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Article Dans Une Revue Frontiers in Medicine Année : 2023

CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases

Thomas Petit Jean
  • Fonction : Auteur
Jerôme Avouac
Sophie Georgin-Lavialle
  • Fonction : Auteur
Edouard Pertuiset
  • Fonction : Auteur
Thao Pham
  • Fonction : Auteur
Pascal Chazerain
  • Fonction : Auteur
Arsene Mekinian
Jérémie Sellam
  • Fonction : Auteur
Nathalie Costedoat-Chalumeau
  • Fonction : Auteur
Christophe Richez
Xavier Mariette

Résumé

Introduction Autoimmune/inflammatory rheumatic diseases (AIRDs) patients might be at-risk of severe COVID-19. However, whether this is linked to the disease or to its treatment is difficult to determine. This study aimed to identify factors associated with occurrence of severe COVID-19 in AIRD patients and to evaluate whether having an AIRD was associated with increased risk of severe COVID-19 or death. Materials and methods Two databases were analyzed: the EDS (Entrepôt des Données de Santé, Clinical Data Warehouse), including all patients followed in Paris university hospitals and the French multi-center COVID-19 cohort [French rheumatic and musculoskeletal diseases (RMD)]. First, in a combined analysis we compared patients with severe and non-severe COVID-19 to identify factors associated with severity. Then, we performed a propensity matched score case–control study within the EDS database to compare AIRD cases and non-AIRD controls. Results Among 1,213 patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher risk of severe COVID-19 [aOR = 1.43 (1.08–1.87), p = 0.01] but analysis restricted to rheumatoid arthritis and spondyloarthritis found no increased risk of severe COVID-19 [aOR = 1.11 (0.68–1.81)]. Conclusion In this multicenter study, we confirmed that AIRD patients treated with rituximab or corticosteroids and/or having vasculitis, auto-inflammatory disease, and sarcoidosis had increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of severe COVID-19 compares general population.
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hal-04106544 , version 1 (25-05-2023)

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Kevin Chevalier, Michaël Genin, Thomas Petit Jean, Jerôme Avouac, Rene-Marc Flipo, et al.. CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases. Frontiers in Medicine, 2023, 10, ⟨10.3389/fmed.2023.1152587⟩. ⟨hal-04106544⟩
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