POS1231 COVID-19 INFECTION IN RHEUMATIC IMMUNE-MEDIATED INFLAMMATORY DISEASES. EPIDEMIOLOGICAL STUDY IN A SINGLE UNIVERSITY HOSPITAL

Abstract

Background:Immune-mediated inflammatory diseases (IMID) have an increased risk of infections due to the disease itself, and/or immunosuppressive therapy. Risk of COVID-19 infection in the different rheumatic IMID (R-IMID) remains controversial.Objectives:To assess the epidemiology and comorbidities of COVID-19 in R-IMID from a Single-University hospital.Methods:Cross-sectional study in a Single-University hospital. We included all consecutive patients with a diagnosis of a R-IMID and a positive test for COVID-19 up to November 6th, 2020. Medical records of 11,199 patients that suffered COVID-19 in our region, and 6891 with R-IMID from our hospital were reviewed. Incidence data in the different underlying R-IMID were calculated for patients with follow-up in our hospital. Confirmed infection was defined if the patient had a positive nasopharyngeal swab for SARS-CoV-2.Results:We included 147 patients from our region (96 women/51 men), mean age 60±18 years. Underlying R-IMID were: Rheumatoid arthritis (RA) (n=36, 24.5%), Axial spondyloarthritis/Psoriatic arthritis (SpA/PsA) (n=54, 36.7%), Polymyalgia Rheumatica (PMR) (n=16, 10.9%), systemic lupus erythematosus (SLE) (n=10, 6.8%), sarcoidosis (n=5, 3.4%), Sjögren’s syndrome (SS) (n=4, 2.7%), giant cell arteritis (GCA) (n=3, 2%), Behçet’s disease (n=3. 2%), ANCA-vasculitis (n=2, 1.4%) and systemic sclerosis (SSc) (n=1, 0.7%).Main comorbidities were hypertension (n=65, 44.2%), dyslipidemia (n=64, 43.5%), age higher than 65 years old (n=55, 37.4%), obesity (n=35, 23.8%), coronary vascular disease (n=27, 18.4%), diabetes mellitus (n=22, 15%), chronic obstructive pulmonary disease (n=15, 10.2%) and chronic kidney disease (n=15, 10.2%).Total cumulative COVID-19 incidence in all patients from our region was 1.9% (11,199 /582,905). From 147 patients with COVID-19 from our region, 115 (76 women/39 men; mean age, 59±18 years) were followed in our hospital. In the latter, the global cumulative incidence in R-IMID was 1.7% (115/6891), ranging from 1.3% in Systemic Scleroderma (SSc) and Giant Cell Arteritis (GCA) up to 5.3% in Behcet’s disease (Table 1 and Figure 1).Table 1.Incidence and relative risk of COVID-19 in patients with different R-IMID in a Single-University hospitalR-IMIDTotal cumulative incidence in our hospital(%)Relative risk (95% confidence interval)Global population582,905 inhabitants1.9-Global R-IMID6,891 patients1.70.9 (0.7-1)Behçet’s disease5.32.7 (0.9-8.2)ANCA-vasculitis3.51.8 (0.4-7.1)PMR2.81.4 (0.8-2.6)SS2.61.4 (0.5-3.6)SLE2.31.2 (0.6-2.3)Sarcoidosis2.31.2 (0.3-4.7)SpA/PsA2.21.1 (0.8-1.5)RA1.60.8 (0.6-1.2)GCA1.30.7 (0.2-2.8)SSc1.30.7 (0.1-4.6)GCA: Giant cell arteritis, PsA: Psoriatic arthritis, RA: Rheumatoid arthritis, SLE: Systemic lupus erythematosus, SpA: Axial spondyloarthritis, SSc: Systemic scleroderma.Figure 1.Number of patients with COVID-19 in different R-IMID in a Single-University hospital. Data are presented on a logarithmic scale.In addition, Relative Risk (RR) in different R-IMID compared to the general population was calculated (Table 1). Although RR did not reach statistical significance in any R-IMID, most R-IMID showed a tendency to a higher risk, with the exception of RA, GCA and SSc.Conclusion:In our series, the total cumulative incidence of COVID-19 in R-IMID was similar to the general population. Higher RR, without statistical significance, was observed in Behçet’s disease, ANCA-vasculitis and Polymyalgia Rheumatica.GCA: Giant cell arteritis, PsA: Psoriatic arthritis, RA: Rheumatoid arthritis, SLE: Systemic lupus erythematosus, SpA: Axial spondyloarthritis, SSc: Systemic scleroderma.Disclosure of Interests:David Martínez-López: None declared, Diana Prieto-Peña Grant/research support from: UCB Pharma, Roche, Sanofi, Pfizer, Abbvie, Lilly, Lara Sanchez-Bilbao: None declared, Alba Herrero-Morant: None declared, Carmen Álvarez-Reguera: None declared, Martin Trigueros-Vazquez: None declared, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi and MSD., Consultant of: Abbvie, Pfizer, Roche, Sanofi and MSD., Grant/research support from: Abbvie, MSD, Jansen, Roche, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD, Grant/research support from: Abbvie, MSD and Roche