COVID-19 in Italian Sjögren's syndrome patients: a monocentric study

Giardina, Federico; Izzo, Rosanna; Gattamelata, Angelica; Colafrancesco, Serena; Conti, Fabrizio; Priori, Roberta

doi:10.1007/s00296-020-04722-1

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…Few specific data are available for individual systemic autoimmune diseases. In pSS, two studies have evaluated the impact of the pandemic in people affected by the disease (13,14), and only one has described the phenotype of SARS-CoV-2 infection in 51 patients with pSS (15). This study confirmed that the main baseline features associated with a more complicated infection were similar to that identified in non-SS studies, including older age, male sex, chronic comorbidities (pulmonary/kidney diseases), pneumonia (respiratory symptoms and pulmonary infiltrates) and lymphopenia (19).…”

Section: Discussionmentioning

confidence: 99%

“…Recently-published guidelines focused on the management of long COVID-19 in a primary care setting have also endorsed the use of these terms and definitions recommended by the NICE (12). Very few studies have analysed the impact of SARS-CoV-2 infection in patients with pSS (13)(14)(15), and none has evaluated the development of the post-COVID-19 syndrome. The objective of this study was to analyse the frequency and characteristics of the post-COV-ID-19 syndrome in patients with pSS affected by acute SARS-CoV-2 infection.…”

Section: Introductionmentioning

confidence: 99%

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Post-COVID-19 syndrome in patients with primary Sjögren's syndrome after acute SARS-CoV-2 infection

Brito-Zerón¹,

Acar-Denizli

Romão

et al. 2021

Clinical and Experimental Rheumatology

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Objective. To analyse the frequency and characteristics of post-COVID-19 syndrome in patients with primary Sjögren's syndrome (pSS) affected by acute SARS-CoV-2 infection. Methods. By the first week of April 2021, all centres included in the Big Data Sjögren Consortium were contacted asking for patients included in the Registry diagnosed with SARS-CoV-2 infection according to the ECDC guidelines. According to the NICE definitions, symptoms related to COVID-19 were classified as acute COVID-19 (signs and symptoms for up to 4 weeks), ongoing symptomatic COVID-19 (presence of signs and symptoms from 4 to 12 weeks) and post-COVID-19 syndrome (signs and symptoms that continue for >12 weeks not explained by an alternative diagnosis after a protocolised study). Results. We identified 132 patients who were followed a mean follow-up of 137.8 days (ranging from 5 days to 388 days) after being diagnosed with COVID-19. In the last visit, 75 (57%) patients remained symptomatic: 68 (52%) remained symptomatic for more than 4 weeks fulfilling the NICE definition for ongoing symptomatic post-COVID-19, and 38 (29%) remained symptomatic for more than 12 weeks fulfilling the definition of post-COV-ID-19 syndrome. More than 40% of pSS patients reported the persistence of four symptoms or more, including anxiety/ depression (59%), arthralgias (56%), sleep disorder (44%), fatigue (40%), anosmia (34%) and myalgias (32%). Age-sex adjusted multivariate analysis identified raised LDH levels (OR 10.36), raised CRP levels (OR 7.33), use of hydroxychloroquine (OR 3.51) and antiviral agents (OR 3.38), hospital admission (OR 8.29), mean length of hospital admission (OR 1.1) and requirement of supplemental oxygen (OR 6.94) as factors associated with a higher risk of developing post-COVID-19 syndrome. A sensitivity analysis including hospital admission in the adjusted model confirmed raised CRP levels (OR 8.6,) and use of hydroxychloroquine (OR 2.52, as the key independent factors associated with an enhanced risk of developing post-COVID-19 syndrome. Conclusion. This is the first study that analyses the frequency and characteristics of post-COVID-19 syndrome in patients affected by a systemic autoimmune disease. We found that 57% of patients with pSS affected by COVID-19 remain symptomatic after a mean follow-up of 5 months. The risk of developing post-COVID-19 syndrome in patients who required hospitalisation was 8-times higher than in non-hospitalised patients, with baseline raised CRP levels and the use of hydroxychloroquine being independent risk factors for post-COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post-COVID-19 syndrome in patients with primary Sjögren's syndrome after acute SARS-CoV-2 infection

