Renaud Felten1,2, Marc Scherlinger1,2, Jacques-Eric Gottenberg1,2, Jean Sibilia1,2, Thierry Martin2,3, Laurent Arnaud4,5, Aurélien Guffroy2,3, Vincent Poindron2,3, Alain Meyer1,2,6, Margherita Giannini2,6, Anne-Sophie Korganow2,3, Christelle Sordet1,2, Emmanuel Chatelus1,2, Rose-Marie Javier1,2, Aurore Meyer2,3, Luc Pijnenburg1,2, Jean-François Kleinmann1,2. 1. Service de rhumatologie, Service de rhumatologie, Hôpitaux Universitaires de Strasbourg et Université de Strasbourg, 1 avenue Molière BP 83049, 67098, Strasbourg cedex, France. 2. Centre National de Référence des Maladies Auto-Immunes Systémiques Rares Est Sud-Ouest (RESO), Strasbourg, France. 3. Service d'immunologie clinique et médecine interne, Hôpitaux Universitaires de Strasbourg et Université de Strasbourg, Strasbourg, France. 4. Service de rhumatologie, Service de rhumatologie, Hôpitaux Universitaires de Strasbourg et Université de Strasbourg, 1 avenue Molière BP 83049, 67098, Strasbourg cedex, France. laurent.arnaud@chru-strasbourg.fr. 5. Centre National de Référence des Maladies Auto-Immunes Systémiques Rares Est Sud-Ouest (RESO), Strasbourg, France. laurent.arnaud@chru-strasbourg.fr. 6. Service de physiologie et explorations fonctionnelles, Hôpitaux Universitaires de Strasbourg et Université de Strasbourg, Strasbourg, France.
Abstract
BACKGROUND: The risk of severe COVID-19 and its determinants remain largely unknown in patients with autoimmune and inflammatory rheumatic diseases. The objective of this study was to assess the prevalence of COVID-19 infection in patients followed for rare autoimmune diseases as well as the predictors of COVID-19 and disease flare-ups. METHODS: Cross-sectional phone survey from April 9, 2020, to July 2, 2020, during which patients with autoimmune diseases followed at the National Reference Center for Rare Autoimmune diseases of Strasbourg were systematically contacted by phone and sent a prescription for a SARS-CoV-2 serology. RESULTS: One thousand two hundred thirty-two patients were contacted. One thousand fifty-five patients with a confirmed diagnosis of systemic autoimmune disease were included (4 unreachable, 4 moves abroad, 5 deaths before pandemic, 50 without consent, and 114 without autoimmune disease). Among them, 469 (44.5%) patients were tested for SARS-CoV-2 serology. Thirty-nine patients (7.9%) had SARS-CoV-2 infection (either through chest CT-scan [n = 5], RT-PCR on nasopharyngeal swab [n = 14], or serology [n = 31]) among the 496 who underwent at least one of those 3 diagnosis modalities. Of the 39 proven cases, 33 had clinical manifestations (6 asymptomatic patients were diagnosed through systematic serology testing), 31 were managed by home care, 3 were hospitalized due to a need for oxygenation, two required admission to an intensive care unit, and one died. Among patients with confirmed SARS-CoV-2 infection, reported flares were more frequent than in uninfected patients (26.3% [10/38] vs. 7.0% [32/457], p < 0.0001). Preventive sick leave had no significant impact on the prevalence of SARS-CoV-2 infection (5.8% [3/53]) compared to work continuation (7.6% [30/397], p = 0.64). Overall, the seroprevalence of SARS-CoV-2 was 6.6% (31/469) which was numerically lower to the Grand-Est general population estimated to be 9.0%. CONCLUSIONS: This systematic survey of more than 1000 patients with rare systemic autoimmune diseases reports a low prevalence of proven SARS-CoV-2 infection and very rare severe infections, probably related to good compliance with prophylactic measures in these patients.
BACKGROUND: The risk of severe COVID-19 and its determinants remain largely unknown in patients with autoimmune and inflammatory rheumatic diseases. The objective of this study was to assess the prevalence of COVID-19infection in patients followed for rare autoimmune diseases as well as the predictors of COVID-19 and disease flare-ups. METHODS: Cross-sectional phone survey from April 9, 2020, to July 2, 2020, during which patients with autoimmune diseases followed at the National Reference Center for Rare Autoimmune diseases of Strasbourg were systematically contacted by phone and sent a prescription for a SARS-CoV-2 serology. RESULTS: One thousand two hundred thirty-two patients were contacted. One thousand fifty-five patients with a confirmed diagnosis of systemic autoimmune disease were included (4 unreachable, 4 moves abroad, 5 deaths before pandemic, 50 without consent, and 114 without autoimmune disease). Among them, 469 (44.5%) patients were tested for SARS-CoV-2 serology. Thirty-nine patients (7.9%) had SARS-CoV-2 infection (either through chest CT-scan [n = 5], RT-PCR on nasopharyngeal swab [n = 14], or serology [n = 31]) among the 496 who underwent at least one of those 3 diagnosis modalities. Of the 39 proven cases, 33 had clinical manifestations (6 asymptomatic patients were diagnosed through systematic serology testing), 31 were managed by home care, 3 were hospitalized due to a need for oxygenation, two required admission to an intensive care unit, and one died. Among patients with confirmed SARS-CoV-2 infection, reported flares were more frequent than in uninfected patients (26.3% [10/38] vs. 7.0% [32/457], p < 0.0001). Preventive sick leave had no significant impact on the prevalence of SARS-CoV-2 infection (5.8% [3/53]) compared to work continuation (7.6% [30/397], p = 0.64). Overall, the seroprevalence of SARS-CoV-2 was 6.6% (31/469) which was numerically lower to the Grand-Est general population estimated to be 9.0%. CONCLUSIONS: This systematic survey of more than 1000 patients with rare systemic autoimmune diseases reports a low prevalence of proven SARS-CoV-2 infection and very rare severe infections, probably related to good compliance with prophylactic measures in these patients.
Authors: Robert Bm Landewé; Pedro M Machado; Féline Kroon; Hans Wj Bijlsma; Gerd R Burmester; Loreto Carmona; Bernard Combe; Massimo Galli; Laure Gossec; Annamaria Iagnocco; John D Isaacs; Xavier Mariette; Iain McInnes; Ulf Mueller-Ladner; Peter Openshaw; Josef S Smolen; Tanja A Stamm; Dieter Wiek; Hendrik Schulze-Koops Journal: Ann Rheum Dis Date: 2020-06-05 Impact factor: 27.973
Authors: Lisa G Rider; Christine G Parks; Jesse Wilkerson; Adam I Schiffenbauer; Richard K Kwok; Payam Noroozi Farhadi; Sarvar Nazir; Rebecca Ritter; Emily Sirotich; Kevin Kennedy; Maggie J Larche; Mitchell Levine; Sebastian E Sattui; Jean W Liew; Carly O Harrison; Tarin T Moni; Aubrey K Miller; Michael Putman; Jonathan Hausmann; Julia F Simard; Jeffrey A Sparks; Frederick W Miller Journal: Rheumatology (Oxford) Date: 2022-06-28 Impact factor: 7.046