Mediterranean Journal of Infection, Microbes and Antimicrobials (Dec 2021)

Disease Course in Hospitalized COVID-19 Patients with and without Rheumatic Disease and Its Relationship with Immunosuppressive Drug Use

  • Selime ERMURAT,
  • Koray AYAR,
  • Suna AVCI,
  • Vildan GÜRSOY

DOI
https://doi.org/10.4274/mjima.galenos.2021.2021.61
Journal volume & issue
Vol. 10, no. 1

Abstract

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Introduction: This study aims to determine the course of Coronavirus disease-2019 (COVID-19) with rheumatic diseases (RDs) and to evaluate the effects of immunosuppressive (IS) drugs on the severity of COVID-19. Materials and Methods: A total of 1905 patients comprising 988 women and 917 men were hospitalized for COVID-19 and were retrospectively analyzed. A total of 57 of them were rheumatic patients (RPs). Rheumatic patients and non-RPs were compared in terms of IS drugs, demographic characteristics, comorbidities, drugs used in the treatment of COVID-19, laboratory and thorax tomography results, and duration of hospitalization (DOH), intensive care unit (ICU), and mortality rates. Patients taking IS drugs were determined as IS patients. Immunosuppressive and non-IS patients were also compared. The effects of each IS drug on the presence of pneumonia, DOH, ICU, and mortality frequency, and poor prognostic factors were further evaluated. Results: Pneumonia (p=0.358), DOH (p=0.650), ICU (p=0.386), and mortality rates (p=0.386) were non significant between RPs and non-RPs. Duration of hospitalization (p=0.881), ICU (p=0.176), and mortality rates (p=0.176) between patients with RDs receiving IS and not receiving IS drugs were also non significant. Intensive care unit (p=0.003) and mortality (p=0.035) rates were significantly higher in RPs receiving sulfasalazine (SSZ). Rheumatic patients receiving cyclosporine A (CsA) had significantly less pneumonia (p=0.040). C-reactive protein level was significantly lower in RPs receiving CsA (p=0.022) and hydroxychloroquine (p=0.033). Conclusion: The presence of RD did not affect the course of COVID-19 disease. Sulfasalazine had a negative effect on the course of COVID-19 disease, whereas CsA had a positive effect. The effect of CsA and SSZ on COVID-19 pneumonia needs to be evaluated with further studies.

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