The effect of COVID-19 infection on the clinical course, outcome and activity of rheumatoid arthritis

Soleimani, Zahra; Esalatmanesh, kamal; Azadceher, Mohammad javad; Aboodarda, Mohsen; Razaghi, Mohammad Javad; Esalatmanesh, Roozbeh

doi:10.48307/FMSJ.2023.0.5.531

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Volume 27, Issue 5 (Bimonthly 2023)

Feyz Med Sci J 2023, 27(5): 529-538

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The effect of COVID-19 infection on the clinical course, outcome and activity of rheumatoid arthritis

Zahra Soleimani

, Kamal Esalatmanesh

, Mohammad javad Azadceher

, Mohsen Aboodarda

, Mohammad Javad Razaghi

, Roozbeh Esalatmanesh ^*

Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran , esalar@gmail.com

Abstract: (921 Views)

Background and Aim: Rheumatoid arthritis is a chronic inflammatory disease of unknown cause characterized by polyarthritis and extra-articular symptoms. Rheumatoid arthritis has been investigated in patients suffering from COVID-19 infection in several studies. The aim of this study was to investigate the role of COVID-19 infection in the intensity of rheumatoid arthritis.
Methods: In this retrospective cohort study, the medical files of 104 rheumatoid arthritis patients with COVID-19 infection were reviewed. Patients were evaluated in terms of rheumatoid arthritis disease activity in the first two weeks of COVID-19 infection based on DAS28 criteria and compared with their disease activity index before COVID-19 infection. Anti-CCP test was used to differentiate the activity of rheumatoid arthritis from the symptoms of viral infection.
Results: The mean age of the patients was 53.3±13.6 years and 84 (80.8%) were women. The mean duration of rheumatoid arthritis in the patients was 95.09±84.05 months. The severity of the COVID-19 disease was severe-critical in 19.3% of patients. The disease activity of 76.5% of the patients did not differ before and after exposing to COVID-19, and only in 14 (13.5%) patients the disease activity intensified after contracting COVID-19. All patients with intensified disease activity had positive Anti-CCP, which was significantly lower in the other two groups. Also, the percentage of mortality in patients whose disease activity was intensified was significantly higher than the other two groups. In terms of outcome, the mean length of hospitalization in patients was 7.3±3.5 days and 10 patients (9.6%) died.
Conclusion: The findings of the present study show that infection with COVID-19 does not have a significant effect on the intensity of rheumatoid arthritis disease, however, it is necessary to conduct more studies in this field.

Keywords: COVID-19, Rheumatoid arthritis, Disease activity, Outcome

Full-Text [PDF 478 kb] (630 Downloads)

Type of Study: Research | Subject: medicine, paraclinic
Received: 2023/09/4 | Revised: 2023/12/12 | Accepted: 2023/11/8 | Published: 2023/12/10

References

1. Jameson JL, Kasper DL, Fauci AS, Hauser SL, Longo DL, Loscalzo J. Harrison's principles of internal medicine: McGraw-hill education; 2018.

2. Rentsch CT, DeVito NJ, MacKenna B, Morton CE, Bhaskaran K, Brown JP, et al. Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform. Lancet Rheumatol 2021; 3(1):e19-e27.

3. Favalli EG, Biggioggero M, Meroni PL. Methotrexate for the treatment of rheumatoid arthritis in the biologic era: still an “anchor” drug? Autoimmunity Reviews 2014;13(11):1102-8.

4. Listing J, Gerhold K, Zink A. The risk of infections associated with rheumatoid arthritis, with its comorbidity and treatment. Rheumatology. 2013;52(1):53-61.

5. Ranganath VK, Maranian P, Elashoff DA, Woodworth T, Khanna D, Hahn T, et al. Comorbidities are associated with poorer outcomes in community patients with rheumatoid arthritis. Rheumatology. 2013;52(10):1809-17.

6. Bogdanos DP, Smyk DS, Invernizzi P, Rigopoulou EI, Blank M, Pouria S, et al. Infectome: a platform to trace infectious triggers of autoimmunity. Autoimmunity Reviews. 2013;12(7):726-40.

7. Franklin J, Lunt M, Bunn D, Symmons D, Silman A. Risk and predictors of infection leading to hospitalisation in a large primary-care-derived cohort of patients with inflammatory polyarthritis. Ann Rheumatic Dis 2007; 66(3):308-12.

8. Smolen JS, Landewé RB, Bijlsma JW, Burmester GR, Dougados M, Kerschbaumer A, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020; 79(6):685-99.

9. Strehl C, Ehlers L, Gaber T, Buttgereit F. Glucocorticoids—All-Rounders tackling the versatile players of the immune system. Frontiers Immunol 2019; 10: 1744.

10. Ni YN, Chen G, Sun J, Liang B-M, Liang ZA. The effect of corticosteroids on mortality of patients with influenza pneumonia: a systematic review and meta-analysis. Crit Care 2019; 23(1): 99. doi: 10.1186/s13054-019-2395-8.

11. Tang NLS, Chan PKS, Wong CK, To KF, Wu AKL, Sung Y-M, et al. Early enhanced expression of interferon-inducible protein-10 (CXCL-10) and other chemokines predicts adverse outcome in severe acute respiratory syndrome. Clinical chemistry. 2005;51(12):2333-40.

