Advances in Rheumatology (Nov 2022)

COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data

  • Claudia Diniz Lopes Marques,
  • Sandra Lúcia Euzébio Ribeiro,
  • Cleandro P. Albuquerque,
  • Samia Araujo de Sousa Studart,
  • Aline Ranzolin,
  • Nicole Pamplona Bueno de Andrade,
  • Andrea T. Dantas,
  • Guilherme D. Mota,
  • Gustavo G. Resende,
  • Adriana O. Marinho,
  • Danielle Angelieri,
  • Danieli Andrade,
  • Francinne M. Ribeiro,
  • Felipe Omura,
  • Nilzio A. Silva,
  • Laurindo Rocha Junior,
  • Danielle E. Brito,
  • Diana C. Fernandino,
  • Michel A. Yazbek,
  • Mariana P. G. Souza,
  • Antonio Carlos Ximenes,
  • Ana Silvia S. Martins,
  • Glaucio Ricardo W. Castro,
  • Lívia C. Oliveira,
  • Ana Beatriz S. B. Freitas,
  • Adriana M. Kakehasi,
  • Ana Paula M. Gomides,
  • Edgard Torres Reis Neto,
  • Gecilmara S. Pileggi,
  • Gilda A. Ferreira,
  • Licia Maria H. Mota,
  • Ricardo M. Xavier,
  • Marcelo de Medeiros Pinheiro,
  • the ReumaCoV-Brasil Registry

DOI
https://doi.org/10.1186/s42358-022-00268-x
Journal volume & issue
Vol. 62, no. 1
pp. 1 – 13

Abstract

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Abstract Objectives To evaluate the disease activity before and after COVID-19 and risk factors associated with outcomes, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV) and death in patients with spondylarthritis (SpA). Methods ReumaCoV Brazil is a multicenter prospective cohort of immune-mediated rheumatic diseases (IMRD) patients with COVID-19 (case group), compared to a control group of IMRD patients without COVID-19. SpA patients enrolled were grouped as axial SpA (axSpA), psoriatic arthritis (PsA) and enteropathic arthritis, according to usual classification criteria. Results 353 SpA patients were included, of whom 229 (64.9%) were axSpA, 118 (33.4%) PsA and 6 enteropathic arthritis (1.7%). No significant difference was observed in disease activity before the study inclusion comparing cases and controls, as well no worsening of disease activity after COVID-19. The risk factors associated with hospitalization were age over 60 years (OR = 3.71; 95% CI 1.62–8.47, p = 0.001); one or more comorbidities (OR = 2.28; 95% CI 1.02–5.08, p = 0.001) and leflunomide treatment (OR = 4.46; 95% CI 1.33–24.9, p = 0.008). Not having comorbidities (OR = 0.11; 95% CI 0.02–0.50, p = 0.001) played a protective role for hospitalization. In multivariate analysis, leflunomide treatment (OR = 8.69; CI = 95% 1.41–53.64; p = 0.023) was associated with hospitalization; teleconsultation (OR = 0.14; CI = 95% 0.03–0.71; p = 0.01) and no comorbidities (OR = 0.14; CI = 95% 0.02–0.76; p = 0.02) remained at final model as protective factor. Conclusions Our results showed no association between pre-COVID disease activity or that SARS-CoV-2 infection could trigger disease activity in patients with SpA. Teleconsultation and no comorbidities were associated with a lower hospitalization risk. Leflunomide remained significantly associated with higher risk of hospitalization after multiple adjustments.

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