Axial spondyloarthritis may protect against poor outcomes in COVID-19: propensity score matched analysis of 9766 patients from a nationwide multi-centric research network

Raiker, Rahul; Pakhchanian, Haig; Kavadichanda, Chengappa; Gupta, Latika; Kardeş, Sinan; Ahmed, Sakir

doi:10.1007/s10067-021-05979-y

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…Raiker et al [13] showed that patients with axSpa had better COVID-19 outcomes such as severity, hospitalization, and mortality but worsened results for venous thromboembolism (VTE) and cerebral infarction than propensity score matched controls, but we didn't observe these complications; anti-TNF agents did not affect poor COVID-19 outcomes as our study. Rosenbaum et al [14] reported that both Spa and its treatment, including cDMARDs or bDMARDs (anti-TNF agents and IL-17 inhibitors), had no unfavourable effect on COVID-19 frequency and severity; 83.5% of study patients were AS and 7% were nr-axSpa, but results didn't include subgroup analysis of spondyloarthropathies.…”

Section: Discussioncontrasting

confidence: 62%

Factors associated with freqeuncy and severity of COVID-19 in patients with axial spondyloarthritis

PEKDİKER

KARA

KOÇ³

et al. 2023

Pam Tıp Derg

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Purpose: The severe course of COVID-19 in individuals with chronic diseases has led to concerns in the management of rheumatic diseases during the pandemic therefore we aimed to define the factors associated with the frequency and severity of COVID-19 in patients with axial spondyloarthritis (axSpa) in this study. Materials-Methods: Patients with axSpa who were followed up in three tertiary hospitals and used their treatment regularly for at least six months were included. We assessed the relationship between axSpa associated variables such as disease duration time, radiological severity, treatment and COVID-19 outcomes. Results: A total of 833 patients with a mean disease duration of 109 months were analyzed; 64.5% had ankylosing spondylitis, 35.5% had non-radiographic axSpa diagnosis, and 59.4% of patients were treated with biologic agent . The frequency of COVID-19 was 23% (n: 192); only five pateints (0.5%) had a history of intensive care unit. Advanced age, hypertension (HT), and diabetes mellitus (DM) were found to be significantly more common in those with involvement in high resolution computed tomography (HRCT) (p:0.02, p:0.01, and p

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Section: Discussioncontrasting

confidence: 62%

Factors associated with freqeuncy and severity of COVID-19 in patients with axial spondyloarthritis

PEKDİKER

KARA

KOÇ³

et al. 2023

Pam Tıp Derg

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“…5 Interestingly, psoriasis also showed reduced risk for all three outcomes in both time periods, and spondyloarthritis was associated with reduced risk in the pre-Omicron period. The latter adds new evidence to support the spondyloarthritis finding reported earlier by Raiker et al 20 In contrast, Rosenbaum et al reported a small increased risk of developing COVID-19 for patients with spondyloarthritis in the pre-Omicron period but mentioned the risk was not consistently demonstrated. 21 While this might reflect unmeasured variables, such as behaviours taken to avoid risk of infection, the results merit further investigation into potential disease-related protective factors, such as HLA-B27.…”

Section: Discussionsupporting

confidence: 57%

Risk factors for severe COVID-19 outcomes: a study of immune-mediated inflammatory diseases, immunomodulatory medications, and comorbidities in a large US healthcare system

