Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID
Comorbidities, particularly cardio-metabolic disorders, are highly prevalent in patients with psoriatic arthritis (PsA) and they were associated with an increased risk of atherosclerotic cardiovascular disease, which have been associated with higher morbidity and mortality. Whether PsA enhances the...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/39095 |
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I10-R327-article-39095 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
psoriatic arthritis COVID 19 comorbidities artritis psoriasica Covid-19 comorbilidades |
| spellingShingle |
psoriatic arthritis COVID 19 comorbidities artritis psoriasica Covid-19 comorbilidades Savio, V Maladini, C Alba Moreyra, P SAURIT, V BERBOTTO , G PISONI , C ISNARDI, C PONS-ESTEL, G Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID |
| topic_facet |
psoriatic arthritis COVID 19 comorbidities artritis psoriasica Covid-19 comorbilidades |
| author |
Savio, V Maladini, C Alba Moreyra, P SAURIT, V BERBOTTO , G PISONI , C ISNARDI, C PONS-ESTEL, G |
| author_facet |
Savio, V Maladini, C Alba Moreyra, P SAURIT, V BERBOTTO , G PISONI , C ISNARDI, C PONS-ESTEL, G |
| author_sort |
Savio, V |
| title |
Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID |
| title_short |
Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID |
| title_full |
Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID |
| title_fullStr |
Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID |
| title_full_unstemmed |
Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID |
| title_sort |
is psoriatic arthritis a risk factor for severe covid -19 infection? data from the argentinian registry sars-covid |
| description |
Comorbidities, particularly cardio-metabolic disorders, are highly prevalent in patients with psoriatic arthritis (PsA) and they were associated with an increased risk of atherosclerotic cardiovascular disease, which have been associated with higher morbidity and mortality. Whether PsA enhances the risk of SARS-CoV-2 infection or affects the disease outcome remains to be ascertained. The purpose of the present work was to describe the sociodemographic, clinical and treatment characteristics of patients with PsA with confirmed SARS-CoV-2 infection from the SAR-COVID registry and to identify the variables associated with poor COVID-19 outcomes, comparing them with those with rheumatoid arthritis (RA)
Cross-sectional observational study including patients ≥18 years old, with diagnosis of PsA (CASPAR criteria) and RA (ACR / EULAR 2010 criteria), who had confirmed SARS-CoV-2 infection (RT-PCR or serology) from the SAR-COVID registry. Recruitment period was between August 13, 2020 and July 31, 2021. Sociodemographic variables, comorbidities, and treatments were analyzed. To assess the severity of the infection, the ordinal scale of the National Institute of Allergy and Infectious Diseases (NIAID) was used, and it was considered that a patient met the primary outcome, if they presented criteria of categories 5 or higher on the severity scale. For this analysis, Chi2 test, Fisher's test, Student's test or Wilcoxon test, and binomial logistic regression using NIAID>=5 as dependent variable were performed.
A total of 129 PsA patients and 808 with RA were included, with similar age (51.7±12.7 vs 53.1±12.9; p=0.239), greater female sex in RA (84.7% vs 55.8 %; p<0.001). Patients with PsA had 2 or more comorbidities (42.6% vs 27.1%; p<0.001), cardiovascular or cerebrovascular disease (11.4% vs 3.9%; p=0.033), less use of conventional DMARD and more biologics (36.4% vs 54.8%; p<0.001, 46.5% vs 23.9%; p<0.001), less methotrexate (48.1% vs 63.4%; p=0.001) and glucocorticoids (11.7% vs 42.7%; p<0.001), JAK inhibitors (3.1% vs 8.9%; p=0.038), and receiving more anti-TNF (27.1% vs 16.8 %; p=0.007). Disease activity was higher in RA (p=0.027). Smoking was low and similar (3.6% vs 8.4%; p=0.079). The frequency of NIAID≥5 was comparable between group (NIAID≥5: 19.5% vs 20.1%; p=0.976), with recovery without sequelae in more than 80%. PsA patients with NIAID≥5 in comparison with NIAID<5 were older (58.6±11.4 vs 50±12.5; p=0.002), had more frequently hypertension (52.2% vs 23%; p=0.011) and dyslipidemia (39.1% vs 15%; p=0.017). In the multivariate analysis, age (OR 1.06; 95% CI 1.02–1.11) was associated with a worse outcome of the COVID-19 (NIAID≥5) in patients with PsA, while those who received methotrexate (OR 0.34 ; 95% CI 0.11–0.92) and biological DMARDs (OR 0.28; 95% CI 0.09–0.78) had a better outcome. Mortality was higher in RA, without statistical significance (4.31% vs 0.8%, p=0.074). Regarding PsA treatment, 12.4% of PsA were receiving IL-17 inhibitors, 5.4% IL12-23 inhibitors, one patient apremilast and one abatacept.
