scholarly journals AB0694 COVID-19 İNFECTION IN PATIENTS WITH RHEUMATIC DISEASES: TWO CENTERS EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1380.1-1380
Author(s):  
A. Şahin ◽  
M. A. Gedikli ◽  
M. E. Derin ◽  
B. Karakaş ◽  
B. Karataş ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Rheumatic Disease ◽  
Autoimmune Diseases ◽  
Rheumatic Diseases ◽  
Clinical Characteristics ◽  
Normal Population ◽  
Meta Analysis ◽  
Demographic Data ◽  
Severe Disease ◽  
University Hospital

Background:Coronavirus disease 2019 (COVID-19) is a new viral infection characterized by dry cough, fever, shortness of breath, fatigue and lymphopenia. It may be complicated by interstitial pneumonia leading to severe acute respiratory distress syndrome(1). The COVID-19 outbreak has increased concerns in those with rheumatological diseases(2).Objectives:To present the clinical course of COVID-19 infection in patients with rheumatological disease and comorbid conditions of patients and drug use.Methods:70 COVID-19 patients with autoimmune and autoinflammatory rheumatic diseases over the age of 18 who were followed up in the internal diseases-rheumatology department of Sivas Cumhuriyet University Hospital and Sivas Numune Hospital between April 2020 and January 2021 were included in this study. An application was made to the ethics committee of Sivas Cumhuriyet University Hospital and approval was obtained. Demographic data, comorbidities, smoking, treatments for their diseases, symptoms and hospitalization status of the patients were evaluated.Results:The median age of the women patients was 48 years (min: 20-max: 73), 41 years in men (min: 21-max: 78). 15 patients (21.4%) were male, 55 patients (78.6%) were female. The most common rheumatic disease was rheumatoid arthritis (RA, 21, 30%) followed by ankylosing spondylitis (19, 27.1%), familial Mediterranean fever (13, 18.6%), Behçet’s disease (12, 17.1%). 22 (31.4%) patients hydroxychloroquine sulfate, 14 (20%) leflunomide, 7 (10%) patients methotrexate, 6 (8.6%) patients sulfasalazine, 10 (14.3%) patients azathioprine/mycophenolate mofetil, 22 (31.4%) patients were using colchicine. As a biological medicine; 20 (28.6%) patients were using infliximab, 5 (7.1%) patients were using adalimumab, 6 (8.6%) patients were using rituximab, and 4 (5.7%) patients were using tocilizumab. Other are summarized in Table 1. The most common comorbidities were hypertension (25.7%) and diabetes mellitus (DM 17.1%). While 56 patients (80%) had symptoms of COVID-19, 14 patients (20%) were asymptomatic. The most common symptoms was fever (32, 45.7%) followed by cough (29, 41.4%), dyspnea (28, 40%), myalgia (25, 35.7%), loss of taste and smell (18, 25.7%). 21 pneumonia cases were diagnosed. 22 (31.4%) patients were hospitalized. Mortality rate was 2/70, 2.9%. Two RA patients who just treated with rituximab and tocilizumab were died. 10 cases were using >10 mg/day prednisolone, 2 died, 8 cases were hospitalized and had severe disease. They had hypertension and DM. Characteristics of the patients are summarized in Table 2.Conclusion:The course of COVID-19 in rheumatic diseases is not clearly. Meta-analysis has shown that the frequency of COVID-19 is increased in autoimmune diseases. However, this increase was mostly associated with the use of> 10mg/day prednisolone. It has been stated that the use of biological drugs and Dmard causes the SARS-CoV 2 process with a milder course and therefore their use is safe (3). Similar results have been obtained in global registry registers (4). In our data, there was no increase in the mortality rate compared to the normal population. However, especially the use of rituximab may increase the rate of severe disease and mortality, so its use should be careful. There is a need for more comprehensive studies.References:[1]Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020.[2]N. Chen, M. Zhou, X. Dong,et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet 395 (10223) (2020) 507*513[3]Akiyama S,Hamdeh S, Micic D, et al, Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis,Ann Rheum Dis 2020 Oct 13;annrheumdis-2020-218946.[4]Gianfrancesco M, Hyrich KL, Al-Adely S,et al, Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2020 Jul;79(7):859-866.Disclosure of Interests:None declared

scholarly journals Clinical characteristics of Chilean patients with rheumatic diseases and COVID-19: data from the Covid-19 Global Rheumatology Alliance physician-reported registry

