دورية أكاديمية
Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry).
| العنوان: | Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry). |
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| المؤلفون: | Isnardi CA, Soriano ER; Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires., Graf C; Argentine Society of Rheumatology, Argentina., de la Vega MC; Argentine Society of Rheumatology, Argentina., Pons-Estel BA; Centro Regional de Enfermedades Autoinmunes y Reumáticas, Rosario, Argentina., Roberts K; From the Research Unit., Quintana R; From the Research Unit., Gomez G; From the Research Unit., Yazdany J; Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA., Saurit V; Hospital Privado Universitario de Córdoba, Córdoba, Córdoba., Báez RM; Hospital Francisco López Lima, General Roca, Río Negro., Coello VVC; Sanatorio Güemes., Pisoni CN; Centro de Educación Médica e Investigaciones Clínicas, Ciudad Autónoma de Buenos Aires., Berbotto G, Vivero F; Hospital Privado de Comunidad, Mar del Plata, Buenos Aires., Zelaya MD; Hospital de Agudos Ramos Mejía, Ciudad Autónoma de Buenos Aires., Haye Salinas MJ; CEMMA, Universidad Nacional de La Rioja, La Rioja., Reyes Torres ÁA; Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires., Ornella S; HIGA San Martín de la Plata, La Plata, Buenos Aires., Nieto RE, Maldonado FN; Sanatorio Güemes., Gamba MJ; Hospital Nacional Alejandro Posadas, El Palomar, Buenos Aires., Severina MLÁ; Centro Privado de Medicina Nuclear and Clinica Villa Dalcar, Río Cuarto., Tissera Y; Hospital Córdoba, Córdoba., Alba P, Cogo AK, Alle G; Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires., Gobbi C; Cátedra de Clínica Médica I, Hospital Córdoba, FCM, UNC, Córdoba, Córdoba., Baños A, Velozo E; Sanatorio Adventista del Plata, Libertador San Martín, Entre Ríos., Pera M; Hospital Ángel C Padilla, San Miguel de Tucumán, Tucumán., Tanten R; Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires., Albiero JA, Maldonado Ficco H, Martire MV; Hospital San Roque, La Plata, Buenos Aires., Elkin MSG; Instituto de Cardiología, Santiago del Estero, Santiago del Estero., Cosatti M; Centro de Educación Médica e Investigaciones Clínicas, Ciudad Autónoma de Buenos Aires., Cusa MA; MR-Medicina Reumatológica, San Fernando, Buenos Aires., Pereira D; Raquis, La Plata, Buenos Aires., Savio VG, Pons-Estel GJ; From the Research Unit. |
| المصدر: | Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases [J Clin Rheumatol] 2023 Mar 01; Vol. 29 (2), pp. 68-77. Date of Electronic Publication: 2022 Nov 30. |
| نوع المنشور: | Multicenter Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9518034 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-7355 (Electronic) Linking ISSN: 10761608 NLM ISO Abbreviation: J Clin Rheumatol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Philadelphia, PA : Lippincott Williams & Wilkins Original Publication: Baltimore, MD : Williams & Wilkins, c1995- |
| مواضيع طبية MeSH: | COVID-19*/complications , Arthritis, Rheumatoid*/drug therapy, Adult ; Humans ; SARS-CoV-2 ; Immunomodulating Agents ; Immunosuppressive Agents/therapeutic use ; Registries |
| مستخلص: | Background/objective: This study describes the impact of immunomodulatory and/or immunosuppressive (IM/IS) drugs in the outcomes of COVID-19 infection in a cohort of patients with immune-mediated inflammatory diseases (IMIDs). Methods: Adult patients with IMIDs with a confirmed SARS-CoV-2 infection were included. Data were reported by the treating physician between August 13, 2020 and July 31, 2021. Sociodemographic data, comorbidities, and DMARDs, as well as clinical characteristics, complications, and treatment of the SARS-CoV-2 infection, were recorded. Descriptive analysis and multivariable logistic regression models were carried out. Results: A total of 1672 patients with IMIDs were included, of whom 1402 were treated with IM/IS drugs. The most frequent diseases were rheumatoid