Although PsA patients have a higher frequency of cardiovascular and metabolic comorbidities than those with RA, the COVID-19 severity was similar. Most of the patients had mild SARS-CoV-2 infection and a low death rate. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2022 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/39095 |
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I10-R327-article-390952024-04-15T16:14:45Z Is psoriatic arthritis a risk factor for severe COVID -19 infection? Data from the Argentinian registry SARS-COVID ¿Es la artritis psoriásica un factor de gravedad para COVID-19? Datos del registro nacional SARS COVID Savio, V Maladini, C Alba Moreyra, P SAURIT, V BERBOTTO , G PISONI , C ISNARDI, C PONS-ESTEL, G psoriatic arthritis COVID 19 comorbidities artritis psoriasica Covid-19 comorbilidades Comorbidities, particularly cardio-metabolic disorders, are highly prevalent in patients with psoriatic arthritis (PsA) and they were associated with an increased risk of atherosclerotic cardiovascular disease, which have been associated with higher morbidity and mortality. Whether PsA enhances the risk of SARS-CoV-2 infection or affects the disease outcome remains to be ascertained. The purpose of the present work was to describe the sociodemographic, clinical and treatment characteristics of patients with PsA with confirmed SARS-CoV-2 infection from the SAR-COVID registry and to identify the variables associated with poor COVID-19 outcomes, comparing them with those with rheumatoid arthritis (RA) Cross-sectional observational study including patients ≥18 years old, with diagnosis of PsA (CASPAR criteria) and RA (ACR / EULAR 2010 criteria), who had confirmed SARS-CoV-2 infection (RT-PCR or serology) from the SAR-COVID registry. Recruitment period was between August 13, 2020 and July 31, 2021. Sociodemographic variables, comorbidities, and treatments were analyzed. To assess the severity of the infection, the ordinal scale of the National Institute of Allergy and Infectious Diseases (NIAID) was used, and it was considered that a patient met the primary outcome, if they presented criteria of categories 5 or higher on the severity scale. For this analysis, Chi2 test, Fisher's test, Student's test or Wilcoxon test, and binomial logistic regression using NIAID>=5 as dependent variable were performed. A total of 129 PsA patients and 808 with RA were included, with similar age (51.7±12.7 vs 53.1±12.9; p=0.239), greater female sex in RA (84.7% vs 55.8 %; p<0.001). Patients with PsA had 2 or more comorbidities (42.6% vs 27.1%; p<0.001), cardiovascular or cerebrovascular disease (11.4% vs 3.9%; p=0.033), less use of conventional DMARD and more biologics (36.4% vs 54.8%; p<0.001, 46.5% vs 23.9%; p<0.001), less methotrexate (48.1% vs 63.4%; p=0.001) and glucocorticoids (11.7% vs 42.7%; p<0.001), JAK inhibitors (3.1% vs 8.9%; p=0.038), and receiving more anti-TNF (27.1% vs 16.8 %; p=0.007). Disease activity was higher in RA (p=0.027). Smoking was low and similar (3.6% vs 8.4%; p=0.079). The frequency of NIAID≥5 was comparable between group (NIAID≥5: 19.5% vs 20.1%; p=0.976), with recovery without sequelae in more than 80%. PsA patients with NIAID≥5 in comparison with NIAID<5 were older (58.6±11.4 vs 50±12.5; p=0.002), had more frequently hypertension (52.2% vs 23%; p=0.011) and dyslipidemia (39.1% vs 15%; p=0.017). In the multivariate analysis, age (OR 1.06; 95% CI 1.02–1.11) was associated with a worse outcome of the COVID-19 (NIAID≥5) in patients with