Pos1188 covid-19 in Patients With Rheumatic Diseases: Comparison of Data From the Argentine Registry (Sar-Covid), With the Latin American and Global Registry (Global Rheumatology Alliance)

Abstract

Background:SARS CoV-2 infection has recently burst onto the global scene, and the knowledge of the course of this infection in patients with rheumatic diseases receiving immunomodulatory treatment is still insufficient. The Argentine Society of Rheumatology (SAR) designed a national registry called SAR-COVID in order to get to assess our reality.Objectives:To identify the particular characteristics of patients with rheumatic diseases and COVID-19 in Argentina (SAR-COVID Registry), and to compare them with the data reported at the Latin American and Global level (Global International Alliance Rheum-COVID Registry).Methods:A national, multicenter, prospective and observational registry was carried out. Patients older than 18 years, with a diagnosis of rheumatic disease and SARS-CoV-2 infection by PCR or serology, were included between August 13, 2020 and January 17, 2021. Demographic data, underlying rheumatic disease (activity of the disease, current treatment), comorbidities, clinical-laboratory characteristics of the SARS-CoV-2 infection, as well as received treatments (pharmacological, oxygen therapy / ventilatory support) and outcomes (hospitalization, mortality) were recorded. The characteristics of the included patients were compared with the data reported at the Latin American and global level. Descriptive statistics were performed. Comparisons between groups were made using ANOVA, chi2 or Fisher’s test, according to the type of variable.Results:Four hundred sixty-five patients from Argentina, 74 patients from Latin America and 583 from the rest of the world were included, mostly women (79.6%, 73% and 71% respectively), with a mean age of 50.2 (SD 15.3), 53.5 (DE 15.6) and 55.8 (15.5), years respectively. The most frequent rheumatic diseases in the three groups were rheumatoid arthritis (43.9%, 35%, and 39%) and systemic lupus erythematosus (16.1%, 22%, and 14%) (Table 1).In Argentina, fewer patients received specific pharmacological treatment for COVID-19 (40.9%, 68% and 43% respectively, p <0.0001), and there was a lower requirement of NIMV / IMV (Non-Invasive Mechanical Ventilation/Invasive Mechanical Ventilation) than in the rest of Latin America and the world (10.5% vs 31% vs 13%, p <0.0001).Hospitalization was lower in Argentina than in the rest of Latin America (37.4% vs 61% p 0.0002) and of the world (37.4% vs 45% p 0.0123), and mortality was numerically lower in Argentina, but without statistically significant differences between the three groups (6.9%, 12% and 11%; p 0.6311). Most of the patients, (86.9%) did not present any complications in Argentina, with a statistically significant difference with the rest of the groups (62% and 77%, p <0.0001) (Graph 1).Conclusion:The patients with rheumatic diseases and SARS-CoV-2 infection reported in this argentinian registry received less specific pharmacological treatment for COVID-19, presented fewer complications and required less ventilatory support, than those reported in the Latinoamerican and Global registry. However, no statistically significant differences were observed in terms of mortality.Graph 1.Main outcomes and evolution of patients with rheumatic disease and COVID-19.References:[1]Stokes, Erin K, Zambrano, Laura D, Anderson, Kayla N, et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep; 69(24): 759-765, 2020 Jun 19.[2]Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm síndromes and immunosuppression. Lancet 2020;395:1033–4.[3]Gianfrancesco M, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis 2020;79:859–866.[4]Manuel F. Ugarte-Gil, et al. Characteristics associated with Covid-19 in patients with Rheumatic Disease in Latin America. Global Rheumatology. Septiembre 2020.Disclosure of Interests:Alvaro Andres Reyes Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Gelsomina Alle Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Romina Tanten Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Marina Scolnik Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Enrique Soriano Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Guillermo Berbotto Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Maria Haye Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, María Julieta Gamba Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Romina Nieto Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Mercedes García Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Veronica Savio Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Luciana Gonzalez Lucero Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Paula Alba Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Lorena Takashima Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, FABIAN RISUEÑO Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Luciana CASALLA Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Natalia Cucchiaro Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Ana Bertoli Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Sabrina POrta Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Carla Maldini Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Rosana Gallo Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Cecilia Goizueta Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Eugenia Picco Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Rosana Quintana Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Karen Roberts Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Carolina Ayelen Isnardi Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”, Guillermo Pons-Estel Grant/research support from: “Unrestricted grants: Pfizer, Abbvie, Elea Phoenix. None of them have access to patient data.”

