Risks and treatment related aspects of COVID-19 infection in patients with ANCA-associated vasculitis
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作者:
Antovic, A.
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Karolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Karolinska Univ Hosp, Unit Rheumatol, Stockholm, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Antovic, A.
[1
,2
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Bruchfeld, A.
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机构:
Linkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Karolinska Univ Hosp, Dept Renal Med, CLINTEC, Karolinska Inst, Stockholm, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Bruchfeld, A.
[3
,4
]
Ekland, J.
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机构:
Uppsala Univ, Dept Med Sci, Rheumatol, Uppsala, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Ekland, J.
[5
]
Lovstrom, B.
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机构:
Karolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Karolinska Univ Hosp, Unit Rheumatol, Stockholm, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Lovstrom, B.
[1
,2
]
Hugelius, A.
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Karolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Karolinska Univ Hosp, Unit Rheumatol, Stockholm, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Hugelius, A.
[1
,2
]
Borjesson, O.
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机构:
Karolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Karolinska Univ Hosp, Unit Rheumatol, Stockholm, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Borjesson, O.
[1
,2
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Knight, A.
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机构:
Uppsala Univ, Dept Med Sci, Rheumatol, Uppsala, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Knight, A.
[5
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Gunnarsson, I
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机构:
Karolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Karolinska Univ Hosp, Unit Rheumatol, Stockholm, SwedenKarolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
Gunnarsson, I
[1
,2
]
机构:
[1] Karolinska Inst, Dept Med, Div Rheumatol, Solna, Sweden
[2] Karolinska Univ Hosp, Unit Rheumatol, Stockholm, Sweden
[3] Linkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
[4] Karolinska Univ Hosp, Dept Renal Med, CLINTEC, Karolinska Inst, Stockholm, Sweden
[5] Uppsala Univ, Dept Med Sci, Rheumatol, Uppsala, Sweden
Objective Patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) require immunosuppressive therapy for disease control and relapse prevention and may be at risk for severe coronavirus disease 2019 (COVID-19). The study objective was to analyse risk factors and outcomes of COVID-19 in well-characterized AAV patients. Method Data were retrieved from March 2020 to May 2021 from medical records of AAV cohorts in Stockholm and Uppsala, Sweden. COVID-19 was confirmed by positive PCR test or by ELISA. Severe COVID-19 was defined as need for non-invasive ventilation, intensive care unit care, and/or death. Age, gender, ANCA antibody type, ongoing immunosuppressive medication, and estimated glomerular filtration rate were recorded. Results The cohort comprised 310 AAV patients, of whom 29 (9%) were diagnosed with COVID-19. Four deaths were attributed to COVID-19. Fifteen patients (52%) were on prednisolone in the COVID-19 group and 130 (46%) in the non-COVID group, with significantly higher doses in COVID-19 patients (p < 0.01). Ongoing induction therapy was more prevalent in the COVID-19 group (p < 0.01). Severe COVID-19 was diagnosed in 9/29 (31%). Significant risk factors for severe COVID-19 were impaired kidney function (p = 0.01) and more intense immunosuppressive therapy (p = 0.02), with a trend for age (p = 0.07). Maintenance therapy with rituximab was not associated with severe COVID-19. Conclusions Our findings highlight risks and suggest that more attention should be given to optimal AAV treatment in a pandemic situation. They also emphasize the need for continued shielding, mitigation strategies, and effective vaccination of AAV patients.
机构:
Univ Alabama Birmingham, Div Rheumatol, Dept Pediat, Childrens Alabama, 1600 7th Ave S CPPN G10, Birmingham, AL 35233 USAUniv Alabama Birmingham, Div Rheumatol, Dept Pediat, Childrens Alabama, 1600 7th Ave S CPPN G10, Birmingham, AL 35233 USA
Reiff, Daniel D.
Meyer, Chloe G.
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Univ Alabama Birmingham, UAB Pediat Residency Program, Birmingham, AL USAUniv Alabama Birmingham, Div Rheumatol, Dept Pediat, Childrens Alabama, 1600 7th Ave S CPPN G10, Birmingham, AL 35233 USA
Meyer, Chloe G.
Marlin, Brittany
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Univ Alabama Birmingham, Dept Pediat, Div Pediat Hosp Med, Birmingham, AL USAUniv Alabama Birmingham, Div Rheumatol, Dept Pediat, Childrens Alabama, 1600 7th Ave S CPPN G10, Birmingham, AL 35233 USA
Marlin, Brittany
Mannion, Melissa L.
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Univ Alabama Birmingham, Div Rheumatol, Dept Pediat, Childrens Alabama, 1600 7th Ave S CPPN G10, Birmingham, AL 35233 USAUniv Alabama Birmingham, Div Rheumatol, Dept Pediat, Childrens Alabama, 1600 7th Ave S CPPN G10, Birmingham, AL 35233 USA
机构:
Brown Univ, Warren Alpert Med Sch, Div Kidney Dis & Hypertens, Providence, RI USABrown Univ, Warren Alpert Med Sch, Div Kidney Dis & Hypertens, Providence, RI USA
Shakoor, Muhammad Tariq
Birkenbach, Mark P.
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Brown Univ, Warren Alpert Med Sch, Dept Pathol, Providence, RI USABrown Univ, Warren Alpert Med Sch, Div Kidney Dis & Hypertens, Providence, RI USA
Birkenbach, Mark P.
Lynch, Matthew
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Brown Univ, Warren Alpert Med Sch, Div Kidney Dis & Hypertens, Providence, RI USABrown Univ, Warren Alpert Med Sch, Div Kidney Dis & Hypertens, Providence, RI USA
机构:
Linkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Karolinska Univ Hosp, Dept Renal Med, Stockholm, Sweden
CLINTEC Karolinska Inst, Stockholm, SwedenLinkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Bruchfeld, Annette
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Kronbichler, Andreas
Alberici, Federico
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Univ Brescia, Dept Med & Surg Specialties, Radiol Sci & Publ Hlth, Brescia, Italy
ASST Spedali Civili Brescia, Nephrol Unit, Spedali Civili Hosp, Brescia, ItalyLinkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Alberici, Federico
Fervenza, Fernando C.
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机构:
Mayo Clin, Div Nephrol & Hypertens, Rochester, MN USALinkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Fervenza, Fernando C.
Jayne, David R. W.
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Univ Cambridge, Dept Med, Cambridge, EnglandLinkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Jayne, David R. W.
Segelmark, Marten
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机构:
Lund Univ, Dept Clin Sci Lund, Nephrol, Lund, SwedenLinkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Segelmark, Marten
Tesar, Vladimir
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机构:
Charles Univ Prague, Fac Med 1, Dept Nephrol, Prague, Czech Republic
Gen Univ Hosp Prague, Prague, Czech RepublicLinkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden
Tesar, Vladimir
Szpirt, Wladimir M.
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Univ Copenhagen, Rigshosp, Dept Nephrol, Copenhagen, DenmarkLinkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden