Title:Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments
Volume: 27
Issue: 41
Author(s): Clodoveo Ferri*, Dilia Giuggioli, Vincenzo Raimondo, Massimo L’Andolina, Lorenzo Dagna, Antonio Tavoni, Francesco Caso, Francesco Ursini, Piero Ruscitti , Maurizio Caminiti, Rosario Foti, Valeria Riccieri , Serena Guiducci, Roberta Pellegrini, Elisabetta Zanatta, Giuseppe Varcasia, Domenico Olivo, Pietro Gigliotti, Giovanna Cuomo, Giuseppe Murdaca, Riccardo Cecchetti, Rossella De Angelis, Nicoletta Romeo, Francesca Ingegnoli, Franco Cozzi, Veronica Codullo, Ilaria Cavazzana, Michele Colaci, Giuseppina Abignano, Maria De Santis, Ennio Lubrano, Enrico Fusaro, Alessandra Della Rossa, Amelia Spinella, Federica Lumetti, Giacomo De Luca, Silvia Bellando-Randone, Elisa Visalli, Ylenia Dal Bosco, Giorgio Amato, Daiana Giannini, Silvia Bilia, Francesco Masini, Greta Pellegrino, Erika Pigatto, Elena Generali, Giuseppa Pagano Mariano, Giorgio Pettiti, Giovanni Zanframundo, Raffaele Brittelli, Vincenzo Aiello, Rodolfo Caminiti, Daniela Scorpiniti, Tommaso Ferrari, Corrado Campochiaro, Veronica Brusi, Micaela Fredi, Liala Moschetti, Fabio Cacciapaglia, Laura Gragnani, Monica Monti, Serena Lorini, Sabrina Rosaria Paparo, Francesca Ragusa, Valeria Mazzi, Giusy Elia, Silvia Martina Ferrari, Ilenia Di Cola, Marta Vadacca, Sebastiano Lorusso, Simone Barsotti, Maria Letizia Aprile, Tasso Marco, Mario Miccoli , Silvia Bosello, Marco Matucci-Cerinic, Salvatore D'Angelo, Andrea Doria, Franco Franceschini, Riccardo Meliconi, Florenzo Iannone, Roberto Giacomelli, Anna Linda Zignego, Poupak Fallahi and Alessandro Antonelli*
Affiliation:
- Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena,Italy
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, School of Medicine, Pisa,Italy
Keywords:
Covid-19, SARS-CoV-2, autoimmune systemic diseases, rheumatic diseases, arthritis, connective tissue diseases, systemic sclerosis,
interstitial lung disease.
Abstract:
Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune
systemic diseases (ASD) due to their deep immune-system alterations.
Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ
involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic.
Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral
centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic
SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal
swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing).
Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian
general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas
(p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to
chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000).
Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological
DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing
low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003).
Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important
clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management
strategies during the current pandemic wave.
