Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study

Sattui, Sebastian E.; Conway, Richard; Putman, Michael; Seet, Andrea M; Gianfrancesco, Milena; Beins, Kaley; Hill, Catherine; Liew, David; McDermott, Michael; Mehta, Puja; Neill, Lorna; Gómez, Gimena; Salinas, Maria Isabel Haye; Maldonado, F.; Mariz, Henrique Ataíde; Studart, Sâmia Araújo de Sousa; Araújo, Nafice Costa; Knight, Ann; Rozza, Davide; Quartuccio, Luca; Samson, M.; Bally, Stéphane; Maria, A.; Chazerain, P.; Hasseli, Rebecca; Müller‐Ladner, Ulf; Hoyer, Bimba F.; Voll, Reinhard; Torres, Rita; Luís, Mariana; Ribeirio, Sandra Lucia Euzebio; Al‐Emadi, Samar; Sparks, Jeffrey A.; Hsu, Tiffany; D’Silva, Kristin M; Patel, Naomi J; Wise, Leanna; Gilbert, Emily L.; Almada, Maria Valenzuela; Duarte‐García, Alí; Ugarte‐Gil, Manuel F.; Jacobsohn, Lindsay; Izadi, Zara; Strangfeld, Anja; Mateus, Elsa F; Hyrich, Kimme L; Gossec, Laure; Carmona, Loreto; Lawson‐Tovey, Saskia; Kearsley‐Fleet, Lianne; Schaefer, Martin; Sirotich, Emily; Hausmann, Jonathan S; Sufka, Paul; Bhana, Suleman; Liew, Jean W; Grainger, Rebecca; Machado, Pedro; Wallace, Zachary S; Yazdany, Jinoos; Robinson, Philip C; Dahou, Brahim; Rath, Eva; Piette, Y; Devinck, Mieke; Maeyaert, Bea; Ribeiro, Francinne Machado; Ribeiro, Sandra Lúcia Euzébio; Pinheiro, Marcelo M.; Quintana, Rosana; Roberts, Karen; Báez, Roberto Miguel; Coello, Vanessa Castro; Salinas, María Jezabel Haye; Torres, Alvaro Andres Reyes; Alle, Gelsomina; Tanten, Romina; Ficco, Hernán Maldonado; Nieto, Romina; Gobbi, Carla; Tissera, Yohana; Pisoni, Cecilia; Paula, Alba; Albiero, J. A.; Schmid, María Marcela; Cosatti, M.; Gamba, María Julieta; Leandro, Carlevaris; Cusa, María Alejandra; Germán, Noelia; Bellomio, Verónica; Takashima, Lorena; Pera, Mariana; Cogo, Karina; Elkin, M. S. Gálvez; Medina, María Alejandra; Savio, V.; Tessel, Ivana Romina Rojas; Alamino, Rodolfo Pérez; Werner, Marina Laura; Ornella, Sofía; Casalla, Luciana; Vega, Marı́a de la; Severina, María de los Ángeles; García, Mercedes; Lucero, Luciana González; Romeo, Cecilia; Moyano, Sebastián; Barbich, Tatiana; Bertoli, Ana M.; Baños, Andrea; Petruzzelli, Sandra; Matellan, Carla; Conti, Santiago; Lazaro, Ma. Alicia; Gil, Gustavo Fabián Rodriguez; Risueño, Fabián; Quaglia, M. I.; Scafati, Julia; Cuchiaro, Natalia Lili; Rebak, J.; Pineda, Susana; Calvo, María Elena; Picco, Eugenia; Yanzi, Josefina Gallino; Maid, Pablo; Guaglianone, Debora; Morbiducci, Julieta Silvana; Porta, Sabrina; Herscovich, Natalia; Zamora, José Luis Velasco; Kisluk, Boris; Menescardi, Maria Sol Castaños; Gallo, Rosana; Martire, María Victoria; Maldini, Carla; Goizueta, Cecilia; Fernandez, Sabrina Solange de la Vega; Aeschlimann, Carolina; Subils, Gisela; Ibáñez, Sebastian; Chassin-Trubert, Anne-Marie; Dong, Lingli; Cajas, L M; Barešić, Marko; Anić, Branimir; Čulo, Melanie-Ivana; Pavelic, Tea Ahel; Stranski, Kristina Kovacevic; Karanović, Boris; Vencovský, Jiří; Píchová, Marta; Filková, Mária; Hamoud, Hesham; Vassilopoulos, Dimitrios; Melgar, Gabriela Maria Guzman; So, Ho; Király, Márta; Vojdanian, Mahdi; Balbir‐Gurman, Alexandra; Abutiban, Fatemah; Zepa, Jūlija; Buliņa, Inita; Bukauskienė, Loreta; Zaueta, Beatriz; Ortiz, Angel Alejandro Castillo; Tehozol, Erick Adrian Zamora; Vega, David; Rosete, Diana Cervántes; Nares, E; Rodríguez‐Reyna, Tatiana Sofía; Gabayet, Marina Rull; Alpizar-Rodriguez, D.; Irazoque, Fedra; Jimenez, Xochitl; Bon, Lenny Geurts-van; Zijlstra, T. R.; Hoekstra, Monique; Al-Adhoubi, Nasra K.; Salim, Babur; Giraldo, Enrique; Salinas, Ariel; Nowakowski, Jarosław; Flood, Rachael; McCarthy, Geraldine; Felea, Ioana; Filipescu, Ileana; Rednic, Simona; Groşeanu, L.; Tamas, Maria Magdelena; Mlynáriková, Vanda; Skamlova, Martina; Zlnay, M; Miceková, D; Cápová, L; Macejová, Želmíra; Šteňová, Emőke; Raffayová, Helena; Belakova, Gabriela; Straková, Eva; Senčarová, Marieta; Žlnayová, Soňa; Sabová, Anna Anna; Spišáková, Daniela; Oetterová, Mária; Lukáčová, Oľga; Bakošová, Martina; Hočevar, Alojzija; Torre-Rubio, Natalia de la; Sancho, Juan José Alegre; Coro, Montserrat Corteguera; García, Juan Carlos Cobeta; Martín, Maria Carmen; Campos, Jose; Puerta, José Alfredo Gómez; Yardimci, Gozd Kubra; Akar, Servet; İçaçan, Ozan Cemal; Çelik, Selda; Vasylets, Viktoriia; Yeoh, Su-Ann; Vandevelde, Claire; Dunt, Sasha; Leeder, Jane; MacPhie, Elizabeth; Salerno, Rosaria; Graver, Christine; Williams, Katie; O’Reilly, Sheila; Devine, Kirsty; Tyler, Jennifer; Warner, Elizabeth; Pilcher, James; Patel, Samir J.; Nikiphorou, Elena; Chadwick, Laura; Jones, Caroline Mulvaney; Harrison, Beverley; Thornton, Lucy; O'Kane, Diana; Fusi, Lucia; Low, Audrey; Horton, Sarah; Jatwani, Shraddha; Baig, Sara; Bajwa, Hammad; Berglund, Vernon; Dahle, Angela; Dorman, Walter; Hargrove, Jody; Hilton, Maren; Lebedoff, Nicholas; Leonard, Susan; Morgan, Jennifer; Pfeifer, Emily; Skemp, Archibald; Wilson, Jeffrey M.; Wolff, Anne; Cepeda, Eduardo J; Todd, Derrick J.; Hare, Denise; Calabrese, Cassandra; Adams, Christopher D.; Khosroshahi, Arezou; Kilian, Adam; White, Douglas W.; Winter, Melanie; Fields, Theodore; Siegel, Caroline H.; Daver, Nicole; Harvey, Melissa; Kramer, Neil; Lamore, Concetta; Hogarty, Suneya; Yeter, Karen; Siddique, Faizah; Ban, Byung; Tanner, Tamar; Ruderman, Eric; Davis, William J.; Quinet, Robert; Scopelitis, E; Toribio, Karen Toribio; Webb-Detiege, Tameka; Zakem, Jerald; Abbass, Khurram; Kepecs, Gilbert; Miranda, Lilliam; Guma, Michael; Haikal, Ammar; Mody, Sushama; Mueller, Daric; Jayatilleke, Arundathi; Zell, JoAnn; Bays, Alison M.; Dao, Kathryn H.; Ezzati, Fatemeh; Parks, Deborah; Karp, David R.; Quiceno, Guillermo

doi:10.1016/s2665-9913(21)00316-7

Cited by 41 publications

(43 citation statements)

