Autoimmune Diseases and COVID-19 as Risk Factors for Poor Outcomes: Data on 13,940 Hospitalized Patients from the Spanish Nationwide SEMI-COVID-19 Registry.
Por:
Ayala Gutiérrez MDM, Rubio-Rivas M, Romero Gómez C, Montero Sáez A, Pérez de Pedro I, Homs N, Ayuso García B, Cuenca Carvajal C, Arnalich Fernández F, Beato Pérez JL, Vargas Núñez JA, Letona Giménez L, Suárez Fernández C, Méndez Bailón M, Tuñón de Almeida C, González Moraleja J, de Guzmán García-Monge M, Helguera Amezua C, Fidalgo Montero MDP, Giner Galvañ V, Gil Sánchez R, Collado Sáenz J, Boixeda R, Ramos Rincón JM, Gómez Huelgas R and On Behalf Of The Semi-Covid-Network
Publicada:
23 abr 2021
Ahead of Print:
23 abr 2021
Resumen:
(1) Objectives: To describe the clinical characteristics and clinical course of hospitalized patients with COVID-19 and autoimmune diseases (ADs) compared to the general population. (2) Methods: We used information available in the nationwide Spanish SEMI-COVID-19 Registry, which retrospectively compiles data from the first admission of adult patients with COVID-19. We selected all patients with ADs included in the registry and compared them to the remaining patients. The primary outcome was all-cause mortality during admission, readmission, and subsequent admissions, and secondary outcomes were a composite outcome including the need for intensive care unit (ICU) admission, invasive and non-invasive mechanical ventilation (MV), or death, as well as in-hospital complications. (3) Results: A total of 13,940 patients diagnosed with COVID-19 were included, of which 362 (2.6%) had an AD. Patients with ADs were older, more likely to be female, and had greater comorbidity. On the multivariate logistic regression analysis, which involved the inverse propensity score weighting method, AD as a whole was not associated with an increased risk of any of the outcome variables. Habitual treatment with corticosteroids (CSs), age, Barthel Index score, and comorbidity were associated with poor outcomes. Biological disease-modifying anti-rheumatic drugs (bDMARDs) were associated with a decrease in mortality in patients with AD. (4) Conclusions: The analysis of the SEMI-COVID-19 Registry shows that ADs do not lead to a different prognosis, measured by mortality, complications, or the composite outcome. Considered individually, it seems that some diseases entail a different prognosis than that of the general population. Immunosuppressive/immunoregulatory treatments (IST) prior to admission had variable effects.
Filiaciones:
Ayala Gutiérrez MDM:
Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29010 Málaga, Spain
Rubio-Rivas M:
Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
Romero Gómez C:
Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29010 Málaga, Spain
Montero Sáez A:
Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
Pérez de Pedro I:
Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29010 Málaga, Spain
Homs N:
Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
Ayuso García B:
Internal Medicine Department, 12 de Octubre University Hospital, 28041 Madrid, Spain
Cuenca Carvajal C:
Internal Medicine Department, Gregorio Marañon University Hospital, 28007 Madrid, Spain
Arnalich Fernández F:
Internal Medicine Department, La Paz University Hospital, 28046 Madrid, Spain
Beato Pérez JL:
Internal Medicine Department, Albacete University Hospital Complex, 02006 Albacete, Spain
Vargas Núñez JA:
Internal Medicine Department, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
Letona Giménez L:
Internal Medicine Department, Miguel Servet Hospital, 50009 Zaragoza, Spain
Suárez Fernández C:
Internal Medicine Department, La Princesa University Hospital, 28006 Madrid, Spain
Méndez Bailón M:
Internal Medicine Department, San Carlos Clinical Hospital, 28040 Madrid, Spain
Tuñón de Almeida C:
Internal Medicine Department, Zamora Hospital Complex, 49022 Zamora, Spain
González Moraleja J:
Internal Medicine Department, Virgen de la Salud Hospital, 45004 Toledo, Spain
de Guzmán García-Monge M:
Internal Medicine Department, Infanta Cristina University Hospital, 28981 Parla, Spain
Helguera Amezua C:
Internal Medicine Department, Cabueñes Hospital, 33394 Gijón, Spain
Fidalgo Montero MDP:
Internal Medicine Department, Henares Hospital, 28822 Coslada, Spain
Giner Galvañ V:
Internal Medicine Department, San Juan de Alicante University Hospital, 03550 San Juan de Alicante, Spain
Gil Sánchez R:
Internal Medicine Department, La Fe University Hospital, 46026 Valencia, Spain
Collado Sáenz J:
Internal Medicine Department, San Pedro Hospital, 26006 Logroño, Spain
Boixeda R:
Internal Medicine Department, Mataró Hospital, 08304e Mataró, Spain
:
Department of Clinical Medicine, Miguel Hernandez University of Elche, 03202 Alicante, Spain
Gómez Huelgas R:
Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29010 Málaga, Spain
Open Access
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