风湿病患者中的 COVID-19:频率和病程

A. N. Kulikov, N. Muravyeva, B. Belov
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Patients with rheumatoid arthritis, ankylosing spondylitis, Sjögren's disease, systemic sclerosis, psoriatic arthritis, systemic lupus erythematosus, microcrystalline arthritis, ANCA- associated vasculitis and poly/dermatomyositis were significantly more likely (p<0.009) to receive COVID-19 therapy compared with the control group. Patients with these diseases are characterized by an increased risk of treatment for COVID-19 by 1.7–6.5 times compared with OA. Also, patients with inflammatory joint diseases (IJD), connective tissue diseases (CTDs) and systemic vasculitis (SV) were hospitalized with COVID-19 more often than patients with OA (p=0.013, p=0.003 and p<0.001, respectively). Patients with IJD, CTDs and SV are characterized by an increased risk of hospitalization with COVID-19 by 3.5–6.8 times compared with OA. 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摘要

研究目的研究旨在评估COVID-19在风湿性疾病(RD)患者中的出现频率和严重程度。研究包括 2021 年 9 月 21 日至 2023 年 12 月 28 日期间在 V. A. Nasonova 风湿病学研究所观察的 9185 名免疫炎症性风湿病(IIRD)患者和 491 名骨关节炎(OA)患者病史中是否存在 COVID-19 的信息。在分析的 IIRD 中,COVID-19 的发病率明显高于 OA(P<0.02)。与 OA 相比,所有纳入分析的 IIRD 的 COVID-19 发生风险均增加了 1.7-3.5 倍。与对照组相比,类风湿性关节炎、强直性脊柱炎、Sjögren's 病、系统性硬化症、银屑病关节炎、系统性红斑狼疮、微晶关节炎、ANCA 相关性血管炎和多发性/皮肌炎患者接受 COVID-19 治疗的几率明显更高(p<0.009)。与 OA 相比,这些疾病患者接受 COVID-19 治疗的风险增加了 1.7-6.5 倍。此外,炎症性关节病(IJD)、结缔组织病(CTD)和系统性血管炎(SV)患者接受 COVID-19 治疗的住院率也高于 OA 患者(分别为 p=0.013、p=0.003 和 p<0.001)。与 OA 相比,IJD、CTD 和 SV 患者因 COVID-19 住院的风险增加了 3.5-6.8 倍。此外,IIRD 老年患者的特点是,COVID-19 的治疗、住院和使用生物制剂或靶向合成改良疾病药物的风险增加。根据所获得的数据,COVID-19 的问题对于 RD 患者来说仍然非常严重。因此,有必要继续研究该疾病不良后果的风险因素以及该传染病的疫苗预防。
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COVID-19 in patients with rheumatic diseases: frequency and course
Objectives. The aim of the study was to assess frequency and severity of COVID-19 in patients with rheumatic diseases (RD).Patients and methods. The study included information on the presence or absence of COVID-19 in the medical history of 9185 patients with immunoinflammatory RD (IIRD) and 491 patients with osteoarthritis (OA) who were observed at the V. A. Nasonova Research Institute of Rheumatology from September 21, 2021 to December 28, 2023.Results. The incidence of COVID-19 in the analyzed IIRD was significantly higher compared to OA (p<0.02). All IIRD included in the analysis are characterized by an increased risk of COVID-19 incidence when compared with OA by 1.7–3.5 times. Patients with rheumatoid arthritis, ankylosing spondylitis, Sjögren's disease, systemic sclerosis, psoriatic arthritis, systemic lupus erythematosus, microcrystalline arthritis, ANCA- associated vasculitis and poly/dermatomyositis were significantly more likely (p<0.009) to receive COVID-19 therapy compared with the control group. Patients with these diseases are characterized by an increased risk of treatment for COVID-19 by 1.7–6.5 times compared with OA. Also, patients with inflammatory joint diseases (IJD), connective tissue diseases (CTDs) and systemic vasculitis (SV) were hospitalized with COVID-19 more often than patients with OA (p=0.013, p=0.003 and p<0.001, respectively). Patients with IJD, CTDs and SV are characterized by an increased risk of hospitalization with COVID-19 by 3.5–6.8 times compared with OA. In addition, elderly patients with IIRD are characterized by an increasing risk of treatment, hospitalization and use of biologics or targeted synthetic disease-modifying drugs for COVID-19.Conclusion. According to the data obtained, the problem of COVID-19 remains very significant for patients with RD. This dictates the need to continue studying risk factors for adverse outcomes of the disease and vaccine prevention of this infectious pathology.
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