scholarly journals Better outcomes of COVID-19 in vaccinated compared to unvaccinated patients with systemic rheumatic diseases

2021 ◽  
pp. annrheumdis-2021-221539
Author(s):  
Charalampos Papagoras ◽  
George E Fragoulis ◽  
Nikoleta Zioga ◽  
Theodora Simopoulou ◽  
Kleopatra Deftereou ◽  
...  

ObjectiveΤo report outcomes of breakthrough COVID-19 in comparison with COVID-19 in unvaccinated patients with systemic rheumatic diseases (SRDs).MethodsPatients with SRD with COVID-19 (vaccinated and unvaccinated) were included by their rheumatologists in a registry operated by the Greek Rheumatology Society in a voluntarily basis. Type, date and doses of SARS-CoV-2 vaccines were recorded, and demographics, type of SRD, concurrent treatment, comorbidities and COVID-19 outcomes (hospitalisation, need for oxygen supplementation and death) were compared between vaccinated and unvaccinated patients.ResultsBetween 1 March 2020 and 31 August 2021, 195 patients with SRD with COVID-19 were included; 147 unvaccinated and 48 vaccinated with at least one dose of a SARS-CoV-2 vaccine (Pfizer n=38 or AstraZeneca n=10). Among vaccinated patients, 29 developed breakthrough COVID-19 >14 days after the second vaccine dose (fully vaccinated), while 19 between the first and <14 days after the second vaccine dose (partially vaccinated). Despite no differences in demographics, SRD type, treatment or comorbidities between unvaccinated and vaccinated patients, hospitalisation and mortality rates were higher in unvaccinated (29.3% and 4.1%, respectively) compared with partially vaccinated (21% and 0%) or fully vaccinated (10.3% and 0%) patients.ConclusionsVaccinated patients with SRD with breakthrough COVID-19 have better outcomes compared with unvaccinated counterparts with similar disease/treatment characteristics.

Reumatismo ◽  
2018 ◽  
pp. 165-177
Author(s):  
F. Saccon ◽  
M. Gatto ◽  
M. Larosa ◽  
F. Ometto ◽  
M. Felicetti ◽  
...  

The objective was to evaluate renal involvement in several rheumatic diseases (i.e. rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, systemic sclerosis, systemic vasculitides). The method chosen was to define histopathological profiles reported in renal biopsies performed on patients with renal involvement due to different rheumatic diseases. Renal involvement observed in patients with rheumatic disease can be the direct result of the disease per se and/or a complication of drugs used in the disease treatment. The clinical-pathological correlations derived from the study of renal tissues can be useful for differential diagnosis, prognosis assessment and therapeutic decisions. Renal biopsy should be considered as an important tool for the management of nephropathies in patients with systemic rheumatic diseases.


2011 ◽  
Vol 1 (3) ◽  
pp. 153
Author(s):  
Kyoung Soo Shin ◽  
La-He Jearn ◽  
Think-You Kim

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 856.2-856
Author(s):  
S. Boussaid ◽  
R. Ben Aissa ◽  
S. Kochbati ◽  
M. Elleuch ◽  
L. Abdelmoula ◽  
...  

