1
|
Hasseli R, Regierer AC, Strangfeld A, Pfeil A. [The German COVID-19 rheumatism register]. Z Rheumatol 2024:10.1007/s00393-024-01516-9. [PMID: 38816582 DOI: 10.1007/s00393-024-01516-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 06/01/2024]
Abstract
At the beginning of the coronavirus disease 2019 (COVID-19) pandemic in December 2019 there was no available evidence regarding the management of immunosuppressive or immunomodulatory treatment and the potential outcomes of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections in inflammatory rheumatic diseases (IRD). As a result, the Justus Liebig University of Giessen, Germany, in collaboration with the German Society for Rheumatology, established the German COVID-19 register ( www.covid19-rheuma.de ). The COVID-19 register enabled for the first time a systematic documentation and evaluation of viral infections in patients with IRD. The data collection started as early as March 2020. Currently, the register is one of the largest global registers in the field of COVID-19 and IRD. As of 18 December 2023 the register has recorded more than 7100 cases. The first scientific findings on SARS-CoV‑2 infections in IRD patients were generated from the register in 2020, showing an association between disease activity of IRD, certain comorbidities, such as cardiovascular diseases and treatment with rituximab, with an unfavorable course. The contents and construction of the database of the register were designed at the conception to allow collaboration and data exchange with other national and international registers (e.g., EULAR COVID-19 register, COVID-19 global rheumatology alliance and the Lean European open survey on SARS-CoV‑2 infected patients). In addition, other registers and surveys were initiated. A vaccination register documents the tolerability and possible adverse reactions to COVID-19 vaccination in IRD patients. The data resulted in numerous publications and formed the basis for national and international recommendations for action in the care and vaccination of IRD patients during the COVID-19 pandemic. In summary, the German COVID-19 register has made a significant contribution to the understanding of the course of COVID-19 in IRD patients and has facilitated international collaboration for a better understanding of COVID-19 and IRD.
Collapse
Affiliation(s)
- Rebecca Hasseli
- Medizinische Klinik D, Sektion für Rheumatologie und Klinische Immunologie, Abteilung für Translationale Rheumatologie und Immunologie, Institut für Muskuloskelettale Medizin (IMM), Universitätsklinikum Münster, Münster, Deutschland.
- Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Campus Kerckhoff, Bad Nauheim, Deutschland.
| | - Anne C Regierer
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum, Berlin, Deutschland
| | - Anja Strangfeld
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum, Berlin, Deutschland
| | - Alexander Pfeil
- Funktionsbereich Rheumatologie und Osteologie, Klinik für Innere Medizin III, Universitätsklinikum Jena, Jena, Deutschland
| |
Collapse
|
2
|
Perrot L, Boyer L, Flipo RM, Marotte H, Pertuiset E, Miceli C, Thomas T, Seror R, Chazerain P, Roux N, Richez C, Pham T. Factors associated with COVID-19 severity in patients with spondyloarthritis: Results of the French RMD COVID-19 cohort. Joint Bone Spine 2023; 90:105608. [PMID: 37414137 DOI: 10.1016/j.jbspin.2023.105608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/15/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES The objective of the current study was to evaluate the severity of COVID-19 and identify factors associated with severe disease outcomes in patients with spondyloarthritis (SpA), a chronic inflammatory rheumatic and musculoskeletal disease (RMD). METHODS We utilized patient data from the French national multicenter RMD COVID-19 cohort (NCT04353609). The primary outcome was to describe COVID-19 characteristics in patients with SpA based on disease severity of COVID-19 (mild, moderate or severe) with serious infection including moderate and severe cases. The secondary outcome was to identify the factors associated with serious COVID-19 classification. RESULTS Among the 626 patients with SpA (56% female, mean age 49±14 years) from the French RMD cohort, COVID-19 severity was mild in 508 (81%), moderate in 93 (15%), and severe in 25 (4%) patients. Clinical signs and symptoms of COVID-19 were reported in 587 (94%) patients, with the most frequent presented symptom of fever (63%) and cough (62%), followed by flu-like symptoms (53%), agueusia (39%), anosmia (37%), dyspnea (32%) and diarrhea (19.9%). COVID-19 severity was associated with corticosteroid therapy (OR=3.08 [95% CI: 1.44-6.58], P=0.004) and age (OR=1.06 [95% CI: 1.04-1.08], P<0.001) while use of tumor necrosis factor inhibitor (TNFi, OR=0.27 [95% CI: 0.09-0.78], P=0.01) was associated with less severe disease. We did not identify an association between NSAID use and COVID-19 severity. CONCLUSIONS In this study, the majority of patients with SpA had a favorable COVID-19 outcome. We confirmed age and corticosteroids therapy had a negative impact on disease outcomes while TNFi use was protective.
