ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1533

Comparison of Hospitalization and Mortality Rate in Patients with Different Rheumatic Diseases: A Brazilian Registry Cross-Sectional Analysis

Claudia Marques1, Ana Paula Reis2, Adriana Kakehasi3, Edgard Neto4, Marcelo Medeiros Pinheiro5, Gecilmara Salviato Pileggi6, Gilda Ferreira7, Licia Maria Henrique Mota8, Odirlei Andre Monticielo9, Sandra Lúcia Ribeiro10, Felipe Omura11, Adriana Marinho12, Francinne Ribeiro13, Laurindo Rocha Jr14, Ana Silvia Martins15, Michel Yazbek16, Mariana Souza17, Nathália Sacilotto18, Samuel Shinjo19, Lilian Valadares20, Ana Silva21, Danielle Christine de Brito22, Viviane de Souza23, Carolina Costa24, Samia Studart25, Antônio Ximenes26 and Ricardo Xavier27, 1Hospital das Clnicas - Universidade Federal de Pernambuco - UFPE, Recife, Brazil, 2Centro Universitrio de Braslia- UniCEUB, Brasilia, Brazil, 3Federal University of Minas Gerais, Belo Horizonte, Brazil, 4UNIFESP, São Paulo, Brazil, 5Universidade Federal de São Paulo, São Paulo, Brazil, 6FACISB, Ribeirao Preto, Brazil, 7Federal University of Minas Gerais, Belo Horizonte, Brazil, 8Universidade de Brasília, Brasilia, Brazil, 9Serviço de Reumatologia do Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, 10Universidade Federal do Amazonas, Amazonas, Brazil, 11Clinica Omura, São Paulo, Brazil, 12FUNDHACRE, Rio Branco, Brazil, 13UERJ, Rio de Janeiro, Brazil, 14Instituto de Medicina Integral Professor Fernando Figueira - IMIP, Recife, Brazil, 15UFU, Uberlandia, MG, Brazil, 16UNICAMP, Campinas, Brazil, 17SCBH, Belo Horizonte, Brazil, 18Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, Brazil, 19Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 20HOSPITAL GETULIO VARGAS, Recife, Brazil, 21UFG, GOIANIA, Goias, Brazil, 22UFPB, Joao Pessoa, Brazil, 23UFJF, JUIZ DE FORA, Brazil, 24UFES, Vitoria, Brazil, 25HOSPITAL GERAL DE FORTALEZA, Fortaleza, Brazil, 26CLINICA CIP, Goiania, Brazil, 27Departamento de Reumatologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

Meeting: ACR Convergence 2021

Keywords: , , ,

Session Information

Date: Tuesday, November 9, 2021

Title: Infection-related Rheumatic Disease Poster (1530–1564)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: The COVID-19 pandemic has brought uncertainties to the rheumatological practice, and despite the large number of publications to date, many questions remain unanswered. One of the unmet needs is related to the differential risk among the immune mediated rheumatic diseases (IMRD), mainly related to the severity COVID-19 outcomes.

The aim of this study was to compare COVID-19 outcomes among patients with Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA) and Spondyloarthritis (SpA) in a cohort of Brazilian patients and the main risk factors associated.

Methods: We performed a cross-sectional analysis from the ReumaCoV-Brasil registry comparing the moderate/ severe forms, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV) and death, in patients with RA, SLE and SpA and COVID-19. COVID-19 diagnosis was defined as clinical symptoms and lab test confirmation (RT-PCR and/ or serology against SARS-CoV-2). Demographic and clinical data, as well as details on COVID-19 management and endpoints were collected on the REDCap database. Specific and international classification criteria were used to define each IMRD of this study. This study was registered at the Brazilian Registry of Clinical Trials—REBEC, RBR-33YTQC.

Results: From May 20th, 2020 to Jan 24th, 2021, a total of 751 patients were included, of whom 317 with SLE (42.2%), 269 with RA (35.8%) and 165 with SpA (22.0%). Most of patients were female (81.6%) with mean age was 46.7 (13.5) years. The main comorbidity was hypertension (36.6%). Regarding the symptoms of COVID-19, patients with RA reported a higher frequency of arthralgia than the other groups (35.3% vs. 23.0% and 21%; p=0.001, respectively) and longer symptoms duration (15.5±10.7 days vs. 12.1±8.8 days and 13.1±9.9 days, p< 0.001, respectively). The COVID-19 endpoints were quite similar among groups, including hospitalization, ICU admission, MV and mortality rate (Table 1). Analyzing the whole group, older age was significantly associated with all outcomes, as well current oral corticosteroids dosage above 10mg/day and cardiopathy. On the other hand, absence of any comorbidity played a protective role for all the outcomes. After multiple adjustments, the risk factors associated with death were age (OR=1.03; 95%CI 1.004-1.09, p=0.027) and have no kidney disease (OR = 0.150; 95%CI 0.04-0.45, p=0.0001) (Figure 1).

Conclusion: Although no differences have been observed regarding COVID-19 outcomes among patients with SLE, RA and SpA, some risk factors associated with death, hospitalization, IUC admission and MV are directly related to DMARDs, particularly current corticosteroids. However, it is important to note that traditional risk factors are more related to unfavorable COVID-19 than underlying IMRD, especially older age and comorbidities.

Disclosures: C. Marques, None; A. Reis, None; A. Kakehasi, Abbvie, 6, UCB, 6, Pfizer, 6, Sandoz, 6, Boehinger, 6, Amgen, 6, Janssen, 6; E. Neto, GlaxoSmithKline (GSK), 6, Novartis, 6, BracePharma, 6; M. Pinheiro, AbbVie, 2, Eli Lilly, 2, Janssen, 2, Novartis, 2; G. Pileggi, None; G. Ferreira, None; L. Mota, Janssen, 1, 6, Pfizer, 6, UCB, 6, Abbvie, 6, Boehringer Ingelheim, 6, Sandoz, 6, Amgen, 6, GSK, 1, Lilly, 6; O. Andre Monticielo, GSK, 6, GSK, 2; S. Ribeiro, None; F. Omura, None; A. Marinho, None; F. Ribeiro, None; L. Rocha Jr, None; A. Martins, None; M. Yazbek, None; M. Souza, UCB, 6, AMGEN, 6, SANDOZ, 6, NOVARTIS, 6, ABBVIE, 6, JANSSEN, 6, PFIZER, 6; N. Sacilotto, None; S. Shinjo, None; L. Valadares, None; A. Silva, None; D. de Brito, None; V. de Souza, None; C. Costa, None; S. Studart, None; A. Ximenes, None; R. Xavier, Abbvie, 2, Janssen, 2, UCB, 2, Pfizer, 2, Novartis, 2, Amgen, 2, Bristol-Myers Squibb, 2, Eli Lilly, 2.

To cite this abstract in AMA style:

Marques C, Reis A, Kakehasi A, Neto E, Pinheiro M, Pileggi G, Ferreira G, Mota L, Andre Monticielo O, Ribeiro S, Omura F, Marinho A, Ribeiro F, Rocha Jr L, Martins A, Yazbek M, Souza M, Sacilotto N, Shinjo S, Valadares L, Silva A, de Brito D, de Souza V, Costa C, Studart S, Ximenes A, Xavier R. Comparison of Hospitalization and Mortality Rate in Patients with Different Rheumatic Diseases: A Brazilian Registry Cross-Sectional Analysis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/comparison-of-hospitalization-and-mortality-rate-in-patients-with-different-rheumatic-diseases-a-brazilian-registry-cross-sectional-analysis/. Accessed .

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