AB1359 CLINICAL FEATURES OF COVID-19 IN PATIENTS WITH CONNECTIVE TISSUE DISEASES DURING THE RECENT PANDEMIC IN GUANGZHOU, CHINA

Abstract

BackgroundPatients with connective tissue diseases (CTD) are vulnerable to SARS-COV-2 infection, given that a proportion of CTD patients suffer from interstitial lung diseases (ILD). Moreover, the use of glucocorticoids and immunosuppressive agents could affect the outcome of lung diseases. The impact of coronavirus disease 2019 (COVID-19) infection on rheumatic diseases remains poorly investigated as the pandemic has recently occurred in Southern China.ObjectivesThe study aimed to describe the clinical features and hospitalisation costs of COVID-19 in CTD patients, especially those with COVID-19 pneumonia.MethodsIt was a cross-sectional case series study. Demographic data, symptoms, signs, medical history, laboratory, radiological findings and costs were collected from 86 CTD patients from the inpatient department in a tertiary hospital during the COVID-19 pandemic in Guangzhou, China.ResultsOf all the 86 CTD patients, 67 (77.9%) were females, and 24 (27.9%) had CTD-ILD before admission. 54 (62.8%) of them had SARS-COV-2 infection dected by nucleic acid or antigen tests for SARS-COV-2. Patients with SARS-COV-2 infection had older age, higher WBC, neutrophil/lymphocyte ratio and CEA. Moreover, 325 (29.1%) of the participants had COVID-19 pneumonia confirmed by the HRCT. Noticeably, 15 CTD patients without ILD presents with COVID-19 pneumonia. Patients with COVID-19 pneumonia had older age, higher serum ferritin, CEA, and C-reactive protein (p<0.05).According to the rheumatologists’ assessment, 6 (41.9%) of the patients had worsened CTD disease activity. 14 (16.3%) of the patients had confirmed infections involving the lung (6), skin (3), urinary tract (2), gastrointestinal tract (1), blood (1), and vagina [1]. The pathogens isolated included staphylococcus aureus, candida albicans, escherichia coli, cytomegalovirus, Epstein-Barr virus and herpes zoster virus.Among all the symptoms related to COVID-19, coughing was the most frequent symptom, followed by sputum, fatigue and fever. 27 (31.4%) of the patients required a nasal cannula for oxygen administration; 7 (8.1%) needed high-flow humidification therapy. 24 of the CTD patients were given higher doses of glucocorticoids. Five patients were given anti-virus medication, 4 were using baricitinib or tocilizumab, and 10 were taking intravenous immunoglobulin. There was no difference in the hospitalisation costs between the patients with or without SARS-COV-2 infection; however, patients with COVID-19 pneumonia had significantly higher costs with a mean of 24083 RMB (≈3318 Euros). All the patients got improved before the discharge.ConclusionDisease flare and COVID-19 pneumonia should be noticed in patients with CTD during the pandemic.AcknowledgementsThis work was supported by Scientific and Technological Planning Project of Guangzhou City [202102020150], Guangdong Provincial Basic and Applied Basic Research Fund Project [2021A1515111172], National Natural Science Foundation of China Youth Fund [82201998] and Third Affiliated Hospital of Sun Yat-Sen University Cultivating Special Fund Project for National Natural Science Foundation of China [2022GZRPYQN01].Disclosure of InterestsNone Declared.