2021 ◽  
Author(s):  
Oriela Martínez ◽  
Francisca Valenzuela ◽  
Sebastián Ibáñez
Keyword(s):  
Rheumatoid Arthritis ◽  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
List Type ◽  
Non Invasive ◽  
Rheumatic Patients

AbstractObjectiveThe coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has registered more than 234 million confirmed cases and more than 4.7 million deaths throughout the world until October 2, 2021. During the last few months, a significant number of reports of COVID-19 in patients with rheumatic diseases have been published. In this study the objective is to report the clinical characteristics of Chilean patients with rheumatic diseases and COVID-19 reported in the “Global Rheumatology Alliance” (GRA) physician registration platform.MethodsChilean patients with rheumatic diseases and COVID-19 were included in the Covid-19 GRA physician-reported registry.Results54 patients were included. The most common primary rheumatic disease was rheumatoid arthritis (RA) with 28 cases (51.9%). 30 patients (55.6%) used corticosteroids, of which 20 (66.7%) used a dose of 10 mg or less. 33 patients (61.1%) only used conventional DMARDs, 4 (7.4%) only biological, and 6 (11.1%) the combination. A total of 35 patients (64.8%) had to be hospitalized. 2 patients (3.7%) died. 26 patients of the 35 hospitalized (74.2%) required some type of ventilatory support, of which 5 (19.2%) required non-invasive and 8 (30.8%) invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO).DiscussionMost of included Chilean rheumatic patients were hospitalized, with a low mortality rate but with a high percentage of patients requiring at least non-invasive mechanical ventilation.Key Points-The most common primary rheumatic disease was rheumatoid arthritis (RA) followed by lupus (LES)-Most of the included Chilean rheumatic patients were hospitalized, with a high percentage of patients requiring at least non-invasive mechanical ventilation, but with a low mortality rate.-Worsening of arthralgias or activation of the rheumatic disease was not reported.

scholarly journals Infant Case of Co-infection with SARS-CoV-2 and Citrobacter koseri Urinary Infection

2020 ◽  
Author(s):  
Hyppolite K Tchidjou ◽  
Bernard Romeo
Keyword(s):  
Mortality Rate ◽  
Infection Control ◽  
Disease Control ◽  
Urinary Infection ◽  
Severe Disease ◽  
Control Measures ◽  
University Hospital ◽  
Infection Control Measures ◽  
Control And Prevention ◽  
Infant Case

Abstract Since 2019 coronavirus disease (COVID-19) is highly contagious with a high mortality rate. France has taken strict infection control measures. According to the report by the Center for Disease Control and Prevention, children are less affected with COVID-19 and seem to have less severe disease than adults. We reported the first confirmed infant case of co-infection with SARS-CoV-2 and Citrobacter koseri urinary infection in 6-week-old child admitted on 25 March 2020 with mild symptoms in the Pediatric COVID Unit of Amiens University Hospital, France.

scholarly journals A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases

2020 ◽  
Author(s):  
Nina M de Gruijter ◽  
Meena Naja ◽  
Hannah Peckham ◽  
Anna Radziszewska ◽  
Matthew Kinsella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Severe Disease ◽  
Delayed Puberty ◽  
Future Research ◽  
Autoimmune Rheumatic Diseases ◽  
Bidirectional Relationship ◽  
The Impact

Abstract Background: Autoimmune rheumatic diseases (ARDs) are associated with a significant sex-bias which becomes more evident post-puberty. This systematic review aims to elucidate the bidirectional relationship between puberty and ARDs related outcomes.Methods: Studies published in English until October 2019 were identified using a systematic search of endocrinology and rheumatology literature. Information was extracted on study design, sample size, demographics, puberty outcome measures, and main findings. The methodological quality of the studies included was analysed using the Newcastle-Ottawa Scale (NOS).Results: 14 non-randomised studies reporting on the impact of puberty on ARD outcomes (n = 7), ARD impact on puberty-related outcomes (n = 6), or both (n = 1) have been identified. The impact of puberty on ARD outcomes have been investigated in patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n = 1), juvenile systemic lupus erythematosus (JSLE) (n = 5) or in healthy controls who developed adult-onset SLE (n = 1) or had non-specific symptoms (n = 1). The impact of ARD on puberty outcomes was explored in JIA (n = 4) and JSLE (n = 3). Quality assessment of studies showed a small to moderate risk of bias overall (NOS 4–9/9). Due to large heterogeneity of the studies it was not possible to perform a meta-analysis. Multiple studies reported on delayed puberty in patients with JIA/JSLE, menstrual and hormonal abnormalities, and lower height and weight than controls. Earlier (pre-pubertal) onset of JSLE was correlated with more severe disease and more need for systemic treatment.Conclusion: A bidirectional relationship exists between puberty and ARDs; however, more and better research is required to elucidate the complexity of this relationship. We propose puberty-related clinical assessments in patients with ARDs, which can improve patient outcomes and facilitate future research.

