Characteristics of patients with sarcoidosis who referred to a pulmonologist during the COVID-19 pandemic

Abstract

Introduction. During the COVID-19 pandemic, the first experience was gained in managing patients with sarcoidosis in the face of a dangerous viral infection, a combination of two diseases and vaccination against COVID-19. Publications on this issue remain ambiguous, which made it relevant to assess the management of patients with sarcoidosis during a pandemic and the features of vaccination of these patients.Aim. To assess the condition of patients with sarcoidosis who turned to a pulmonologist during the pandemic, to compare the parameters of patients with sarcoidosis who had and did not have COVID-19, with mild and severe course, as well as to evaluate the effectiveness and safety of vaccination.Materials and methods. The study was a retrospective, observational, non-interventional study. We included 299 patients who visited a pulmonologist in 176 (58.9%) of whom developed COVID-19 and 123 (41.1%) did not have a viral disease. Information on survivors of COVID-19 was collected using the COVIZ application. Data summarization and statistical processing were carried out using the SPPS-18 program (IBM) p < 0.05 values were considered statistically significant.Research results. Comparison of data of patients with sarcoidosis who fell ill and did not become ill with COVID-19 during the pandemic period showed that those who fell ill with this viral infection were significantly younger, more often had extrapulmonary manifestations of sarcoidosis. Patients did not differ in the radiation stage of sarcoidosis, the frequency of Löfgren’s syndrome, and the frequency of familial cases of granulomatosis. The use of methotrexate was accompanied by a higher incidence of COVID-19, the probability of getting sick was more than 3 times higher (OR = 3.39; 95% CI 1.12–10.28). Among those who received GCS (n = 49), those who received a dose of 10 mg prednisolone equivalent and above (OR = 12.056; CI95% 2.12–68.5) were more likely to develop COVID-19. The risk of developing COVID-19 in those who were not vaccinated was significantly higher than in those who received the vaccine after a viral illness (OR = 2.50; CI95% 1.75–3.58). One case of death is presented.Conclusion. A retrospective analysis of cases of sarcoidosis during the COVID-19 pandemic indicated a favorable course of both diseases when combined. Negative prognostic factors were the use of immunosuppressive therapy for sarcoidosis and severe comorbidities of the cardiovascular system. Vaccination against COVID-19 was effective and safe in patients with pulmonary sarcoidosis.