Objective To describe the cohort of patients with inflammatory rheumatic diseases (IRD) hospitalized due to SARS-CoV-2 infection in our hospital and to determine the increased risk of severe coronavirus disease regarding no IRD patients. Methods Retrospective single-center observational study of patients with IRD actively monitored in the Department of Rheumatology who were hospitalized due to COVID- 19. Results 41 (1,8%) out of 2,315 patients admitted due to severe SARS-CoV-2 pneumonia suffered from an IRD. The admission Odds ratio (OR) for IRD patients was 1.87 against the general population, and it was higher in patients with Sjögren’s syndrome, vasculitis and systemic lupus erythematosus. Twenty-seven patients were receiving treatment for IRD with corticosteroids, 23 with conventional DMARDs, 12 with biologics (7 rituximab, 4 anti-TNF and 1 abatacept) and 1 with JAK inhibitors. Ten deaths were registered among patients with IRD. A higher hospitalization rate and a higher number of deaths were observed in patients treated with rituximab (OR=12.8) but not in patients treated with anti-TNF (OR=0.9). Conclusion Patients with IRD, especially autoimmune diseases and patients treated with rituximab, may be at higher risk of severe pneumonia due to SARS-Cov 2, compared to the general population. More studies are needed to analyze this association further in order to help managing these patients during the pandemic.

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Background Treatment of moderate to severe carpal tunnel syndrome includes the possibility of local steroid injections, however the treatment success rate and its duration are very variable. There is no study designed to predict if a local steroid injection will be success or not. Sometimes local steroids injections delays surgical procedures without solving patient symtoms. A marker capable to predict success of failure should be useful in terms of chosing best therapy for these patients. Objectives The purpose of this study was to determine the weight of different factors as predictors of the therapeutic success of steroid joint injections. Methods We conducted a retrospective study with a cohort of 166 patients diagnosed with moderate or severe carpal tunnel syndrome according to electrophysiological criteria and who had undergone carpal ultrasound between 2010 and 2013. A multivariate analysis, using as the variable response a reduction in the score at the Boston Carpal Tunnel Syndrome Questionnaire three months after the steroid infiltration was performed. Results The presence of positive power- Doppler signal in the carpal tunnel showed a high correlation with the improvement at the Boston Carpal Tunnel Syndrome Questionnaire (Pearson r -0.7079, p=0.0001) in the bivariate analysis, and a ratio of 49.8% in the multivariate analysis (Heat coeff -0.4777 [95% CI -1.4775 to -0.5612], p<0.0001). Other relevant variables were: duration of symptoms (Heat coeff 0.0071 [95% CI 0.0025 to 0.0117], p=0.0027), the cross-sectional area of the median nerve within the carpal tunnel (Heat coeff 0.0223 [95% CI 0.0023 to 0.0424], p=0.0293) and age (0.0029 Heat coeff [CI -0.0005 to 0.0064], p=0.0979). Conclusions Our results suggest that the therapeutic success of infiltration is mainly associated with the finding of power- Doppler signal. According to our analysis we believe it is reasonable to recommend steroids joint injections in patients with this finding and to consider the risk/benefit in patients without this sonographic predictor. Acknowledgements To Dr. Domingo Ly Pen for his contribution to this study. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.5556

Objectives To determine the prevalence of subclinical synovitis in Lupus patients without peripheral joint symptoms, in those with arthralgias without arthritis and those with episodic arthritis but without radiological structural damage. Methods We conducted a multicentre cross-sectional study. Patients with lupus from those three categories were recruited to take part in a greyscale ultrasound scan performed by an expert blinded rheumatologist. Data from a historical control group from a previous study was also included for comparisons. Images were assessed separately in order to determine the presence and level of synovitis following Eular recommendations. Results Ninety-six patients (88.5% female) with an average age of 40 ± 6.2 years old, were included. SLICC/ACR score was 0.6 ± 0.3 in the group without joint symptoms (group 0), 0.8 ± 0.3 in the group with arthralgias (group I) and 1.1 ± 0.4 in the group with episodic arthritis. The global prevalence of subclinical synovitis was 38.5%. In group 0, that prevalence was 30%. The time since onset of symptoms of patients with subclinical synovitis was longer than the rest of the patients (9.4 ± 2.2 vs 6.5 ± 4.0 years, P < 0.001). No other remarkable association was founded with clinical features of the disease. Conclusions This is the first study focused on subclinical synovitis in patients with lupus. Other previous studies had included patients with different levels of arthropathy. Subclinical synovitis does exist in lupus patients in over a third of patients. Its meaning remains unclear and must be a topic of further studies.

Objective. To compare the proportion of synovitis detected by ultrasonographic study (USS) of the hands, in subjects with no rheumatologic known disease according to self-reported level of overexertion performed the day before. Methods. 407 consecutive volunteers were enrolled in a twelve-month period and underwent an ultrasound assessment of the hand. All studies were performed on Monday or Friday. Subjects were grouped according to their self-reported overexertion carried out the day before. Presence or absence of ultrasonographic findings compatible with synovitis was compared between groups. Results. 95.8% of those tested on Friday had made no overexertion the day before the study, while 30.2% of those assessed on Monday declared to have carried out an overexertion. Presence of carpal synovial hypertrophy, synovial fluid/effusion, and power-Doppler signal was statistically higher in subjects who carried out an overexertion the day before the study than the rest of subjects when the dominant hand was assessed. Globally, presence of any synovitis ultrasonographic finding was statistically higher in subjects who were studied on Monday than Friday (34.9% versus 12.1%) and in subjects who self-reported an overexertion the day before compared to the rest of subjects (47.7 versus 11.5%). Conclusions. In general, we recommend performing the USS as many days as possible after the most recent overexertion.