Abstract
One of the most controversial issues among rheumatologists is the best approach to managing a rheumatic patient (RP) with coronavirus disease 2019 (COVID-19). This study aims to evaluate the prevalence of COVID-19 in RPs compared to the general population and to relatively assess the potential role of RPs’ treatment regimen against COVID-19. In a cross-sectional study, all RPs with an updated medical record between December 1, 2019, and February 29, 2020, at the rheumatology clinic of Shahid Beheshti Hospital, Qom, Iran were included (as the case group), and the prevalence of COVID-19 was compared to the paired control group—individuals without RDs, randomly selected from the Qom Health Network’s database. Qom was the first city in Iran in which COVID-19 was identified and spread rapidly. Both groups were paired regarding sex, age, and underlying severe conditions. The prevalence of COVID-19 was lower in RPs than the control group (p = 0.028). Moreover, patients who were under treatment with disease-modifying anti-rheumatic drugs (DMARDs) and biologic agents seemed to possess a lower risk for COVID-19. Two RPs died from COVID-19, both of whom had granulomatosis and polyangiitis (GPA). The prevalence of COVID-19 in the RPs was lower than the control group, which could be associated with more adherence to the quarantine and social distancing rules by RPs and stricter routine follow-ups than the general population. Besides, taking DMARDs, such as leflunomide, might possess a protective effect against severe COVID-19, probably as a result of preventing cytokine storm.
Highlights
The global risk for the coronavirus disease 2019 (COVID19) was assessed by World Health Organization (WHO) as very high; it was considered as a pandemic that affected more than two million people worldwide [1]
Internal and Emergency Medicine (2021) 16:919–923 some potential drugs were considered to have a beneficial effect in treating patients with COVID-19, including some antibiotics and antivirals [3] as well as angiotensinconverting enzyme (ACE) inhibitors, and hydroxychloroquine, a disease-modifying anti-rheumatic drug (DMARD) [4–6]
Some drugs which are commonly used in the treatment of rheumatic disease (RD) has been considered as potential candidates for COVID-19 treatment, based on recent studies, including chloroquine, hydroxychloroquine, leflunomide, tumor necrosis factor (TNF) inhibitors, Janus kinase (JAK) inhibitors, interleukin antagonists, and even corticosteroids [6, 7]
Summary
The global risk for the coronavirus disease 2019 (COVID19) was assessed by World Health Organization (WHO) as very high; it was considered as a pandemic that affected more than two million people worldwide [1]. Internal and Emergency Medicine (2021) 16:919–923 some potential drugs were considered to have a beneficial effect in treating patients with COVID-19, including some antibiotics and antivirals [3] as well as angiotensinconverting enzyme (ACE) inhibitors, and hydroxychloroquine, a disease-modifying anti-rheumatic drug (DMARD) [4–6]. One of the most controversial issues among rheumatologists is the best approach to manage a rheumatic patient (RP) with COVID-19. There are still controversial views on the use of the immunosuppressive (IS) drugs, as well as their potential risks in RPs during the COVID-19 outbreak
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