arthritis (47.7%) and systemic lupus erythematosus (18.4%). COVID-19 symptoms were present in 95.2% of the patients. A total of 461 (27.6%) patients were hospitalized, 8.2% were admitted to the intensive care unit, and 4.4% died due to COVID-19.Patients without IM/IS treatment used glucocorticoids less frequently but at higher doses, had higher levels of disease activity, were significantly older, were more frequently hospitalized, admitted to the intensive care unit, and died due to COVID-19. After adjusting for these factors, treatment with IM/IS drugs was not associated with a worse COVID-19 outcome (World Health Organization-Ordinal Scale ≥5) (odds ratio, 1.24; 95% confidence interval, 0.73-2.06). Conclusions: SAR-COVID is the first multicenter Argentine registry collecting data from patients with rheumatic diseases and SARS-CoV-2 infection. After adjusting for relevant covariates, treatment with IM/IS drugs was not associated with severe COVID-19 in patients with IMIDs. Study Registration: This study has been registered in ClinicalTrials.gov under the number NCT04568421. Competing Interests: Conflicts of interest: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SAR-COVID is a multisponsor registry, where Pfizer, Abbvie, and Elea Phoenix had provided unrestricted grants. None of them has participated or influenced the development of the project, data collection, analysis, and interpretation, or the drafting of this report. They do not have access to the information collected in the database. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.) |
| References: | Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med . 2020;382:1708–1720. World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020 [Web site]. March 11, 2020. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 . Accessed August 1, 2020. Ministerio de Salud, Argentina. Reporte de situación COVID-19. [Web site]. January 31, 2022. Available at: https://www.argentina.gob.ar/salud/coronavirus-COVID-19/informacion-epidemiologica/enero-2022 . Accessed January 25, 2021. Furst DE. The risk of infections with biologic therapies for rheumatoid arthritis. Semin Arthritis Rheum . 2010;39:327–346. Favalli EG, Ingegnoli F, De Lucia O, et al. COVID-19 infection and rheumatoid arthritis: faraway, so close! Autoimmun Rev . 2020;19:102523. Schönfeld D, Arias S, Bossio JC, et al. Clinical presentation and outcomes of the first patients with COVID-19 in Argentina: results of 207079 cases from a national database. PLoS One . 2021;16:e0246793. Santos CS, Morales CM, Álvarez ED, et al. Determinants of COVID-19 disease severity in patients with underlying rheumatic disease. Clin Rheumatol . 2020;39:2789–2796. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet . 2020;395:1033–1034. Sarzi-Puttini P, Giorgi V, Sirotti S, et al. COVID-19, cytokines and immunosuppression: what can we learn from severe acute respiratory syndrome? Clin Exp Rheumatol . 2020;38:337–342. Strangfeld A, Schäfer M, Gianfrancesco MA, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis . 2021;80:930–942. Gianfrancesco M, Hyrich KL, Al-Adely S, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance Physician-reported registry. Ann Rheum Dis . 2020;79:859–866. Liew JW, Bhana S, Costello W, et al. The COVID-19 Global Rheumatology Alliance: evaluating the rapid design and implementation of an international registry against best practice. Rheumatology (Oxford) . 2021;60:353–358. Wallace ZS, Bhana S, Hausmann JS, et al. The rheumatology community responds to the COVID-19 pandemic: the establishment of the COVID-19 Global Rheumatology Alliance. Rheumatology (Oxford) . 2020;59:1204–1206. Méndez H. Sociedad y Estratificación. Método Graffar-Méndez Castellano . Caracas, Venezuela: Fundacredesa; 1994. Fajgenbaum DC, June CH. Cytokine Storm. N Engl J Med . 