PsA, while those who received methotrexate (OR 0.34 ; 95% CI 0.11–0.92) and biological DMARDs (OR 0.28; 95% CI 0.09–0.78) had a better outcome. Mortality was higher in RA, without statistical significance (4.31% vs 0.8%, p=0.074). Regarding PsA treatment, 12.4% of PsA were receiving IL-17 inhibitors, 5.4% IL12-23 inhibitors, one patient apremilast and one abatacept. Although PsA patients have a higher frequency of cardiovascular and metabolic comorbidities than those with RA, the COVID-19 severity was similar. Most of the patients had mild SARS-CoV-2 infection and a low death rate. Los pacientes con artritis psoriásica (APs) presentan mayores comorbilidades cardiovasculares y metabólicas que el resto de las patologías articulares inflamatorias. Existen pocos estudios sobre como son afectados por COVID-19. El objetivo del presente trabajo fue describir las características sociodemográficas, clínicas y tratamiento de los pacientes con APs que padecieron infección por SARS-CoV-2 en el registro SAR-COVID e identificar las variables asociadas a complicaciones. Estudio observacional transversal, de casos y controles. Pacientes incluídos en el registro SAR-COVID de la Sociedad Argentina de Reumatología, con APs y artritis reumatoide (AR), ≥18 años, con infección por SARS-CoV-2. Período 13/08/2020-31/07/2021. Se evaluaron variables demográficas, comorbilidades, y tratamientos. Gravedad evaluada mediante escala del National Institute of Allergy and Infectious Diseases (NIAID). La actividad de la enfermedad fue evaluada a criterio del investigador )remisiòn, baja, moderada y alta). Análisis estadístico: test Chi2, Fisher, Student ó de Wilcoxon según correspondiera. Modelos de regresión logística binomial para variables de mal pronóstico. p<0,05 se consideraró significativa. Se incluyeron 129 pacientes con APs y 808 con AR, con edad similar (51,7±12,7 vs 53,1±12,9; p=0,239), mayor sexo femenino en AR (84,7% vs 55,8%; p<0,001). Los pacientes con APs presentaban 2 ó más comorbilidades (42,6% vs 27,1%; p<0,001), enfermedad cardiovascular o cerebrovascular (11,4% vs 3,9%; p=0,033), menor uso de DMARD convencional y más biológicos (36,4% vs 54,8%; p<0,001, 46,5% vs 23,9%; p<0,001), menos metotrexato (48,1% vs 63,4%; p=0,001) y glucocorticoides (11,7% vs 42,7%; p<0,001), inhibidores de JAK (3,1% vs 8,9%; p=0,038), más anti-TNF (27,1% vs 16,8%; p=0,007). La actividad de la enfermedad fue mayor en AR (p=0,027). El tabaquismo fue bajo y similar (3,6% vs 8,4%; p=0,079). La gravedad de la infección fue similar en ambos grupos (NIAID≥5: 19,5% vs 20,1%; p=0,976), con recuperación sin secuelas en más del 80%. Los pacientes con APs con NIAID≥5 fueron 25, asociándose la edad (58,6 vs 50; p=0,002), hipertensión (52,2% vs 23%; p=0,011) y dislipemia (39,1% vs 15%; p=0,017). La mortalidad fue mayor en AR, sin significancia estadística (4,31% vs 0,8%,p=0,074). A pesar que los pacientes con APs presentan más comorbilidades cardiovasculares y metabólicas que otras patologías articulares inflamatorias, la mayoría de los pacientes del registro SAR-COVID cursaron infección leve y baja mortalidad. Tampoco se encontraron diferencias en la severidad de la infección entre APs y AR. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-10-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion . https://revistas.unc.edu.ar/index.php/med/article/view/39095 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. Suplemento JIC XXIII (2022): Suplemento JIC XXIII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |