Risk factors for severe COVID-19 in patients with rheumatic diseases

A. N. Kulikov, N. Muravyeva, B. Belov
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Abstract

The aim – to study risk factors for severe COVID-19 in patients with rheumatic diseases (RD).Patients and methods. The study included medical histories of 464 patients with RD who were admitted at the V.A. Nasonova Research Institute of Rheumatology from September 27, 2021 to April 26, 2023Results. Age over 60 years, hypertension, obesity, lung disease, chronic kidney disease, coronary heart disease, diabetes mellitus, acute cerebrovascular accident or a history of pulmonary tuberculosis increase the risk of hospitalization in patients with RD with COVID-19 by 3–5 times. In addition, with an increase in the number of concomitant diseases, an increase in the risk of hospitalization was noted by 2–6 times. Taking glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, leads to an increase risk of hospitalization by 1.5–4.5 times, while patients taking hydroxychloroquine or tumor necrosis factor α inhibitors was more often required outpatient treatment.Conclusions. It has been established that older age, the presence of comorbid pathology and the use of glucocorticoids, including at a dose of ≥10 mg per day for prednisolone, mycophenolate mofetil and rituximab, are risk factors for severe COVID-19.
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风湿病患者出现严重 COVID-19 的风险因素
目的--研究风湿病(RD)患者患严重COVID-19的风险因素。研究纳入了2021年9月27日至2023年4月26日期间在V.A. Nasonova风湿病研究所住院的464名风湿病患者的病史。年龄超过 60 岁、高血压、肥胖、肺病、慢性肾病、冠心病、糖尿病、急性脑血管意外或有肺结核病史的 COVID-19 RD 患者住院风险增加 3-5 倍。此外,随着伴随疾病数量的增加,住院风险也会增加 2-6 倍。服用糖皮质激素,包括每天剂量≥10毫克的泼尼松龙、霉酚酸酯和利妥昔单抗,会导致住院风险增加1.5-4.5倍,而服用羟氯喹或肿瘤坏死因子α抑制剂的患者更多地需要门诊治疗。已经证实,年龄较大、存在合并病症以及使用糖皮质激素(包括泼尼松龙、霉酚酸酯和利妥昔单抗的每日剂量≥10毫克)是导致严重COVID-19的危险因素。
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