Collapse
Affiliation(s)
- Léa Perrot
- Department of Rheumatology, Aix-Marseille université, AP-HM, CHU de Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - Laurent Boyer
- School of Medicine, La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of life Center, Aix-Marseille université, Marseille, France
| | - René-Marc Flipo
- Department of Rheumatology, université de Lille, CHU de Lille, Lille, France
| | - Hubert Marotte
- Department of Rheumatology, Inserm U1059, université de Lyon, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - Edouard Pertuiset
- Department of Rheumatology, centre hospitalier René-Dubos, Pontoise, France
| | - Corinne Miceli
- Department of Rheumatology, Cochin Hospital, AP-HP, Paris University, Paris, France
| | - Thierry Thomas
- Department of Rheumatology, Inserm U1059, université de Lyon, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - Raphaele Seror
- Department of Rheumatology, CHU Le Kremlin-Bicêtre, AP-HP, Inserm UMR 1184, université Paris-Sud, Paris, France
| | - Pascal Chazerain
- Department of Rheumatology, groupe hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Nicolas Roux
- Department of Rheumatology, hôpital Robert-Schuman, Metz, France
| | - Christophe Richez
- Rheumatology Department, ImmunoConcEpt, CNRS, UMR 5164, University of Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Thao Pham
- Department of Rheumatology, Aix-Marseille université, AP-HM, CHU de Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
| |
Collapse
|
3
|
Erdes SF, Belov BS. Axial spondyloarthritis and COVID-19: course, interactions, outcomes, and the role of vaccination. MODERN RHEUMATOLOGY JOURNAL 2023. [DOI: 10.14412/1996-7012-2023-1-101-107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The review analyzes data on the course and outcomes of axial spondyloarthritis (axSpA) accumulated over the previous 2.5 years of the COVID-19 pandemic. The issues of clinical and immunological efficacy of vaccination against COVID-19 in this disease are considered. It was noted that the presence of axSpA, as well as treatment with tumor necrosis factor-á inhibitors and non-steroidal anti-inflammatory drugs, did not significantly increase the risk of COVID-19 infection and did not worsen its outcomes, apart from an increase in the incidence of venous thromboembolism. At the same time, it is assumed that anticytokine therapy for SpA may protect against severe COVID-19 course.The data presented suggest that the benefits of vaccination in SpA far outweigh the potential harms associated with the development of adverse events. It has been shown that in patients with SpA, vaccination does not affect the activity of the inflammatory process, and biologic disease modifying antirheumatic drugs have almost no significant effect on the post-vaccination response.
Collapse
Affiliation(s)
- Sh. F. Erdes
- V.A. Nasonova Research Institute of Rheumatology
| | - B. S. Belov
- V.A. Nasonova Research Institute of Rheumatology
| |
Collapse
|
4
|
Izadi Z, Gianfrancesco MA, Aguirre A, Strangfeld A, Mateus EF, Hyrich KL, Gossec L, Carmona L, Lawson‐Tovey S, Kearsley‐Fleet L, Schaefer M, Seet AM, Schmajuk G, Jacobsohn L, Katz P, Rush S, Al‐Emadi S, Sparks JA, Hsu TY, Patel NJ, Wise L, Gilbert E, Duarte‐García A, Valenzuela‐Almada MO, Ugarte‐Gil MF, Ribeiro SLE, de Oliveira Marinho A, de Azevedo Valadares LD, Giuseppe DD, Hasseli R, Richter JG, Pfeil A, Schmeiser T, Isnardi CA, Reyes Torres AA, Alle G, Saurit V, Zanetti A, Carrara G, Labreuche J, Barnetche T, Herasse M, Plassart S, Santos MJ, Rodrigues AM, Robinson PC, Machado PM, Sirotich E, Liew JW, Hausmann JS, Sufka P, Grainger R, Bhana S, Costello W, Wallace ZS, Yazdany J. Development of a Prediction Model for COVID-19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry. ACR Open Rheumatol 2022; 4:872-882. [PMID: 35869686 PMCID: PMC9350083 DOI: 10.1002/acr2.11481] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Some patients with rheumatic diseases might be at higher risk for coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS). We aimed to develop a prediction model for COVID-19 ARDS in this population and to create a simple risk score calculator for use in clinical settings. METHODS Data were derived from the COVID-19 Global Rheumatology Alliance Registry from March 24, 2020, to May 12, 2021. Seven machine learning classifiers were trained on ARDS outcomes using 83 variables obtained at COVID-19 diagnosis. Predictive performance was assessed in a US test set and was validated in patients from four countries with independent registries using area under the curve (AUC), accuracy, sensitivity, and specificity. A simple risk score calculator was developed using a regression model incorporating the most influential predictors from the best performing classifier. RESULTS The study included 8633 patients from 74 countries, of whom 523 (6%) had ARDS. Gradient boosting had the highest mean AUC (0.78; 95% confidence interval [CI]: 0.67-0.88) and was considered the top performing classifier. Ten predictors were identified as key risk factors and were included in a regression model. The regression model that predicted ARDS with 71% (95% CI: 61%-83%) sensitivity in the test set, and with sensitivities ranging from 61% to 80% in countries with independent registries, was used to develop the risk score calculator. CONCLUSION We were able to predict ARDS with good sensitivity using information readily available at COVID-19 diagnosis. The proposed risk score calculator has the potential to guide risk stratification for treatments, such as monoclonal antibodies, that have potential to reduce COVID-19 disease progression.
