Background/Purpose: Patients with immune-mediated inflammatory diseases (IMID) have a higher risk of infections related to their disease, comorbidities or immunosuppressive treatments, but recent studies addressing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) didn´t support more frequent or severe disease in these patients. Our objective is to describe our cohort of patients with IMID who had a probable or confirmed SARS-CoV-2 infection.

Methods: Patients with IMID currently followed in the Rheumatology Department of Ramón y Cajal University Hospital with probable or confirmed SARS-CoV-2 infection diagnosed between 01-02-2020 and 22-05-2020 were selected. Confirmed infection was defined if the patient had a positive nasopharyngeal swab for SARS-CoV-2 or characteristic bilateral infiltrates on chest radiograph/computerized tomography (CT); probable infection was defined by 2 or more symptoms related to COVID-19 (fever, dry cough, dyspnoea, myalgia, anosmia or ageusia) if other causes were excluded. We analysed the demographic and clinical data on patients who had IMID with symptomatic COVID-19.

Results: Eighty patients were selected (58 patients with confirmed COVID-19, and 22 patients with probable COVID-19). Median age at diagnosis was 61.50 years (Interquartile range [IQR], 37.5-85.5). Fifty patients (62.5%) were female. Thirty-one patients were treated as outpatients, 49 were admitted in our hospital, out of them 11 died. Their characteristics are described and compared in table 1.

All patients that were hospitalised (n=49) suspended their conventional and biologic DMARDs at the time of admission. Their outcome and treatment prescribed during hospitalization is represented in table 2.

Conclusion:

• We found that patients with IMID share risk factors for hospitalization/death described for the general population.
• Patients with systemic vasculitis, polymyalgia rheumatica (PMR) and IMID-associated interstitial lung disease had a worse prognosis (more frequent hospitalization and/or higher mortality). Patients treated with moderate/high GC doses for their IMID had a worse outcome, while patients treated with anti-TNF or tocilizumab had a better prognosis.
• Among the patients that were hospitalised, those who developed ARDS or heart failure and those who required non-invasive mechanical ventilation (NIMV) had higher mortality.
• Nevertheless, these results must be interpreted with caution, given the relatively low number of patients, interaction between variables associated with mortality couldn´t be analysed.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/covid-19-among-patients-with-immune-mediated-inflammatory-diseases-a-descriptive-study/