Date: Friday, November 6, 2020
Session Type: Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Advanced age and cardiovascular diseases are recognized as major comorbidities associated with severe forms of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with large vessels vasculitis (LVV) could be considered at-risk for severe COVID-19 due to frequent age over 65 years in patients with giant cell arteritis (GCA), severe hypertension in patients with Takayasu arteritis (TAK) and current use of immunomodulating therapies in both LVV. The aim of this study was to determine the prevalence, clinical presentation and outcome of COVID-19 among LVV patients.
Methods: We retrospectively collected symptoms compatible with COVID-19 reported during SARS-CoV-2 pandemic in France, and severity, therapeutic management and outcomes of COVID-19 infection in all LVV patients followed for GCA or TAK in a single-tertiary centre.
Results: Between 04 and 20 may 2020, 148 patients with LVV were enrolled, including 84 GCA and 64 TAK. Median age at inclusion was 73 (67-82) years vs. 48 (42-62) for GCA and TAK, respectively, p < 0.001. Comorbidities such as hypertension, diabetes, obesity, and smoking habit were not significantly different between GCA and TAK group, except for the presence of solid cancer (19% vs 3% for GCA and TAK, respectively, p = 0.004). Seventy-seven percent of LVV patients were currently receiving glucocorticoids, 33% DMARDs and 20% biotherapies. Sixteen (11%) LVV patients presented a COVID-19 infection, including 9/84 (11%) GCA patients and 7/64 (11%) TAK patients. COVID-19 infections in LVV patients were confirmed by nasal PCR (n=3) and/or thoracic CT scan (n=3) and/or serological tests (n=3). Pneumonia occurred in 5 (31%) COVID-19 positive LVV patients, all requiring hospitalization and 4 oxygen therapy. LVV-COVID+ patients had a more active vasculitis disease than LVV-COVID– patients (p = 0.044). Over a two-month period contemporary with the SARS-CoV-2 pandemic, in our LVV cohort we observed 3 COVID-19 related deaths (2 TAK and 1 GCA), leading to a mortality rate of 3/16 (18.8%).
Conclusion: Severe COVID-19 may occur in LVV requiring hospitalization in up to 30% of patients and frequent fatal issue. Active LVV or recent remission appear to increase the risk of COVID-infection.
To cite this abstract in AMA style:Comarmond C, Leclercq M, Leroux G, Marques C, Le Joncour A, Domont F, Hatte C, Toquet S, Guillaume-Jugnot P, Desbois A, Vautier M, Rigolet A, Allenbach Y, Benveniste O, Saadoun D, Cacoub P. 2019 Novel Coronavirus Disease (COVID-19) in Patients with Large-Vessels Vasculitis: Single-centre Experience in Paris [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/2019-novel-coronavirus-disease-covid-19-in-patients-with-large-vessels-vasculitis-single-centre-experience-in-paris/. Accessed September 16, 2021.
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