PMID- 33613703
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220420
IS  - 1759-720X (Print)
IS  - 1759-7218 (Electronic)
IS  - 1759-720X (Linking)
VI  - 13
DP  - 2021
TI  - Hospital admissions in inflammatory rheumatic diseases during the peak of 
      COVID-19 pandemic: incidence and role of disease-modifying agents.
PG  - 1759720X20962692
LID - 10.1177/1759720X20962692 [doi]
LID - 1759720X20962692
AB  - AIMS: In this pandemic, it is essential for rheumatologists and patients to know 
      the relationship between COVID-19 and inflammatory rheumatic diseases (IRDs). We 
      wanted to assess the role of targeted synthetic or biologic disease-modifying 
      antirheumatic drugs (ts/bDMARDs) and other variables in the development of 
      moderate-severe COVID-19 disease in IRD. METHODS: An observational longitudinal 
      study was conducted during the epidemic peak in Madrid (1 March to 15 April 
      2020). All patients attended at the rheumatology outpatient clinic of a tertiary 
      hospital in Madrid with a medical diagnosis of IRD were included. Main outcome: 
      hospital admission related to COVID-19. Independent variable: ts/bDMARDs. 
      Covariates: sociodemographic, comorbidities, type of IRD diagnosis, 
      glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), and conventional 
      synthetic disease-modifying antirheumatic drugs (csDMARDs). Incidence rate (IR) 
      of hospital admission related to COVID-19 was expressed per 1000 patient-months. 
      Cox multiple regression analysis was run to examine the influence of ts/bDMARDs 
      and other covariates on IR of hospital admission related to COVID-19. RESULTS: A 
      total of 3951 IRD patients were included (5896 patient-months). Methotrexate was 
      the csDMARD most used. Eight hundred and two patients were on ts/bDMARDs, mainly 
      anti-TNF agents, and Rtx. Hospital admissions related to COVID-19 occurred in 54 
      patients (1.36%) with an IR of 9.15 (95% confidence interval: 7-11.9). In the 
      multivariate analysis, older, male, comorbidities, and specific systemic 
      autoimmune conditions (Sjogren, polychondritis, Raynaud, and mixed connective 
      tissue disease) had more risk of hospital admissions. Exposition to ts/bDMARDs 
      did not achieve statistical significance. Use of glucocorticoids, NSAIDs, and 
      csDMARDs dropped from the final model. CONCLUSION: This study provides additional 
      evidence in IRD patients regarding susceptibility to moderate-severe infection 
      related to COVID-19.
CI  - (c) The Author(s), 2021.
FAU - Fernandez-Gutierrez, Benjamin
AU  - Fernandez-Gutierrez B
AUID- ORCID: 0000-0002-6126-8786
AD  - Rheumatology Department, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Leon, Leticia
AU  - Leon L
AUID- ORCID: 0000-0001-7142-0545
AD  - Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IDISSC), 
      Hospital Clinico San Carlos, Martin Lagos s/n, Madrid, 28040, Spain Universidad 
      Camilo Jose Cela, Madrid, Spain.
FAU - Madrid, Alfredo
AU  - Madrid A
AD  - Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Rodriguez-Rodriguez, Luis
AU  - Rodriguez-Rodriguez L
AD  - Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Freites, Dalifer
AU  - Freites D
AD  - Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Font, Judit
AU  - Font J
AD  - Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Mucientes, Arkaitz
AU  - Mucientes A
AD  - Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Culebras, Esther
AU  - Culebras E
AD  - Microbiology Department, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Colome, Jose Ignacio
AU  - Colome JI
AD  - Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain.
FAU - Jover, Juan Angel
AU  - Jover JA
AD  - Rheumatology Department, Hospital Clinico San Carlos, Madrid, and Medicine 
      Department, Universidad Complutense, Madrid, Spain.
FAU - Abasolo, Lydia
AU  - Abasolo L
AD  - Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain.
LA  - eng
PT  - Journal Article
DEP - 20210204
PL  - England
TA  - Ther Adv Musculoskelet Dis
JT  - Therapeutic advances in musculoskeletal disease
JID - 101517322
PMC - PMC7869066
OTO - NOTNLM
OT  - COVID-19
OT  - autoimmune diseases
OT  - disease-modifying antirheumatic drugs
OT  - rheumatic diseases
COIS- Conflict of interest statement: The authors declare that there is no conflict of 
      interest.
EDAT- 2021/02/23 06:00
MHDA- 2021/02/23 06:01
PMCR- 2021/02/04
CRDT- 2021/02/22 05:54
PHST- 2020/07/03 00:00 [received]
PHST- 2020/09/01 00:00 [accepted]
PHST- 2021/02/22 05:54 [entrez]
PHST- 2021/02/23 06:00 [pubmed]
PHST- 2021/02/23 06:01 [medline]
PHST- 2021/02/04 00:00 [pmc-release]
AID - 10.1177_1759720X20962692 [pii]
AID - 10.1177/1759720X20962692 [doi]
PST - epublish
SO  - Ther Adv Musculoskelet Dis. 2021 Feb 4;13:1759720X20962692. doi: 
      10.1177/1759720X20962692. eCollection 2021.