Infección por COVID-19 en paciente ecuatorianos con enfermedades reumáticas

“…Estos datos concuerdas con los estudios de grandes cohortes en donde los pacientes con enfermedades reumáticas mayores de 50 años, de sexo masculino, y con comorbilidades (en especial cardiovasculares), presentan mayores tasas y probabilidades de riesgo para hospitalización, ventilación mecánica y muerte asociada a infección por COVID-19. El porcentaje de pacientes que requirieron hospitalización es esta nueva edición, se corresponde a aquellas notificadas en los primeros estudios realizados por cohortes internacionales, estando aun, muy por debajo de los países de la región, en nuestro estudio fue del 18.50%, [9][10][11]16,18 contando la presente entrega con un número mayor de pacientes que recibieron vacunación, esta última mostró correlación negativa para ingreso hospitalario, sin efectos significativo en cuanto a: ingreso a UCI, muerte, e infección sintomática. Aunque el número de centros participantes ha aumentado, el número de sujetos dentro del estudio no ha registrado un aumento sustancial, estando afectado en sumo grado por el pobre contenido, y precisión en el llenado de las historias clínicas, esto sumado a la falta de seguimiento durante la pandemia, ocasionando no se tenga registro de la medicación antirreumática, y la actividad de la enfermedad de los pacientes.…”

“…[12][13] Es de carácter imperativo mencionar el importante aporte que realizó la Alianza Global de Reumatología (GRA, por sus siglas en inglés) para la investigación de los efectos provocados por la infección por COVID-19 en pacientes con enfermedades reumáticas, contribuyendo también a la investigación inicial de pacientes con enfermedades reumáticas e infección por COVID-19 realizada en Ecuador. [14][15][16][17] El presente estudio tiene como propósito determinar los factores de riesgos asociados a hospitalización por COVID-19 en pacientes con enfermedades reumáticas.…”

Infección por COVID-19 en pacientes ecuatorianos con enfermedades reumáticas

“…Con respecto a hospitalización debido a COVID-19, en concordancia con otros estudios, esta se asoció con edad mayor de 50 años, también se encontró a esclerosis sistémica y cáncer, este hallazgo no se encuentra en los estudios iniciales, los cuales mostraron asociación con LES, vasculitis, enfermedades cardiovasculares (HTA, DM), enfermedad pulmonar, enfermedad renal crónica. 11 El porcentaje de pacientes que requirieron hospitalización es menor a las cohortes internacional, incluso cuando se compara con otros países de la región, en nuestro estudio fue del 8.42%, [9][10][11]15,17 esto podría ser porque los estudios iniciales se realizaron cuando la vacuna no estaba disponible, en cambio este estudio se pudo realizar cuando ya estaba disponible. En base a la vacunación, los pacientes vacunados mostraron menos riesgo de hospitalización, pero con mayor probabilidad de infección sintomática, pero en este estudio no se evaluó la presencia de infección pasada.…”

“…12 La presente investigación formó parte de la iniciativa llevada a cabo por la Alianza Global de Reumatología (GRA, por sus siglas en inglés) para la investigación de los efectos provocados por la infección por COVID-19 en pacientes con enfermedades reumáticas. [13][14][15][16] El presente estudio tiene como propósito determinar los factores de riesgos asociados a infección y hospitalización por COVID-19 en pacientes con enfermedades reumáticas.…”