2020;383:2255–2273. World Health Organization. [Web site]. November 20, 2020. Publication February 18, 2020. Available at: https://www.who.int/blueprint/priority-diseases/key-action/COVID-19_Treatment_Trial_Design_Master_Protocol_synopsis_Final_18022020.pdf . Accessed November 20, 2020. Ministerio de Salud de la Nación. [Web site]. January 10, 2021. Publication January 10, 2021. Available at: https://www.argentina.gob.ar/coronavirus/vacuna/cuales . Accessed February 15, 2021. Herdman M, Fox-Rushby J, Rabin R, et al. Producing other language versions of the EQ-5D. In: Brooks R, Rabin R, Charro F, editors. The Measurement and Valuation of Health Status Using EQ-5D: A EUROPEAN perspective. Dordrecht, the Netherlands: Kluwer Academic Publishers; 2003. Citera G, Arriola MS, Maldonado-Cocco JA, et al. Validation and crosscultural adaptation of an Argentine Spanish version of the health assessment questionnaire disability index. J Clin Rheumatol . 2004;10:110–115. National Institute for Health and Care Excellence (NICE). COVID-19 rapid guideline: managing the long-term effects of COVID-19 [Web site]. December 18, 2020. Publication December 18, 2020. Available at: https://www.nice.org.uk/guidance/ng188 . Accessed April 22, 2021. Andersen KM, Bates BA, Rashidi ES, et al. Long-term use of immunosuppressive medicines and in-hospital COVID-19 outcomes: a retrospective cohort study using data from the national COVID cohort collaborative. Lancet Rheumatol . 2022;4:e33–e41. Rommasi F, Nasiri MJ, Mirsaeidi M. Immunomodulatory agents for COVID-19 treatment: possible mechanism of action and immunopathology features. Mol Cell Biochem . 2022;477:711–726. Sparks JA, Wallace ZS, Seet AM, et al. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: results from the COVID-19 Global Rheumatology Alliance physician registry. Ann Rheum Dis . 2021;80:1137–1146. Sattui SE, Conway R, Putman MS, et al. Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study. Lancet Rheumatol . 2021;3:e855–e864. Ugarte-Gil MF, Alarcón GS, Izadi Z, et al. Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance. Ann Rheum Dis . 2022;81:970–978. Izadi Z, Brenner EJ, Mahil SK, et al. Association between tumor necrosis factor inhibitors and the risk of hospitalization or death among patients with immune-mediated inflammatory disease and COVID-19. JAMA Netw Open . 2021;4:e2129639. Marques C, Kakehasi AM, Gomides APM, et al. A Brazilian cohort of patients with immuno-mediated chronic inflammatory diseases infected by SARS-CoV-2 (ReumaCoV-Brasil registry): protocol for a prospective, observational study. JMIR Res Protoc . 2020;9:e24357. Marques CDL, Kakehasi AM, Pinheiro MM, et al. High levels of immunosuppression are related to unfavourable outcomes in hospitalised patients with rheumatic diseases and COVID-19: first results of ReumaCoV Brasil registry. RMD Open . 2021;7:e001461. Ugarte-Gil MF, Marques CDL, Alpizar-Rodriguez D, et al. Characteristics associated with Covid-19 in patients with rheumatic disease in Latin America: data from the Covid-19 Global Rheumatology Alliance physician-reported registry. Publication September 15, 2020. Available at: https://www.globalrheumpanlar.org/node/254 . Accessed November 20, 2020. Esatoglu SN, Tascilar K, Babaoğlu H, et al. COVID-19 among patients with inflammatory rheumatic diseases. Front Immunol . 2021;12:651715. Lévesque LE, Hanley JA, Kezouh A, et al. Problem of immortal time bias in cohort studies: example using statins for preventing progression of diabetes. BMJ . 2010;340:b5087. |
| سلسلة جزيئية: | ClinicalTrials.gov NCT04568421 |
| المشرفين على المادة: | 0 (Immunomodulating Agents) 0 (Immunosuppressive Agents) |
| تواريخ الأحداث: | Date Created: 20221201 Date Completed: 20230224 Latest Revision: 20240302 |
| رمز التحديث: | 20240302 |
| مُعرف محوري في PubMed: | PMC9940788 |
| DOI: | 10.1097/RHU.0000000000001903 |
| PMID: | 36454054 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1536-7355 |
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| DOI: | 10.1097/RHU.0000000000001903 |