Effect of traditional therapeutics on prevalence and clinical outcomes of coronavirus disease 2019 in Chinese patients with autoimmune diseases

IF 4.7 Q2 IMMUNOLOGY Journal of Translational Autoimmunity Pub Date : 2023-12-12 DOI:10.1016/j.jtauto.2023.100227
Saisai Huang , Xiaolei Ma , Juan Cao , Mengru Du , Zhiling Zhao , Dandan Wang , Xue Xu , Jun Liang , Lingyun Sun
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Abstract

The impact of the Coronavirus disease 2019 (COVID-19) pandemic on autoimmune diseases (AID) patients has been an important focus. This study was undertaken to characterize the incidence, clinical manifestations and hospitalization among AID affected by COVID-19 and to analyze the association between immunomodulatory medication and these outcomes. Clinical, demographic, maintenance treatment, symptoms and disease course data and outcomes of AID patients with COVID-19 infection were assessed via an online survey tool and printed copy from 1 January till February 28, 2023. A total of 432 patients with AID were enrolled in the study. The results showed the most common conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was hydroxychloroquine (HCQ). The usage of csDMARDs didn't increase the risk of COVID-19 infection. Patients who warranted hospitalization were significantly older. ILD was associated with higher hospitalization rate. No csDMARDs other than calcineurin inhibitor (CNI) was associated with increased risk of hospitalization. HCQ intake was associated with cough. Compared with no glucocorticoids (GCs) group, high doses of GCs were accompanied with higher proportion of gastrointestinal symptoms and tachycardia, lower proportion of sore throat and ageusia. GCs didn't provoke the COVID‐19 infection in patients with AID, but chronic use of oral GCs was significantly more common in those requiring hospitalization, and higher dose of GCs were correlated with higher risk of hospitalization. 97 patients discontinued csDMARDs after infection, which resulted in an elevated risk of hospitalization. Meanwhile, withdrawal of csDMARDs was associated with higher odds of disease flare and lower proportion of remission than maintenance groups. Collectively, our analysis provides the evidence that maintenance treatment of csDMARDs may be more prudent for AID patients during COVID-19 pandemic.

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传统疗法对 2019 年中国自身免疫性疾病患者冠状病毒病发病率和临床结果的影响
2019冠状病毒病(COVID-19)大流行对自身免疫性疾病(AID)患者的影响一直是一个重要的焦点。本研究旨在分析COVID-19感染艾滋病患者的发病率、临床表现和住院情况,并分析免疫调节药物与这些结果的关系。从2023年1月1日至2月28日,通过在线调查工具和打印件评估aids合并COVID-19感染患者的临床、人口学、维持治疗、症状和病程数据以及结果。共有432名艾滋病患者参加了这项研究。结果显示,羟基氯喹(HCQ)是最常见的常规合成疾病缓解抗风湿药物。使用csDMARDs不会增加COVID-19感染的风险。需要住院治疗的患者明显年龄较大。ILD与较高的住院率相关。除钙调磷酸酶抑制剂(CNI)外,没有其他csdmard与住院风险增加相关。摄入HCQ与咳嗽有关。与无糖皮质激素(GCs)组相比,高剂量GCs组胃肠道症状和心动过速比例较高,喉咙痛和衰老比例较低。GCs并未引起AID患者的COVID - 19感染,但在需要住院治疗的患者中,慢性口服GCs更为常见,且GCs剂量越大,住院风险越高。97名患者在感染后停用csDMARDs,导致住院风险升高。同时,与维持组相比,停用csDMARDs与更高的疾病爆发几率和更低的缓解比例相关。总的来说,我们的分析提供的证据表明,在COVID-19大流行期间,对艾滋病患者进行csdmard的维持治疗可能更为谨慎。
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来源期刊
Journal of Translational Autoimmunity
Journal of Translational Autoimmunity Medicine-Immunology and Allergy
CiteScore
7.80
自引率
2.60%
发文量
33
审稿时长
55 days
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