Background:The development of biologics for the treatment of systemic rheumatic diseases increased the risk of infections. The management of this complication deserves particular attention since it remains a major cause of morbidity and mortality.Objectives:The aim of our study was to determine infection frequency under biological treatment and consequences on the therapeutic management.Methods:Patients included in the Biological National Registry (BINAR) from 2016 to 2020. Data related to the disease, biological agents, and infections occurring under biologic disease-modifying antirheumatic drugs (bDMARDs) were collected.Results:The study included 298 patients with a mean age of 49.2 years [18-79] 175 patients with rheumatoid arthritis and 123 with spondyloarthritis (Axial Spondyloarthritis=48, Enteropathic Arthritis=41, Psoriatic Arthritis=34). Anti Tumor necrosis factor-alpha (Anti-TNF) agents were the most prescribed bDMARDs in 87.9% (n=263) of patients: Infliximab 20.4% (n=61),Etanercept 23.1%(n=69), Adalimumab 24.6%(n=74) and Certolizumab (n=79). No patients were treated with Golimumab. Tocilizumab and Rituximab were prescribed respectively in 10.4% (n=31) and 5% (n=15) of patients. Infections occured in 9 patients (3.1%) with a total of 13 infectious episodes 12 bacterial and a viral one. The site of infections was: respiratory (38%), urinary (15%), cutaneous (23%), ORL (8%), infective endocarditis (8%), and other (8%). The infectious agent was identified in only 3 patients. The outcomes were favorable in most cases except in one patient where there was a definitive interruption of bDMARDs. The patient was hospitalized for sepsis complicating a cutaneous infection with favorable outcomes under antibiotics within a week. The biological agent with higher risk of infections was Tocilizumab (p = 0.056), unlike Rituximab (p = 0.483) and Anti-TNF (p = 0.082). All patients who had an infectious episode were under corticosteroids.Conclusion:Our results confirm that bDMARDs are predisposing to infections, but data from BINAR showed that most infections were trivial with no serious outcomes. Therefore, infections should be assessed in patients under bDMARDs for an early therapeutic intervention.Disclosure of Interests:None declared.


2010 ◽  
Vol 16 (8) ◽  
pp. 400-402 ◽  
Author(s):  
Javier A. Cavallasca ◽  
María del Rosario Maliandi ◽  
Sergio Sarquis ◽  
Maria Betina Nishishinya ◽  
Alejandra Schvartz ◽  
...  

Rheumatology ◽  
2009 ◽  
Vol 49 (4) ◽  
pp. 820-821 ◽  
Author(s):  
M. Tikly ◽  
N. Govind ◽  
J. Frost ◽  
M. Ramsay

2021 ◽  
pp. 83-104
Author(s):  
Layla Borham ◽  
Waleed Hafiz

AbstractBy the end of this chapter, you should be able to:


2020 ◽  
Author(s):  
Min Jung Kim ◽  
Eun Bong Lee ◽  
Yeong Wook Song ◽  
Jin Kyun Park

Abstract Background The host inflammatory response against infection is characterized by leukocytosis, and the release of cytokines and acute phase proteins. However, routine inflammatory markers are not always elevated in systemic rheumatic diseases (SRD). Here, we aimed to systematically evaluate and compare the clinical implications of common inflammatory markers in systemic rheumatic diseases (SRDs). Methods We investigated the profiles of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and white blood cell (WBC) count in treatment-naïve patients with SRDs, osteoarthritis and pneumonia diagnosed at Seoul National University Hospital during 2004-2016. SRDs included rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), systemic sclerosis (SSc), idiopathic inflammatory myopathy (IIM) and adult onset of Still disease (AOSD). Associations between inflammatory markers were evaluated using Pearson’s correlation and regression analysis. Differences between correlations were compared using Steiger’s z-test. Receiver operating characteristic (ROC) curve analysis was performed to examine the predictive value of inflammatory markers for SRD diagnosis. Results We identified 1191 patients with SRDs, osteoarthritis and pneumonia. Leukocytosis was present in <15% SRD patients. There was marked variability in ESR and CRP levels among different SRDs. The highest mean CRP levels (mean ± SD, mg/dL) were observed in those with AOSD (11.3±7.9), followed by RA (2.0±3.3), IIM (1.8±3.5), SLE (1.5±3.1), SSc (0.6±1.3) and AS (0.08±0.1). Mean ESR (mm/hr) was also highest in AOSD (71.2±31.0), followed by SLE (47.3±34.2), RA (45.5±30.6), IIM (40.8±24.8) and SSc (27.8±26.0). All SRDs showed significant positive correlations between ESR and CRP: greatest in RA (r=0.53, p<0.001) and weakest in SLE (r=0.20, p=0.03). WBC correlated weakly with CRP but not with ESR in most SRDs. While the AUC for WBC count (0.54-0.68) was less than that of ESR or CRP, the AUC for ESR and CRP (0.69-0.86) were similar in SRD. The optimal cuff-off values for inflammatory markers predicting SRD were within or slightly above the normal limit. Conclusions Unlike acute infection, ESR, CRP and WBC count are not always elevated in treatment-naïve patients with SRD. Thus, common inflammatory markers have limited value for diagnosis and assessment of disease activity of SRD.


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