scholarly journals High prevalence of SARS-CoV-2 infection among symptomatic healthcare workers in a large university tertiary hospital in São Paulo, Brazil

2020 ◽  
Author(s):  
Carolina Palamin Buonafine ◽  
Beatriz Nobre Monteiro Paiatto ◽  
Fabyano Leal ◽  
Samantha Matos ◽  
Camila Ohomoto Moraes ◽  
...  
Keyword(s):  
Latin America ◽  
Healthcare Workers ◽  
Clinical Characteristics ◽  
Medical Condition ◽  
Demographic Data ◽  
Sao Paulo ◽  
University Hospital ◽  
São Paulo ◽  
Ocular Pain ◽  
Increased Risk

Abstract Background: Latin America became the epicenter of the COVID-19 pandemic in May 2020, mostly driven by Brazil's situation. Healthcare workers are at increased risk of SARS-CoV-2 infection, experiencing a significant burden from COVID-19. Identifying and understanding the clinical characteristics and risk factors associated with infection are of paramount importance to inform screening strategies and infection control practices in this scenario. The aims of this study were to investigate the prevalence and clinical characteristics of healthcare workers with COVID-19 symptoms. Methods: Between March 21 st and May 22 nd , 2020 a cross-sectional study was performed in a tertiary university hospital in São Paulo. Prevalence of SARS-CoV-2 infection among health care workers with COVID-19 symptoms was determined by RT-PCR testing on nasopharyngeal and oropharyngeal samples. Participants were asked to complete an electronic structured questionnaire including clinical and demographic data. Results: Overall, 125 (42.37%) of 295 symptomatic healthcare workers tested positive for SARS-CoV-2. Over the 10-week study period, positivity rates varied from 22.2% (CI 95% 15.9% - 60.3%) in the second week to 55.9% (CI 95% 43.2% - 68.6%) in the sixth week, reaching a plateau (38% - 46%) thereafter. Median (SD) age was 34.2 (9.9) years and 205 (69.5%) were female. We did not find significant differences in the prevalence of the most commonly reported underlying medical condition among healthcare workers that tested positive or negative for SARS-CoV-2 infection. After multivariate analysis, using logistic regression, anosmia (OR 4.4 95% C.I. 2.21 - 8.74) and ocular pain (OR 1.95 C.I. 95% 1.14 - 3.33) were the only symptoms independently associated with positivity for SARS-CoV-2 infection. Follow-up information on clinical outcomes showed that 9 (7.2%) healthcare workers were hospitalized (seven were male) and 2 (1.6%) died. Conclusions: The findings of this study confirmed the high burden of SARS-CoV-2 infection among healthcare workers in the hardest hit city by the pandemic in Latin America. Anosmia and ocular pain were symptoms independently associated with COVID-19 diagnosis. In low and middle-income countries, where limited availability of tests is frequent, these findings may contribute to optimize a targeted symptom-oriented screening strategy.

scholarly journals Seasonal variation of clinical characteristics and prognostic of adult patients admitted to an intensive care unit

2019 ◽  
Vol 65 (11) ◽  
pp. 1374-1383
Author(s):  
Glaucia Galvão ◽  
Ana Luiza Mezzaroba ◽  
Fernanda Morakami ◽  
Meriele Capeletti ◽  
Olavo Franco Filho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Clinical Characteristics ◽  
Seasonal Pattern ◽  
Diagnostic Category ◽  
Adult Patients ◽  
University Hospital ◽  
Seasonal Behavior ◽  
Icu Admission

SUMMARY OBJECTIVE: To evaluate seasonal variations of clinical characteristics, therapeutic resource use, and outcomes of critically ill patients admitted to an intensive care unit. METHODS: A retrospective cohort study conducted from January 2011 to December 2016 in adult patients admitted to the intensive care unit (ICU) of a University Hospital. Data were collected on the type of admission, APACHE II, SOFA, and TISS 28 scores at ICU admission. Length of hospital stay and vital status at hospital discharge were recorded. A significance level of 5% was adopted. RESULTS: During the study period, 3.711 patients were analyzed. Patients had a median age of 60.0 years (interquartile range = 45.0 − 73.0), and 59% were men. The independent risk factors associated with increased hospital mortality rate were age, chronic disease, seasonality, diagnostic category, need for mechanical ventilation and vasoactive drugs, presence of acute kidney injury, and sepsis at admission. CONCLUSION: It was possible to observe variations of the clinical characteristics and prognosis of patients; summer months presented a higher proportion of clinical and emergency surgery patients, with higher mortality rates. Sepsis at ICU admission did not show seasonal behavior. A seasonal pattern was found for mortality rate.

