Managing ANCA-associated vasculitis during the COVID-19 pandemic: results from an online survey

Kopp, Chirag Rajkumar; Naidu, Gsrsnk; Misra, Durga Prasanna; Deo, Prateek; Jakulla, Roopesh Sai; Makan, Kavita; Maharaj, Ajesh B.; Agarwal, Vikas; Sharma, Aman

doi:10.1007/s00296-021-04975-4

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…To the best of our knowledge, this is the first patient survey designed to assess (1) the changes in medical care provided to vasculitis patients in the COVID-19 pandemic and (2) vaccination acceptance in this patient cohort. While several published reports document the results of surveys that included patients with RMDs, the proportion of vasculitis patients was small and their responses were not analyzed separately; in other studies, only data from the first month of the pandemic were presented (18)(19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

et al. 2023

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ObjectiveTo analyze the impact of the COVID-19 pandemic on medical care and vaccination acceptance of vasculitis patients in Germany.MethodsA web-based national survey was developed by rheumatology centers and vasculitis patient advocacy groups. The survey was distributed nationwide by mail and flyers and could be accessed via a QR-code or weblink from December 2021 to April 2022. Descriptive statistics [mean, median, standard derivation (SD), 25%, 75% quantile] were calculated. 95% confidence intervals were presented for responses that were directly related to the impact of COVID-19 on parameters associated with vasculitis patient care.ResultsThe online survey was completed by 117 patients with small and large vessel vasculitis [granulomatosis with polyangiitis (n = 69), eosinophilic granulomatosis with polyangiitis (n = 16), microscopic polyangiitis (n = 12), giant cell arteritis (n = 17) and Takayasu's arteritis (n = 3)]. Prescheduled rheumatological appointments had been canceled due to the COVID-19 pandemic in 12.6% of the respondents [95% confidence interval (CI), 7.3–20.0%); in 9% (95% CI, 4.5–15.6%)] appointments had been replaced by digital services. Therapeutic regimens were changed (shifted, reduced, or discontinued) due to the pandemic in 15.5% (95% CI 9.5–22.2%). Vaccination coverages were generally high compared to patients with other rheumatic diseases and the general population. Highest vaccination coverage was observed against COVID-19 (98.1% 95% CI 93.9–99.6%).ConclusionVasculitis patients experienced changes in medical care during COVID-19 pandemic such as cancelation of prescheduled rheumatology appointments and modifications in therapeutic regimens. The overall acceptance rate for vaccination was comparatively high, particularly for vaccination against COVID-19.

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Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

et al. 2023

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“…Endothelial injury and NETosis found in COVID-19 may predispose to small-vessel vasculitis such as AAV [ 29 ]. But in a clinical scenario, it is always difficult to balance the correct amount of immunosuppression and the clinicians might want to err on the side of omission rather than commission, as was evident from a previous survey on this topic [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Physicians’ perceptions about antineutrophil cytoplasmic antibody-associated vasculitis: an online survey report in the time of the COVID-19 pandemic

et al. 2022

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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are characterized by necrotizing inflammation of small and medium-size vessels that often manifest with devastating multi-organ effects. They present with a myriad of systemic features and require potent immunosuppression. Since they are uncommonly encountered in clinical practice, it is necessary to understand physicians’ knowledge and perceptions about this group of diseases. An online questionnaire was designed featuring 28 questions based on relevant global practice guidelines, recommendations, and previous online surveys on AAV. The questionnaire was validated by a core group of specialists with an interest in AAV. It was shared via social networking sites and entries were restricted to physicians. Only completed entries were analyzed with descriptive statistics. A total of 113 respondents from 21 different countries responded of whom the commonest were rheumatologists, internists, and general practitioners. Forty-five (40%) ran clinics dedicated to AAV patients as a part of their practice. They commented on organs involved in AAV; vasculitis secondary to infections, drugs or other rheumatic diseases; various tests useful for AAV diagnosis; and drug choices for induction and maintenance. They mentioned their experience regarding COVID-19 in AAV patients as well as vasculitic manifestations of COVID-19. Various methods to mitigate cardiovascular risks in AAV were mentioned. Finally, the respondents indicated how medical education needed to be strengthened to increase awareness and knowledge regarding AAV. This survey helped to inform about various perceptions regarding AAV across countries, including current practices and recent evolution of management. It also provided information on treatment of the COVID-19 in AAV patients. This survey showed that there is still a lack in understanding the prevalent definitions and there is gap between guidelines and current practice. Key Points • Perception about ANCA-associated vasculitis differ across countries. • The number of cases encountered across 21 different countries are limited implying a need for multi-national cooperation to study this disease further. • The COVID-19 pandemic has changed the approach towards ANCA-associated vasculitis by the various clinicians. Supplementary Information The online version contains supplementary material available at 10.1007/s10067-022-06452-0.

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“…Patients with AIRDs are at increased risk of various infections both due to the various immunosuppressive drugs used to control the disease manifestations and due to the immune dysregulation seen in these patients due to underlying AIRD [ 1 ]. Hence the ongoing COVID-19 pandemic has created a great dilemma for clinicians treating various AIRDs, especially life-threatening diseases like anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) which has been well recognized over past year [ 2 ]. Data from the OpenSAFELY database have shown that the mortality is definitely higher in patients with AIRDs compared to general population [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Managing ANCA-associated vasculitis during COVID-19 pandemic: a single-center cross-sectional study

et al. 2022

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The objective of the study is to report the outcomes of COVID-19 in ANCA-associated vasculitis (AAV) patients. This was a registry-based observational study conducted at a tertiary care center in north India. AAV patients with at least one follow-up visit between March 2020 and September 2021 were included. Demographic features, clinical manifestations, disease activity, and treatment details of underlying AAV were noted in all patients. Details of COVID-19 infection including severity, treatment, and outcomes were noted. Predictors of COVID-19 severity were determined using univariate analysis. A total of 33 (18.3%) out of 180 AAV patients contracted COVID-19 infection. Moderate COVID-19 infection was seen in 33.3% and severe or critical infection was seen in 36.3% of patients. Seventeen patients (51.5%) required supplemental oxygen therapy. Nine patients had active disease at the time of COVID-19 infection and three of them died due to COVID-19 infection. The risk of COVID-19 infection and its severity did not differ between patients receiving different immunosuppressants including rituximab induction. Hypothyroidism ( p = 0.046) and ocular ( p = 0.038) involvement due to AAV predicted the development of moderate to severe/critical COVID-19. Three (9.1%) patients died from COVID-19 and the rate of AAV flare after COVID-19 was similar to that in non-COVID-19 patients (15.3/100 person-year vs. 15.6/100 person-year, p = 0.95). Majority of the patients with AAV had moderate to severe or critical COVID-19 infection. The rate of death due to COVID-19 in AAV is higher than in general population. Use of standard remission induction regimens did not lead to increased risk of COVID-19 infection in our AAV cohort. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-022-05177-2.

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Managing ANCA-associated vasculitis during the COVID-19 pandemic: results from an online survey

Cited by 3 publications

References 26 publications

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

COVID-19 pandemic impairs medical care of vasculitis patients in Germany: Results of a national patient survey

Physicians’ perceptions about antineutrophil cytoplasmic antibody-associated vasculitis: an online survey report in the time of the COVID-19 pandemic

Managing ANCA-associated vasculitis during COVID-19 pandemic: a single-center cross-sectional study

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