Brito-Zerón¹,

Acar-Denizli

Romão

et al. 2021

Clinical and Experimental Rheumatology

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“…In the study of Giardina et al, evaluating the impact of the outbreak on patients with SS, 32.6% never left home and 65.3% left home for necessities [ 2 ]. As in this study, similar adherence to lockdown measures were also reported in our survey, namely 35.7% respected strictly the lockdown measures, while 56.2% left home with caution, only for important reasons.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, in most countries with a significant number of cases, the various general (wearing masks, social distancing) or more restrictive lockdown measures adapted to each country or region were applied to stop the infection from spreading. However, beyond limiting the SARS-CoV-2 infection, these measures had a significant impact on the general quality of life, the access to some specific medications (i.e., hydroxychloroquine) and on healthcare providers of patients with chronic diseases, including autoimmune pathologies like SS [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on patients with primary Sjögren syndrome

Serban¹,

Mihai²,

Dima

et al. 2021

Rheumatol Int

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The aim of this study was to investigate the perspective of Romanian patients with Sjögren syndrome (SS) on various aspects of the disease during the SARS-CoV-2 outbreak, including both the impact of COVID-19 on the disease itself as well as the effects of vaccination against SARS-CoV-2 in this group of patients. The study is an online questionnaire-based survey. We received responses from 137 SS patients. Regarding the general emotional status, 33 patients (24.0%) and 47 patients (34.3%) declared to have been sadder/depressive and more agitated/anxious during the SARS-CoV2 outbreak, respectively. During the lockdown, 49 (33.7%) patients strictly and 77 patients (56.2%) did their best to respect the home isolation measures. The income was unchanged for most of the patients (94 patients, 68.6%). Regarding access to healthcare providers, 27 patients (18.7%) postponed the consultation for fear of getting SARS-CoV2. In our study group, 31 patients (22.6%) responded that they have had COVID-19. Only one patient was completely asymptomatic, while the most frequently declared symptom was weakness (84.0%). In 17 patients among the respondents (68%) the symptoms lasted for at least 2 weeks; the most frequent long-lasting symptoms were fatigue (40.0%) and weakness (36.0%). Out of all the respondents, 53 patients (41.4%) were vaccinated against SARS-CoV2 with at least one dose. After the first dose, the most prevalent side effect was pain at the site of injection (89.2%), followed by weakness (25.0%) and myalgias (21.4%). This information will be useful for developing special programs dedicated to SARS-CoV2 infection and vaccination in patients with SS and other autoimmune diseases. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-021-04967-4.

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“…COVID -19 is an infectious disease with a strong inflammatory response as demonstrated by the phenomenon of "cytokines storm" [7]; therefore, it is intriguing to speculate that the reports on positive SSA antibodies in these patients [8,9] may indicate the existence of autoimmune inflammatory response similar to the one described in Sjogren's syndrome [10,11] that can result in dry mouth as well.…”

mentioning

confidence: 94%

Prevalence of dry mouth in COVID-19 patients with and without Sicca syndrome in a large hospital center

Katz

2021

Ir J Med Sci

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COVID-19 in Italian Sjögren's syndrome patients: a monocentric study

Cited by 3 publications

References 9 publications

Post-COVID-19 syndrome in patients with primary Sjögren's syndrome after acute SARS-CoV-2 infection

Post-COVID-19 syndrome in patients with primary Sjögren's syndrome after acute SARS-CoV-2 infection

The impact of the COVID-19 pandemic on patients with primary Sjögren syndrome

Prevalence of dry mouth in COVID-19 patients with and without Sicca syndrome in a large hospital center

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