scholarly journals 549. Monoclonal Antibody Therapy for COVID-19 Infection in Michigan: The Flint Experience

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S376-S377
Author(s):  
Mariam Younas ◽  
Danielle Osterholzer ◽  
Brandon R Flues ◽  
Carlos Rios-Bedoya ◽  
Philip McDonald ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
High Risk ◽  
Mortality Rate ◽  
Medical Center ◽  
Demographic Data ◽  
Severe Disease ◽  
Antibody Therapy ◽  
Hospitalization Rate ◽  
P Value ◽  
Underserved Area

Abstract Background Bamlanivimab (BAM), a neutralizing IgG1 monoclonal antibody (mAb), received emergency use authorization (EUA) by the U.S. Food and Drug Administration (FDA) for treatment of mild to moderate COVID-19 infection in patients 12 years of age and older weighing at least 40 kg at high risk for progressive and severe disease on Nov 10, 2020. The purpose of this study is to describe our experience with this treatment modality. Methods Hurley Medical Center (HMC), is a 443-bed inner city teaching hospital in Flint, MI. HMC administered its first BAM infusion on Nov 19, 2020. Through April 30, 2021, 407 patients with confirmed SARS-CoV-2 infection, received a mAb infusion. 62/407 patients received the combination mAb therapy of BAM + Etesevimab, as the EUA for BAM monotherapy was revoked on 04/16/21. We retrospectively collected basic demographic data and hospitalization to our facility within 14 days of receiving mAb therapy on these patients. Results During the 5.5 month study period, patients receiving mAb therapy at HMC had a mean age of 56 years (yrs) (± standard deviation) (± 15.4) and a mean Body Mass Index (BMI) of 34 kg/m² (± 8.5) (Tables 1,2). African Americans (AA) comprised 48% (194/407) (Table 3) and females comprised 54% (220/407) of the cohort. 6% (25/407) of the patients required hospitalization within 14 days of mAb infusion, had a mean age of 58 yrs (± 17) (p-value 0.62) and a mean BMI of 32 kg/m² (± 9) (p-value 0.33). Females and AA comprised 56% (14/25) and 48% (12/25) of this subgroup respectively (p-value 1.0). No deaths were reported within 30 days of infusion in this cohort. Conclusion Previously published reports cite a hospitalization rate in untreated high-risk COVID-19 infected patients of 9-15%. During the period of study, the county hospitalization rate and county mortality rate for all comers with COVID-19 was 6.6% and 2.7% respectively while our high risk cohort had a hospitalization rate of 6% and with no deaths reported. Our cohort had much lower rates of hospitalization and death than would be expected especially in a group which comprised of 48% AA in an underserved area. mAb therapy seems to have a protective effect with significant reduction in the hospitalization and mortality rate among high-risk patients with COVID-19 infection and should be prioritized for administration. Disclosures All Authors: No reported disclosures

scholarly journals Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Jaber S. Alqahtani ◽  
Tope Oyelade ◽  
Abdulelah M. Aldhahir ◽  
Saeed M. Alghamdi ◽  
Mater Almehmadi ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Disease Risk ◽  
Meta Analysis ◽  
Severe Disease ◽  
Case Fatality ◽  
Chronic Obstructive ◽  
Prevalence Rates ◽  
Copd Patients ◽  
Pooled Prevalence ◽  
Never Smokers

AbstractBackgroundCoronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarised the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers.MethodsWe systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI).ResultsIn total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 6.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%–3%) and 9% (95% CI, 4%–14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4– 2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03–2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%.ConclusionAlthough COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.

scholarly journals Clinical Characteristics ofNocardiaInfection in Patients with Rheumatic Diseases

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mieko Yamagata ◽  
Koichi Hirose ◽  
Kei Ikeda ◽  
Hiroshi Nakajima
Keyword(s):  
Risk Factors ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Mortality Rates ◽  
Pulmonary Diseases ◽  
High Dose ◽  
Glucocorticoid Treatment ◽  
Pulmonary Lesions