Collapse
Affiliation(s)
| | | | | | | | - Elsa F. Mateus
- Portuguese League Against Rheumatic DiseasesLisbonPortugal
| | - Kimme L. Hyrich
- The University of Manchester and National Institute for Health Research Manchester Biomedical Research Centre, Manchester University and NHS Foundation TrustManchesterUK
| | - Laure Gossec
- INSERM, Sorbonne Universite and Hopital Universitaire Pitie Salpetriere, AP‐HPParisFrance
| | | | - Saskia Lawson‐Tovey
- The University of Manchester and National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust and Manchester Academic Health Science CentreManchesterUK
| | - Lianne Kearsley‐Fleet
- The University of Manchester and Manchester Academic Health Science CentreManchesterUK
| | | | | | - Gabriela Schmajuk
- University of CaliforniaSan Francisco and San Francisco Department of Veterans Affairs Medical Center
| | | | | | | | | | - Jeffrey A. Sparks
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | - Tiffany Y‐T Hsu
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | - Naomi J. Patel
- Massachusetts General Hospital and Harvard Medical SchoolBoston
| | - Leanna Wise
- University of Southern CaliforniaLos Angeles
| | | | | | | | - Manuel F. Ugarte‐Gil
- Universidad Científica del Sur and Hospital Nacional Guillermo Almenara IrigoyenEsSalud, LimaPeru
| | | | | | | | | | - Rebecca Hasseli
- Justus‐Liebig University Giessen, Campus KerckhoffGiessenGermany
| | | | - Alexander Pfeil
- Jena University Hospital and Friedrich Schiller University JenaJenaGermany
| | - Tim Schmeiser
- Rheumatology im Veedel (Private Practice)CologneGermany
| | | | | | | | | | - Anna Zanetti
- Italian Society for Rheumatology and University of Milano‐BicoccaMilanItaly
| | - Greta Carrara
- Italian Society for Rheumatology and University of Milano‐BicoccaMilanItaly
| | | | - Thomas Barnetche
- FHU ACRONIM, Centre for Autoimmune Systemic Rare Diseases, Bordeaux University HospitalBordeauxFrance
| | - Muriel Herasse
- Filière des Maladies Autoimmunes et Autoinflammatoires Rares, Hôpital Huriez, Centre Hospitalier Universitaire de LilleLilleFrance
| | - Samira Plassart
- Filière des Maladies Autoimmunes et Autoinflammatoires Rares, Hôpital Huriez, Centre Hospitalier Universitaire de LilleLilleFrance
| | - Maria José Santos
- Hospital Garcia de Orta, Almada, Portugal, and Instituto de Medicina Molecular Faculdade Medicina and Rheumatic Diseases Portuguese RegisterLisbonPortugal
| | - Ana Maria Rodrigues
- Rheumatic Diseases Portuguese Register, Sociedade Portuguesa de Reumatologia, Nova Medical School, and Hospital dos LusiadasLisbonPortugal
| | - Philip C. Robinson
- The University of Queensland, Brisbane, Queensland, Australia, and Royal Brisbane and Women's Hospital, Metro North Hospital and Health ServiceHerstonQueenslandAustralia
| | - Pedro M. Machado
- University College London, University College London Hospitals NHS Foundation Trust and Northwick Park Hospital, London North West University Healthcare NHS TrustLondonUK
| | - Emily Sirotich
- McMaster University, Hamilton, Ontario, Canada, and Canadian Arthritis Patient AllianceTorontoOntarioCanada
| | - Jean W. Liew
- Boston University School of MedicineBostonMassachusetts
| | - Jonathan S. Hausmann
- Beth Israel Deaconess Medical Center, Harvard Medical School and Boston Children's HospitalBostonMassachusetts
| | | | | | | | | | | | | | | |
Collapse
|