类风湿性关节炎患者的COVID-19和COVID-19后综合征

Аронова Е.С, Белов Б.С, Гриднева Г.И, Фгбну «Научно-исследовательский, шоссе, 34А
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摘要

目的:研究类风湿性关节炎(RA)患者的新冠肺炎病程及其后综合征(PCS)。材料和方法。该研究包括32名确诊为RA的成年患者,他们符合ACR/EULAR标准。所有患者都感染了COVID-19。分析材料是通过va Nasonova风湿病研究所制定的问卷调查获得的,患者在与研究人员面谈时完成问卷调查。结果和讨论。研究组主要由女性组成(n= 29,90%)。患者平均年龄50.75±16.48岁。在新冠肺炎的临床表现中,虚弱/乏力占90.6%;P <0.0001),发热(71.9%;P =0.0005)和嗅觉缺失(62.5%;P =0.045)更为常见。几乎一半的患者有发音困难(59.4%)、关节痛加重(53.1%)、用力时呼吸困难(50%)和咳嗽(46.9%)。COVID-19期间关节痛的增加与RA活性之间存在显著的正相关(r=0.72;p < 0.05)。37.5%的COVID-19患者需要住院治疗。在12.5%的病例中,COVID-19出现并发症。RA活动度较高的患者更有可能出现作为感染症状的关节痛的增加。新冠肺炎患者中有47.8%的患者登记为PCS。对PCS患者的回顾性评估显示,在传染病科住院的比例更高,COVID-19病程更严重。随后,该组的重复感染病例更为常见。有必要对PCS发展进行风险评估,以适当分配卫生保健系统的负担,并制定预防、及时诊断和治疗风湿病患者这种综合征的策略。为了实现这一目标,需要在更大的RA和风湿病患者队列中进行新的研究。
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COVID-19 and post-covid syndrome in patients with rheumatoid arthritis
Objective: to study the course of COVID -19 and post-covid syndrome (PCS) in patients with rheumatoid arthritis (RA).Material and methods. The study included 32 adult patients with a confirmed diagnosis of RA, who met ACR/EULAR criteria. All patients had COVID-19. Material for analysis was obtained by means of a questionnaire developed at the V.A. Nasonova Research Institute of Rheumatology, which patients completed during their interview with the researcher.Results and discussion. The study group consisted mainly of women (n=29, 90%). The mean age of the patients was 50.75±16.48 years. Among the clinical manifestations of COVID-19, weakness/fatigue (90.6%; p<0.0001), fever (71.9%; p=0.0005) and anosmia (62.5%; p=0.045) were significantly more common. Almost half of the patients had dysgeusia (59.4%), increased arthralgia (53.1%), dyspnea on exertion (50%), and cough (46.9%). A significant positive association was found between increased arthralgia during COVID-19 and RA activity (r=0.72; p<0.05). Hospitalisation was required in 37.5% of patients with COVID-19. In 12.5% of cases, COVID-19 progressed with complications. Patients with higher RA activity were more likely to have an increase in arthralgia as a symptom of infection. PCS was registered in 47.8% of patients who underwent COVID-19. Retrospective evaluation of patients with PCS revealed a higher rate of hospitalisation in infectious disease departments and a more severe course of COVID-19. Subsequently, repeated cases of COVID-19 were more common in this group.Conclusion. Risk assessment of PCS development is necessary to appropriately distribute the burden on the health care system and to develop a strategy for prevention, timely diagnosis, and treatment of this syndrome in patients with rheumatic diseases. To achieve this goal, new studies in a larger cohort of patients with RA and rheumatic diseases in general are needed.
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