AlthoughNocardiosishas considerable recurrence and mortality rates, characteristics and risk factors ofNocardiainfection have not been assessed in patients with rheumatic diseases. Here, we examined the characteristics and risk factors ofNocardiainfection in rheumatic disease patients in our hospital. Ten rheumatic disease patients who developedNocardiainfection were identified by retrospectively reviewing the medical records. Possible predisposing factors forNocardiainfection were high-dose glucocorticoid treatment, concomitant use of immunosuppressants, preexisting pulmonary diseases, and diabetes mellitus. All patients had pulmonaryNocardiosis, and six of them had disseminatedNocardiosiswhen their pulmonary lesions were identified.

scholarly journals EP09 COVID-19 and rheumatic disease clinical characteristics and outcomes of rheumatic disease patients hospitalised with COVID-19: a single centre experience

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Myrto Cheila ◽  
Ali Elrashid ◽  
Nicola Erb ◽  
Karen Douglas ◽  
Christos Koutsianas
Keyword(s):  
Case Report ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Clinical Characteristics ◽  
Fatal Outcome ◽  
Previous History ◽  
True Incidence ◽  
Viral Spread ◽  
Increased Risk ◽  
History Of

Abstract Case report - Introduction There is limited evidence on the outcomes of COVID-19 in patients with rheumatic diseases. Since severe COVID-19 is characterised by hyperinflammation, the effects of a pre-existing inflammatory state and immunomodulatory treatments on the disease’s course are of great interest. Even though patients in this group are perceived of being at higher risk for severe disease, most of the relevant observational studies have had controversial results. We aimed to investigate the clinical characteristics and outcomes of patients with a history of rheumatic disease and COVID-19 related admission in our centre. Case report - Case description We conducted a retrospective observational study of COVID-19 RT-PCR positive admissions of patients coded as having rheumatic disease in the Dudley Group NHS Foundation Trust between April 1st and June 24th, 2020. Data were extracted from the patient clinical notes and electronic medical records and were captured and analysed on MS Excel. Among 613 COVID-19 related admissions, 19 (3.1%) patients were coded as having comorbid rheumatic disease. 8 cases were excluded from further analysis as, upon records review, they had osteoarthritis or a history of gout. Thus, the true incidence of comorbid rheumatic disease among COVID-19 related hospitalisations was even lower at 11/613 (1.8%). The mean age of the patients was 80.5 ± 8.06 years, 9/11 (81.8%) were female and 8/11 (73%) were Caucasian. In the vast majority the diagnosis was that of Rheumatoid Arthritis (9/11, 81.8%), while one patient had Polymyalgia Rheumatica and another Systemic Lupus Erythematosus. Only a quarter of the patients had moderate (2, 18%) or high (1, 9%) disease activity on their most recent outpatient visit. In terms of antirheumatic medication, 5 (45%) patients were on regular Prednisolone (20% <5mg, 80% 5-10mg), 8 (72%) were on cs DMARDs and only 1 (9%) on bDMARDs. A substantial proportion of the patient cohort also suffered with other comorbidities. 8/11 (72.7%) patients had arterial hypertension, 5 (45.4%) had a history of cardiovascular disease, 3 (27.3%) obesity (BMI 30+), 3 (27.3%) previous history of cancer, 2 (18.2%) COPD, 2 (18.2%) CKD, 1 (9%) Interstitial lung disease, 1 (9%) Diabetes, 1 (9%) Cerebrovascular disease and 1 (9%) immunodeficiency. During their admission, 7 (63.6%) patients required supplemental oxygen therapy. Unfortunately, 5/11 (45.5%) patients had a fatal outcome. Case report - Discussion In our cohort, the percentage of patients with rheumatic diseases among inpatients with confirmed COVID-19 infection was low (∼1.8%). Potential explanations for this observation could be a beneficial effect of concomitant antirheumatic treatment (steroids and/or DMARDs) in controlling hyperinflammation, but also rheumatic disease patients’ increased risk awareness and thus increased compliance with viral spread mitigation measures (‘shielding’) as per Government guidelines. We also note the low rate of biologic DMARD use with only 1 (9%) inpatient having received Rituximab for RA. Case report - Key learning points The incidence of rheumatic disease among COVID-19 related admissions in our centre was exceptionally low. Per recently published reports from worldwide registries, older age and multiple comorbidities appear to drive the risk for hospitalisation, need for oxygen supplementation and fatal outcome. Better understanding of the effect of DMARDs on COVID-19 severity requires further investigation, perhaps with SARS-CoV-2 antibody studies, but our observations appear to be reassuring.

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