Incidence and predictors of COVID-19 and flares in patients with rare autoimmune diseases: a systematic survey and serological study at a national reference center in France

Arthritis Research & Therapy

Anne-Sophie Korganow¹  Vincent Poindron¹  Aurélien Guffroy¹  Aurore Meyer¹  Margherita Giannini¹  Thierry Martin¹  Laurent Arnaud²  Alain Meyer²  Marc Scherlinger²  Rose-Marie Javier²  Jean-François Kleinmann²  Jacques-Eric Gottenberg²  Jean Sibilia²  Luc Pijnenburg²  Emmanuel Chatelus²  Christelle Sordet²  Renaud Felten² 

[1] Centre National de Référence des Maladies Auto-Immunes Systémiques Rares Est Sud-Ouest (RESO);Service de rhumatologie, Service de rhumatologie, Hôpitaux Universitaires de Strasbourg et Université de Strasbourg;

关键词: Autoimmune diseases;    Epidemiology;    Immune system diseases;    COVID-19;   

DOI  :  10.1186/s13075-021-02565-0

来源: DOAJ

【 摘 要 】

Abstract Background The risk of severe COVID-19 and its determinants remain largely unknown in patients with autoimmune and inflammatory rheumatic diseases. The objective of this study was to assess the prevalence of COVID-19 infection in patients followed for rare autoimmune diseases as well as the predictors of COVID-19 and disease flare-ups. Methods Cross-sectional phone survey from April 9, 2020, to July 2, 2020, during which patients with autoimmune diseases followed at the National Reference Center for Rare Autoimmune diseases of Strasbourg were systematically contacted by phone and sent a prescription for a SARS-CoV-2 serology. Results One thousand two hundred thirty-two patients were contacted. One thousand fifty-five patients with a confirmed diagnosis of systemic autoimmune disease were included (4 unreachable, 4 moves abroad, 5 deaths before pandemic, 50 without consent, and 114 without autoimmune disease). Among them, 469 (44.5%) patients were tested for SARS-CoV-2 serology. Thirty-nine patients (7.9%) had SARS-CoV-2 infection (either through chest CT-scan [n = 5], RT-PCR on nasopharyngeal swab [n = 14], or serology [n = 31]) among the 496 who underwent at least one of those 3 diagnosis modalities. Of the 39 proven cases, 33 had clinical manifestations (6 asymptomatic patients were diagnosed through systematic serology testing), 31 were managed by home care, 3 were hospitalized due to a need for oxygenation, two required admission to an intensive care unit, and one died. Among patients with confirmed SARS-CoV-2 infection, reported flares were more frequent than in uninfected patients (26.3% [10/38] vs. 7.0% [32/457], p < 0.0001). Preventive sick leave had no significant impact on the prevalence of SARS-CoV-2 infection (5.8% [3/53]) compared to work continuation (7.6% [30/397], p = 0.64). Overall, the seroprevalence of SARS-CoV-2 was 6.6% (31/469) which was numerically lower to the Grand-Est general population estimated to be 9.0%. Conclusions This systematic survey of more than 1000 patients with rare systemic autoimmune diseases reports a low prevalence of proven SARS-CoV-2 infection and very rare severe infections, probably related to good compliance with prophylactic measures in these patients.

【 授权许可】

Unknown