COVID-19 Research Paper Advance Articles pp 23427—23435

Evolution of COVID-19 in patients with autoimmune rheumatic diseases

Rongrong Pang1,2, *, , Jun Zhao1,3, *, , Zhenhua Gan4,5, *, , Zhiliang Hu6,7, *, , Xiang Xue8, , Yanjun Wu9,10, , Qinghua Qiao11,12, , Aifang Zhong12,13, , Xinyi Xia1,5,12, , Hui Liao14, , Zhihua Wang5,12,15, , Libo Zhang1,2, ,

  • 1 COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, The First School of Clinical Medicine, Southern Medical University, Nanjing 210002, Jiangsu, China
  • 2 Department of Laboratory Medicine, Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, China
  • 3 Graduate School, Nanjing Medical University, Nanjing 211166, Jiangsu, China
  • 4 Department of Medical Administration, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
  • 5 Joint Expert Group, Wuhan Huoshenshan Hospital, Wuhan 430100, Hubei, China
  • 6 Nanjing Infectious Disease Center, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu, China
  • 7 School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China
  • 8 Department of Biochemistry and Molecular Biology, University of New Mexico, Albuquerque, NM 87131, USA
  • 9 Department of Information, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
  • 10 Department of Information, Wuhan Huoshenshan Hospital, Wuhan 430100, Hubei, China
  • 11 Medical and Technical Support Department, Pingdingshan Medical District, The 989th Hospital, Pingdingshan 467000, Henan, China
  • 12 Department of Laboratory Medicine and Blood Transfusion, Wuhan Huoshenshan Hospital, Wuhan 430100, Hubei, China
  • 13 Medical Technical Support Division, Changzhou Medical District, The 904th Hospital, Changzhou 213003, Jiangsu, China
  • 14 Department of Hematology, The Air Force Hospital from Eastern Theater of PLA, Nanjing 210002, Jiangsu, China
  • 15 Department of Laboratory Medicine and Blood Transfusion, The 907th Hospital, Nanping 350702, Fujian, China
* Equal contribution

Received: May 15, 2020       Accepted: October 20, 2020       Published: December 3, 2020      

https://doi.org/10.18632/aging.202193
How to Cite

Copyright: © 2020 Pang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The characteristics of COVID-19 patients with autoimmune rheumatic diseases (AIRD) have rarely been reported. Patients with AIRD have suppressed immune defense function, which may increase their susceptibility to COVID-19. However, the immunosuppressive agents AIRD patients routinely used may be beneficial for protecting the cytokine storm caused by SARS-CoV-2. In this retrospective study, we included all confirmed cases in Huoshenshan Hospital from February 4 to April 9. Data were extracted from electronic medical records and were analyzed for clinical and laboratory features using SPSS (version 25.0). Of 3059 patients, 21 had the comorbidities with systematic lupus erythematosus (SLE) and/or rheumatoid arthritis (RA), including 5 with SLE, 15 with RA, and 1 with Rhupus. The proportion was 57.1% for severe cases, 61.9% for either severe or critical cases, and 4.8% for critical cases. The main manifestations, ARDS and ICU admission rate, as well as the mortality and length of hospital stay of COVID-19 in AIRD patients were similar to COVID-19 patients in the general population. Our preliminary experience shows that patients with AIRD tend to have a higher risk of SARS-CoV-2 infection, and may be at risk for a severe but less likely critical disease course. Further investigation is needed to understand the immunological features of these diseases.

Abbreviations

COVID-19: coronavirus disease 2019; SLE: systematic lupus erythematosus; RA: rheumatoid arthritis; ICU: Intensive Care Unit; ARDS: acute respiratory distress syndrome; CPT: convalescent plasma therapy; HCQ: hydroxychloroquine; CQ: chloroquine.