CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases
Kevin Chevalier, Michaël Genin, Thomas Petit Jean, Jerôme Avouac, Rene-Marc Flipo, Sophie Georgin-Lavialle, Soumaya El Mahou, Edouard Pertuiset, Thao Pham, Amelie Servettaz, Hubert Marotte, Fanny Domont, Pascal Chazerain, Mathilde Devaux, Arsene Mekinian, Jérémie Sellam, Bruno Fautrel, Diane Rouzaud, Esther Ebstein, Nathalie Costedoat-Chalumeau, Christophe Richez, Eric Hachulla, Xavier Mariette, Raphaèle Seror
Frontiers in Medicine, doi:10.3389/fmed.2023.1152587
Results: Among 1,213 patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher risk of severe ), p = 0.01] but analysis restricted to rheumatoid arthritis and spondyloarthritis found no increased risk of severe ].
Conclusion: In this multicenter study, we confirmed that AIRD patients treated with rituximab or corticosteroids and/or having vasculitis, autoinflammatory disease, and sarcoidosis had increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of severe COVID-19 compares general population.
Ethics statement This present study was approved by the institutional review board (APHP Scientific and Ethical Committee, authorization no. CSE 20-60_CovAID) from the Scientific and Ethical Committee of the AP-HP and by the CNIL. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
Author contributions KC collected the data, analyzed them, and wrote the manuscript. RS, XM, and EH designed the study. MG and TJ performed the statistics and help for the data collection. JA, R-MF, SG-L, SE, EP, TP, AS, HM, FD, PC, MD, AM, JS, BF, DR, EE, NC-C, and CR collected data from the patients. All authors reviewed and corrected the manuscript.
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Supplementary material The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fmed.2023. 1152587/full#supplementary-material
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doi:10.1016/S0140-6736(20)30566-3{ 'indexed': {'date-parts': [[2023, 3, 23]], 'date-time': '2023-03-23T04:55:26Z', 'timestamp': 1679547326879},
'reference-count': 68,
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'license': [ { 'start': { 'date-parts': [[2023, 3, 22]],
'date-time': '2023-03-22T00:00:00Z',
'timestamp': 1679443200000},
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'abstract': '<jats:sec><jats:title>Introduction</jats:title><jats:p>Autoimmune/inflammatory rheumatic '
'diseases (AIRDs) patients might be at-risk of severe COVID-19. However, whether this is '
'linked to the disease or to its treatment is difficult to determine. This study aimed to '
'identify factors associated with occurrence of severe COVID-19 in AIRD patients and to '
'evaluate whether having an AIRD was associated with increased risk of severe COVID-19 or '
'death.</jats:p></jats:sec><jats:sec><jats:title>Materials and methods</jats:title><jats:p>Two '
'databases were analyzed: the EDS (Entrepôt des Données de Santé, Clinical Data Warehouse), '
'including all patients followed in Paris university hospitals and the French multi-center '
'COVID-19 cohort [French rheumatic and musculoskeletal diseases (RMD)]. First, in a combined '
'analysis we compared patients with severe and non-severe COVID-19 to identify factors '
'associated with severity. Then, we performed a propensity matched score case–control study '
'within the EDS database to compare AIRD cases and non-AIRD '
'controls.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 1,213 '
'patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, '
'interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, '
'auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated '
'with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having '
'AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher '
'risk of severe COVID-19 [aOR = 1.43 (1.08–1.87), p = 0.01] but analysis restricted to '
'rheumatoid arthritis and spondyloarthritis found no increased risk of severe COVID-19 [aOR = '
'1.11 (0.68–1.81)].</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In '
'this multicenter study, we confirmed that AIRD patients treated with rituximab or '
'corticosteroids and/or having vasculitis, auto-inflammatory disease, and sarcoidosis had '
'increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of '
'severe COVID-19 compares general population.</jats:p></jats:sec>',
'DOI': '10.3389/fmed.2023.1152587',
'type': 'journal-article',
'created': {'date-parts': [[2023, 3, 22]], 'date-time': '2023-03-22T04:40:48Z', 'timestamp': 1679460048000},
'update-policy': 'http://dx.doi.org/10.3389/crossmark-policy',
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': 'CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory '
'rheumatism or autoimmune diseases',
'prefix': '10.3389',
'volume': '10',
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{'given': 'Thomas Petit', 'family': 'Jean', 'sequence': 'additional', 'affiliation': []},
{'given': 'Jerôme', 'family': 'Avouac', 'sequence': 'additional', 'affiliation': []},
{'given': 'Rene-Marc', 'family': 'Flipo', 'sequence': 'additional', 'affiliation': []},
{'given': 'Sophie', 'family': 'Georgin-Lavialle', 'sequence': 'additional', 'affiliation': []},
{'given': 'Soumaya', 'family': 'El Mahou', 'sequence': 'additional', 'affiliation': []},
{'given': 'Edouard', 'family': 'Pertuiset', 'sequence': 'additional', 'affiliation': []},
{'given': 'Thao', 'family': 'Pham', 'sequence': 'additional', 'affiliation': []},
{'given': 'Amelie', 'family': 'Servettaz', 'sequence': 'additional', 'affiliation': []},
{'given': 'Hubert', 'family': 'Marotte', 'sequence': 'additional', 'affiliation': []},
{'given': 'Fanny', 'family': 'Domont', 'sequence': 'additional', 'affiliation': []},
{'given': 'Pascal', 'family': 'Chazerain', 'sequence': 'additional', 'affiliation': []},
{'given': 'Mathilde', 'family': 'Devaux', 'sequence': 'additional', 'affiliation': []},
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