Risks and treatment related aspects of COVID-19 infection in patients with ANCA-associated vasculitis

被引:2
|
作者
Antovic, A. [1 ,2 ]
Bruchfeld, A. [3 ,4 ]
Ekland, J. [5 ]
Lovstrom, B. [1 ,2 ]
Hugelius, A. [1 ,2 ]
Borjesson, O. [1 ,2 ]
Knight, A. [5 ]
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
关键词
REGISTRY;
D O I
10.1080/03009742.2022.2109337
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:418 / 423
页数:6
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