Investigating The Clinical Manifestations, Severity And Outcomes Of COVID-19 Among Inpatients With Rheumatic Diseases: A Retrospective Cross-Sectional Study In Iran

Abstract

Introduction — Patients with rheumatic diseases (RD) may be at an increased risk of developing severe symptoms of COVID-19. They are likely to have a wide range of manifestations and outcomes that can make it difficult to control the disease. The goal of this study was to investigate the clinical manifestations, severity, and outcomes of adult patients with RD hospitalized for COVID-19. Methods — We conducted a retrospective cross-sectional study. Eligible rheumatology patients were confirmed by a rheumatologist in compliance with American College of Rheumatology (ACR) criteria and had COVID-19 confirmed by computed tomography (CT) scan or polymerase chain reaction (PCR) test. Information about their gender, age, and clinical manifestations of COVID-19, along with the variables pertaining to the outcomes of the patients, was collected. Descriptive statistics and Fisher’s exact test were performed using IBM SPSS Statistics software. Results — A total of 105 patients with RD and COVID-19 were included. Rheumatoid arthritis (RA) was the most common disease (86 patients). Most patients were female (75.2%). The mean age of the participants was 58.97±12.25 years. Myalgia/arthralgia was the predominant symptom of COVID-19 (77.1%), followed by shortness of breath, cough, and fever. Only platelet count exhibited a significant association with the type of RD (p = 0.004). Conclusion — Common adverse outcomes included moderate severity based on CT grading, anemia, oxygen saturation levels (SpO2) below 90%, and severe CT-based grade of severity. The mortality rate was relatively high.