References 24 publications

(37 reference statements)

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“…We observed a higher rate of severe COVID-19 before March 2021, a finding that coincides with the anti-SARS-CoV-2 vaccination, which began in Slovenia at the end of December 2020 for the elderly and was expanded soon after to all patients with chronic diseases and the rest of the population. These data extend previous observations from cohorts of patients with rheumatic diseases [ 13 , 19 ]. In recently published data from the COVID-19 Global Rheumatology Alliance registry, 36.1% of patients with GCA were hospitalized and 20.3% died.…”

Section: Discussionsupporting

confidence: 90%

“…We found that patients with GCA and arterial hypertension, cardiovascular disease or obesity were at higher risk for severe COVID-19, as shown by several previous studies in patients with rheumatic diseases [ 35 , 37 , 38 ]. We did not find a significant association between other comorbidities and severe COVID-19, although prior data in patients with rheumatic diseases show that diabetes, lung disease, chronic kidney disease among others are known risk factors for severe COVID-19; however, to our knowledge, there are as yet no data for the subgroup of patients with GCA [ 13 , 35 – 38 ].…”

Section: Discussioncontrasting

confidence: 86%

“…In recently published data from the COVID-19 Global Rheumatology Alliance registry, 36.1% of patients with GCA were hospitalized and 20.3% died. Patients in this cohort were diagnosed with COVID-19 between October 2020 and April 2021 [ 13 ]. Compared with the data from our study, which extends over the period of the fourth wave of the coronavirus pandemic and covers the time period of prevalent SARS-CoV-2 Omicron variant, our results provide additional support for previously published data of an improvement in outcomes over time, which is likely multifactorial, related to improved treatments and management of COVID-19, increased vaccination rate, increased testing capacity and reduced pathogenicity of Omicron variant [ 13 , 19 – 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Advanced age and pre-existing medical conditions are considered major risk factors for severe forms of COVID-19 [ 10 – 12 ]. In a recent study, high rates of severe COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica were reported and were associated with a higher number of comorbidities, higher disease activity and prednisolone ≥ 10 mg/day [ 13 ]. The high mortality rate observed in patients with GCA may reflect the impact of age on COVID-19 mortality, as these patients represent a fragile population at increased risk of infection [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 among patients with giant cell arteritis: a single-centre observational study from Slovenia

et al. 2022

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Objectives Patients with giant cell arteritis (GCA) represent a fragile population with an increased infection risk. In a recent study, older age, a higher number of comorbidities, higher disease activity and prednisolone ≥ 10 mg/day were associated with worse COVID-19 outcome. We aimed to evaluate the frequency and severity of COVID-19 in a well-defined GCA cohort. Methods We reviewed medical records of histologically and/or by imaging-proven GCA patients diagnosed between September 2011 and February 2020 at our secondary/tertiary centre and followed during the COVID-19 pandemic between March 2020 and February 2022 (24 months). Descriptive statistics were used to explore the studied population. Results Of 314 patients with GCA diagnosed for the first time during a 102-month period, 49 patients died before March 2020. Of the remaining 265 patients, 55 (20.8%) patients suffered from a total of 57 SARS-CoV-2 infections. We observed 44 (77.2%) mild and 13 (22.8%) severe COVID-19 episodes (the latter defined as needing hospitalization, death or thrombotic complication). Patients with severe COVID-19 were more likely to have arterial hypertension (12 [92.3%] vs. 25 [56.8%]; p = 0.022), cardiovascular disease (7 [53.8%] vs. 10 [22.7%]; p = 0.043) or obesity (5 [38.5%] vs. 5 [11.4%]; p = 0.038). Neither prednisolone dose 1–5 mg/day ( p = 0.483) nor leflunomide use ( p = 1.000) was associated with COVID-19 course. There were no significant differences in sex, age, GCA type, GCA disease duration and other comorbidities in patients with mild and severe COVID-19 in our cohort. Conclusion More than a fifth of our GCA patients had severe COVID-19. Treatment with leflunomide or low doses of glucocorticoids were not associated with severe course in our cohort. Key Points • Treatment with leflunomide or low doses of glucocorticoids were not associated with worse COVID-19 outcome . • Outcomes of COVID-19 improved as the COVID-19 pandemic, prevention and treatment options evolved . • Arterial hypertension, cardiovascular disease or obesity were associated with severe COVID-19 .