Hadlock

Mease³

et al. 2023

Preprint

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Background COVID-19 outcomes, in the context of immune-mediated inflammatory diseases (IMIDs), are incompletely understood. Reported outcomes vary considerably depending on the patient population studied. It is essential to analyse data for a large population, while considering the effects of the pandemic time period, comorbidities, long term use of immunomodulatory medications (IMMs), and vaccination status. Methods In this retrospective case-control study, patients of all ages with IMIDs were identified from a large U.S. healthcare system. COVID-19 infections were identified based on SARS-CoV-2 NAAT test results. Controls without IMIDs were selected from the same database. Severe outcomes were hospitalisation, mechanical ventilation (MV), and death. We analysed data from 1 March 2020 to 30 August 2022, looking separately at both pre-Omicron and Omicron predominant periods. Factors including IMID diagnoses, comorbidities, long term use of IMMs, and vaccination and booster status were analysed using multivariable logistic regression (LR) and extreme gradient boosting (XGB). Findings Out of 2 167 656 patients tested for SARS-CoV-2, there were 290 855 with confirmed COVID-19 infection: 15 397 patients with IMIDs and 275 458 controls (patients without IMIDs). Age and most chronic comorbidities were risk factors for worse outcomes, whereas vaccination and boosters were protective. Patients with IMIDs had higher rates of hospitalisation and mortality compared with controls. However, in multivariable analyses, few IMIDs were rarely risk factors for worse outcomes. Further, asthma, psoriasis and spondyloarthritis were associated with reduced risk. Most IMMs had no significant association, but less frequently used IMM drugs were limited by sample size. XGB outperformed LR, with the AUROCs for models across different time periods and outcomes ranging from 0.77 to 0.92. Interpretation For patients with IMIDs, as for controls, age and comorbidities were risk factors for worse COVID-19 outcomes, whereas vaccinations were protective. Most IMIDs and immunomodulatory therapies were not associated with more severe outcomes. Interestingly, asthma, psoriasis and spondyloarthritis were associated with less severe COVID-19 outcomes than those expected for the population overall. These results can help inform clinical, policy and research decisions. Funding Pfizer, Novartis, Janssen, NIH

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“…В другом исследовании на основании анализа электронных баз данных сравнивались исходы COVID-19 у 9766 больных аксиальным СпА (аксСпА) и пациентов, не имевших СпА [14]: при аксСпА наблюдались более низкие смертность (ОР 0,71; 95% ДИ 0,60-0,84; р<0,0001), частота тяжелых форм COVID-19 (ОР 0,79; 95% ДИ 0,69-0,91; р=0,0007), госпитализаций (ОР 0,87; 95% ДИ 0,83-0,92: р<0,0001) и острых почечных поражений (ОР 0,90; 95% ДИ 0,82-0,997; р=0,044). Только риск венозных тромбоэмболий при аксСпА оказался несколько выше (ОР 1,22; 95% ДИ 1,04-1,43; р=0,016).…”

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Axial spondyloarthritis and COVID-19: course, interactions, outcomes, and the role of vaccination

S¹,

Белов²

2023

Sovremennaâ revmatologiâ

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The review analyzes data on the course and outcomes of axial spondyloarthritis (axSpA) accumulated over the previous 2.5 years of the COVID-19 pandemic. The issues of clinical and immunological efficacy of vaccination against COVID-19 in this disease are considered. It was noted that the presence of axSpA, as well as treatment with tumor necrosis factor-á inhibitors and non-steroidal anti-inflammatory drugs, did not significantly increase the risk of COVID-19 infection and did not worsen its outcomes, apart from an increase in the incidence of venous thromboembolism. At the same time, it is assumed that anticytokine therapy for SpA may protect against severe COVID-19 course.The data presented suggest that the benefits of vaccination in SpA far outweigh the potential harms associated with the development of adverse events. It has been shown that in patients with SpA, vaccination does not affect the activity of the inflammatory process, and biologic disease modifying antirheumatic drugs have almost no significant effect on the post-vaccination response.

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Axial spondyloarthritis may protect against poor outcomes in COVID-19: propensity score matched analysis of 9766 patients from a nationwide multi-centric research network

Cited by 10 publications

References 34 publications

Factors associated with freqeuncy and severity of COVID-19 in patients with axial spondyloarthritis

Factors associated with freqeuncy and severity of COVID-19 in patients with axial spondyloarthritis

Risk factors for severe COVID-19 outcomes: a study of immune-mediated inflammatory diseases, immunomodulatory medications, and comorbidities in a large US healthcare system

Axial spondyloarthritis and COVID-19: course, interactions, outcomes, and the role of vaccination

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