm and hypertension), and a delay in COVID-19 diagnosis were predictors of hospitalization. The only ARD-associated predictor feature was the number of organs involved. Key Points • Patients with ARD and COVID-19 have an adverse course in comparison to the general population. • Previous predictors of COVID-19 hospitalization, including known risk factors (such as older age and comorbidities) and systemic manifestations, should be taken into account in the management of these patients. • Delayed diagnosis of COVID-19 impacts negatively on prognosis. • Availability of diagnostic tests is of utmost importance.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
Clinical rheumatology - 40(2021), 11 vom: 29. Nov., Seite 4725-4734 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gamboa-Cárdenas, Rocío-V [VerfasserIn] |
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| Links: |
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| Themen: |
Autoimmune rheumatic disease |
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| Anmerkungen: |
Date Completed 19.10.2021 Date Revised 18.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10067-021-05833-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM327365536 |
|---|
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| 100 | 1 | |a Gamboa-Cárdenas, Rocío-V |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Predictors of hospitalization for COVID-19 in patients with autoimmune rheumatic diseases |b results from a community cohort follow-up |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 19.10.2021 | ||
| 500 | |a Date Revised 18.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. International League of Associations for Rheumatology (ILAR). | ||
| 520 | |a OBJECTIVE: The identification of risk factors for COVID-19 adverse course in autoimmune rheumatic diseases (ARDs) is of the utmost importance when approaching patient management; however, data are scarce in relation to the Latin American population. The objective of this study was to determine predictors of hospitalization for COVID-19 patients from an ARD community cohort | ||
| 520 | |a METHODS: A real setting longitudinal study (March to November 2020) in an ARD community cohort was carried out. Potential predictors of hospitalization for COVID-19 examined included (1) sociodemographic variables (age, gender, education, tobacco use, socioeconomic status, and co-inhabitants), (2) comorbidities, (3) time to COVID-19 diagnosis, and (4) ARD's features: clinical (disease type, disease duration, activity), treatment [corticosteroids use/doses, use of synthetic DMARDs (cDMARDs, tsDMARDs, and bDMARDs)], treatment schedule and non-adherence, and the Multidimensional Health Assessment Questionnaire (MDHAQ). Univariable and multivariable regression analysis were conducted; OR and 95% CI (p < 0.05) were determined | ||
| 520 | |a RESULTS: One thousand and one hundred forty-eight patients with ARDs were included; 154 had COVID-19; of these 139 (90.3%) were women, aged 52.5 (13.7) years; 33.1% had hypertension and 61.0% an affected organ by ARD. Infection was detected 8.4 (10.1) days after symptoms started; there were 33 hospitalized patients (rate 21.4%). Predictors of hospitalization by multivariable analysis were age (OR: 1.06; CI: 1.01-1.10; p: 0.01), comorbidities: hypertension (OR: 3.95; 95% CI: 1.40-10.95, p: 0.01) and neoplasm (OR: 9.0; 95% CI: 1.6-52.3; p: 0.01), number of organs involved by ARD (OR: 2.26; 95% CI: 1.16-4.41; p: 0.02), and infection diagnosis delay (OR: 1.36; 95% CI: 1.03-1.80; p: 0.01) | ||
| 520 | |a CONCLUSIONS: In our ARD patients with COVID-19, older age, comorbidities (neoplasm and hypertension), and a delay in COVID-19 diagnosis were predictors of hospitalization. The only ARD-associated predictor feature was the number of organs involved. Key Points • Patients with ARD and COVID-19 have an adverse course in comparison to the general population. • Previous predictors of COVID-19 hospitalization, including known risk factors (such as older age and comorbidities) and systemic manifestations, should be taken into account in the management of these patients. • Delayed diagnosis of COVID-19 impacts negatively on prognosis. • Availability of diagnostic tests is of utmost importance | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Autoimmune rheumatic disease | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a COVID-19 adverse predictors | |
| 650 | 4 | |a SARS-CoV-2 | |
| 700 | 1 | |a Barzola-Cerrón, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Toledo-Neira, Denisse |e verfasserin |4 aut | |
| 700 | 1 | |a Reátegui-Sokolova, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Pimentel-Quiroz, Víctor |e verfasserin |4 aut | |
| 700 | 1 | |a Zevallos-Miranda, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Alarcón, Graciela S |e verfasserin |4 aut | |
| 700 | 1 | |a Ugarte-Gil, Manuel |e verfasserin |4 aut | |
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