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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COVID-19 among patients with giant cell arteritis: a single-centre observational study from Slovenia

et al. 2022

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“… 5 Many researchers reported COVID-19 triggering systemic vasculitis, polymyalgia rheumatica, and giant-cell arteritis, with variable and largely unmodifiable risk factors. 6 - 8 We reported a case of GCA associated with PMR in a patient with COVID-19.…”

Section: Introductionmentioning

confidence: 97%

A Case Report of Post COVID19 Giant Cell Arteritis and Polymyalgia Rheumatica With Visual Loss

Mursi

Mirghani

Elbeialy

2022

Clin Med Insights Case Rep

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COVID-19 shares some features of giant-cell arteritis, in which the diagnosis needs a high suspicion for prompt investigation and therapy. When the diseases coexist this might lead to diagnosis delay with grave consequences. We reported a case of a post-COVID-19 giant cell arteritis and polymyalgia rheumatica with visual loss. We treated the patient with pulse methylprednisolone 1 gm daily for 3 consecutive days followed by 60 mg prednisolone for 4 weeks until normalization of ESR, and then, gradual withdrawal. Oral Paracetamol, vitamin-D3, and calcium carbonate were added to the treatment regimen. The headache continued, so, we started perineural injection therapy (PIT) once daily, for 6 sessions, at which the headache was completely resolved after the third injection. The vision was regained completely after the sixth injection.

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COVID‐19 Hospitalization Outcomes Among Patients With Autoimmune Rheumatic Diseases in the United States

Khalaf

Ibrahim

Goble

et al. 2023

ACR Open Rheumatology

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Objectives To investigate the outcomes of COVID‐19‐related hospitalizations among patients with autoimmune rheumatic diseases (ARDs) in the United States in 2020. The primary outcome was in‐hospital mortality, and secondary outcomes included intubation rate, length of hospital stay (LOS), and total hospital charges (THCs). Methods Data for the study were obtained from the National Inpatient Sample database and included patients who were hospitalized with a principal diagnosis of COVID‐19. Univariable and multivariable logistic regression analyses were conducted to calculate odds ratios for the outcomes, adjusting for age, sex, and comorbidities. Results Out of the 1,050,720 COVID‐19 admissions, 30,775 had an ARD diagnosis. The unadjusted analysis showed higher mortality (12.21%) and intubation (9.2%) rates in the ARD group compared with the non‐ARD group (mortality rate: 11.14%, P = 0.013; intubation rate: 8.5%, P = 0.048). However, this difference was not significant after adjusting for confounding factors. The mean LOS and THCs did not differ significantly between the two groups. Among all ARD subgroups, the vasculitis group had significantly higher intubation rate, LOS, and THC. Conclusion The study suggests that ARD is not associated with an increased risk of mortality or worse outcomes among patients hospitalized with COVID‐19 after adjusting for confounding factors. However, the vasculitis group had poorer outcomes during COVID‐19 hospitalizations. Further studies are needed to evaluate the effect of ARD activity and immunosuppressants on outcomes. Additionally, more research is required to investigate the relationship between COVID‐19 and vasculitis.

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Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study

Cited by 41 publications

References 24 publications

COVID-19 among patients with giant cell arteritis: a single-centre observational study from Slovenia

COVID-19 among patients with giant cell arteritis: a single-centre observational study from Slovenia

A Case Report of Post COVID19 Giant Cell Arteritis and Polymyalgia Rheumatica With Visual Loss

COVID‐19 Hospitalization Outcomes Among Patients With Autoimmune Rheumatic Diseases in the United States

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