12. Organization WH. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected: interim guidance, 25 January 2020. World Health Organization; 2020.

13. Lacaille D, Guh DP, Abrahamowicz M, Anis AH, Esdaile JM. Use of nonbiologic disease‐modifying antirheumatic drugs and risk of infection in patients with rheumatoid arthritis. Arthritis Care Res 2008;59(8):1074-81.

14. Smitten AL, Choi HK, Hochberg MC, Suissa S, Simon TA, Testa MA, et al. The risk of hospitalized infection in patients with rheumatoid arthritis. J Rheumatol 2008; 35(3): 387-93.

15. Atzeni F, Sarzi-Puttini P, Mutti A, Bugatti S, Cavagna L, Caporali R. Long-term safety of abatacept in patients with rheumatoid arthritis. Autoimmunity Reviews. 2013;12(12):1115-7.

16. Gianfrancesco M, Hyrich KL, Al-Adely S, Carmona L, Danila MI, Gossec L, Izadi Z, Jacobsohn L, Katz P, Lawson-Tovey S, Mateus EF. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Annals of the rheumatic diseases. 2020; 79(7):859-66.

17. Gordon AC, Angus DC, Derde LP. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. Reply. New England J Med 2021; 385(12): 1147-9.

18. Kalil AC, Patterson TF, Mehta AK, Tomashek KM, Wolfe CR, Ghazaryan V, et al. Baricitinib plus remdesivir for hospitalized adults with Covid-19. New England J Med 2021; 384(9):795-807.

19. Selmi C, Ceribelli A, Naguwa SM, Cantarini L, Shoenfeld Y. Safety issues and concerns of new immunomodulators in rheumatology. Expert Opin Drug Saf 2015; 14(3):389-99.

20. Sparks JA, Wallace ZS, Seet AM, Gianfrancesco MA, Izadi Z, Hyrich KL, et al. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: results from the COVID-19 global rheumatology alliance physician registry. Ann Rheumatic Dis 2021; 80(9): 1137-46.

21. Galloway JB, Hyrich KL, Mercer LK, Dixon WG, Fu B, Ustianowski AP, et al. Anti-TNF therapy is associated with an increased risk of serious infections in patients with rheumatoid arthritis especially in the first 6 months of treatment: updated results from the British Society for Rheumatology Biologics Register with special emphasis on risks in the elderly. Rheumatology. 2011;50(1):124-31.

22. Esalatmanesh K, Jamali R, Jamali A, Jamali B, Nikbakht M. Serum anti-cyclic citrullinated peptide antibodies may predict disease activity in rheumatoid arthritis. Rheumatol Int 2012; 32(12):3799-805.

23. Roongta R, Ghosh A. Managing rheumatoid arthritis during COVID-19. Clinical rheumatology. 2020 Nov;39(11):3237-44.

24. Chuo CY, Yau V, Madhavan S, Tsai L, Chia J. Risk of Severe COVID-19 Outcomes Among Patients with Rheumatoid Arthritis in the United States. medRxiv. 2021 Jan 1.

25. Van Riel PL, Renskers L. The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS28) in the management of rheumatoid arthritis. Clin Exp Rheumatol. 2016; 34(5 Suppl 101): S40-4.

26. Smolen JS, Aletaha D. Assessment of rheumatoid arthritis activity in clinical trials and clinical practice. Curr Opin Rheumatol 2011; 23(3): 252-8.

27. National Health Commission of China. The guidelines for diagnosis and treatment of novel coronavirus (2019‐nCoV) infected pneumonia (the sixth edition draft) issued by the National Health Commission of China.

28. Wang D, Hu B, Hu C, Zhu F, Xing Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus‐infected pneumonia in Wuhan, China. JAMA 2020; 323(11): 1061–9.

29. Zhu Y, Zhong J, Dong L. Epidemiology and clinical management of rheumatic autoimmune diseases in the COVID-19 pandemic: A review. Frontiers in Medicine. 2021;8.

30. Pablos JL. Clinical outcomes of hospitalised patients with COVID-19 and chronic inflammatory and autoimmune rheumatic diseases: a multicentric matched cohort study. Cells. 2020; 79:1544–9. doi: 10.1136/annrheumdis-2020-218296

31. Tan EH, Sena AG, Prats-Uribe A, You SC, Ahmed WU, Kostka K, et al. COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries. Rheumatology. 2021; keab250. doi: 10.1093/rheumatology/keab250

32. Vázquez-Díaz M, Freites Nuñez DD, Leon L. Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases. Rheumatol Int 2020; 79: 1393–9. doi: 10.1136/annrheumdis-2020-217984

33. Tiendrébéogo WJS, Kaboré F, Ntsiba H, Montero F. Coronavirus disease 2019. (COVID-19) in autoimmune and inflammatory conditions: clinical characteristics of poor outcomes. Clin Rheumatol. 2020; 40:1593–8. doi: 10.1007/s00296-020-04676-4

34. Ladani AP, Loganathan M, Danve A. Managing rheumatic diseases during COVID-19. Clin Rheumatol 2020;39(11):3245-54.

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Soleimani Z, Esalatmanesh K, Azadceher M J, Aboodarda M, Razaghi M J, Esalatmanesh R. The effect of COVID-19 infection on the clinical course, outcome and activity of rheumatoid arthritis. Feyz Med Sci J 2023; 27 (5) :529-538
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