Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave.
Ferri, C., Giuggioli, D., Raimondo, V., L'Andolina, M., Dagna, L., Tavoni, A., Caso, F., Ursini, F., Ruscitti, P., Caminiti, M., Foti, R., Riccieri, V., Guiducci, S., Pellegrini, R., Zanatta, E., Varcasia, G., Olivo, D., Gigliotti, P., Cuomo, G., Murdaca, G., Cecchetti, R., De Angelis, R., Romeo, N., Ingegnoli, F., Cozzi, F., Codullo, V., Cavazzana, I., Colaci, M., Abignano, G., De Santis, M., Lubrano, E., Fusaro, E., Rossa, A. D., Spinella, A., Lumetti, F., De Luca, G., Bellando-Randone, S., Visalli, E., Dal Bosco, Y., Amato, G., Giannini, D., Bilia, S., Masini, F., Pellegrino, G., Pigatto, E., Generali, E., Mariano, G. P., Pettiti, G., Zanframundo, G., Brittelli, R., Aiello, V., Caminiti, R., Scorpiniti, D., Ferrari, T., Campochiaro, C., Brusi, V., Fredi, M., Moschetti, L., Cacciapaglia, F., Gragnani, L., Monti, M., Lorini, S., Paparo, S. R., Ragusa, F., Mazzi, V., Elia, G., Ferrari, S. M., Di Cola, I., Vadacca, M., Lorusso, S., Barsotti, S., Aprile, M. L., Marco, T., Miccoli, M., Bosello, S. L., Matucci-Cerinic, M., D'Angelo, S., Doria, A., Franceschini, F., Meliconi, R., Iannone, F., Giacomelli, R., Zignego, A. L., Fallahi, P., Antonelli, A., Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments, <<CURRENT PHARMACEUTICAL DESIGN>>, 2021; 27 (41): 4245-4252. [doi:10.2174/1381612827666210903103935] [https://hdl.handle.net/10807/237794]
Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments
Bosello, Silvia Laura;D'Angelo, Salvatore;
2021
Abstract
Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave.
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