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COVID-19 in French patients with chronic inflammatory rheumatic diseases: Clinical features, risk factors and treatment adherence - 11/02/21

Doi : 10.1016/j.jbspin.2020.105095 
Félicie Costantino a, b, Léa Bahier b, Luis Coronel Tarancón b, Ariane Leboime b, François Vidal b, Lamouri Bessalah c, Maxime Breban a, b, Maria-Antonietta D’Agostino a, b,
a Inserm U1173, Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay, UVSQ, Montigny-Le-Bretonneux, France 
b Rheumatology Department, AP–HP, Ambroise Paré Hospital, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France 
c BEPATIENT, Paris, France 

Corresponding author at: Rheumatology Department, AP–HP, Ambroise Paré Hospital, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.Rheumatology Department, AP–HP, Ambroise Paré Hospital9, avenue Charles-de-GaulleBoulogne-Billancourt92100France

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Highlights

Incidence of COVID 19 was not increased in patients with inflammatory rheumatisms.
Continuation of anti-rheumatic drugs was not associated with an increased risk of COVID-19.
In inflammatory rheumatisms treatment adherence was reduced because of fear of contagion.

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Abstract

Objective

To explore how patients with chronic inflammatory rheumatic diseases (CIRDs) coped with their disease during the COVID-19 pandemic and to identify possible predictive factors of SARS-CoV-2 infection in this population.

Methods

Patients followed in a single rheumatology department in France or registered on the Spondy+ platform, a secure e-health platform for spondyloarthritis patients, were invited to complete a questionnaire focused on their experiences around COVID19 symptoms, testing and medications access during the lockdown period. Descriptive statistics were used to report questionnaire's results. Factors associated with COVID-19 or with treatment discontinuation were assessed by logistic regression.

Results

We obtained 655 answers from the 2,081 contacted patients: 474 with spondyloarthritis, 129 with rheumatoid arthritis and 52 with psoriatic arthritis. The population was predominantly female (61.8%) with a mean age of 51.0±13.4 years. Incidence of COVID-19 was 6.9% (95%CI: 5.1–9.2%), including 12 confirmed and 33 highly suspicious cases. No death was observed and five patients needed to be hospitalized. Factors independently associated with an increased risk of infection were SARS-CoV-2 exposure, younger age and non-smoking. More than 30% of the patients suspended or decreased the dosage of one of their drugs during the lockdown period. This was followed in 63.4% of them by increased disease activity. Modifications were mostly motivated by fear of contagion (79.3%).

Conclusion

We did not observe any increase of incidence or severity of COVID-19 in patients suffering of the 3 most common CIRDs. This survey also adds evidence of the safety of anti-rheumatic drugs use regarding COVID-19.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : COVID-19, Spondyloarthritis, Psoriatic arthritis, Rheumatoid arthritis, Non-steroidal anti-inflammatory drugs


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© 2020  Société française de rhumatologie. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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