Session Type: Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: In mid-March 2020, state of alarm was declared in Spain due to the novel coronavirus disease 2019 (COVID-19) pandemic. Patients with rheumatic diseases (RD) under immunosuppressive drugs are considered at high risk of severe outcome. Some commonly used treatments in RD such as corticosteroids, hydroxycloroquine or anti-IL6 drugs are also hypothesized to help treat COVID-19. We set out to determine the prevalence of SARS-CoV-2 infection among patients who reported respiratory symptoms during COVID-19 pandemic from March up to June 2020 in a group of patients treated with biological agents such as anti-TNF, anti-IL6, abatacept and JAK inhibitors like baricitinib or tofacitinib.
Methods: A registry of all patients under treatment with adalimumab, anti-IL6, abatacept, baricitinib and tofacitinib in our Rheumatology Service was obtained. All the patients were called and asked to participate in a telephone survey screening for infectious respiratory symptoms in the past 4 months (phone calls were made from mid-April to early-June). Other epidemiological data (previous contact with a suspected case, number of household members and confinement measures) were collected. Reported symptoms were evaluated by a clinician to assess whether or not these were suggestive of acute respiratory disease. Those who presented new onset acute respiratory symptoms were tested for SARS-Cov-2 serology (IgM/IgG).
Results: A total of 355 patients participated in the survey, 66.5% were females. Mean age (S.D.) was 54.7 years (16.5). Rheumatoid arthritis was the most common diagnosis (56%), followed by spondyloarthritis (16.3%), psoriasic arthritis (11.3%), idiopathic juvenile arthritis (6.8%) and others (9.6%). Adalimumab (46%) and tocilizumab (20.9%) were the most common treatment groups, followed by abatacept (12.4%), tofacitinib (12.1%), baricitinib (6.5%) and sarilumab (2.3%). Mean time under current treatment was 59.8 months.
Patients were asked for the presence of respiratory symptoms out of a list with 20 items. Follow-up questions were asked when necessary to determine the acute or chronic nature of the symptoms. The most common reported symptoms were cough (8.2%), odynophagia (6.8%), fatigue (5.4%), shortness of breath (4.8%), joint or muscular pain (3.7%) and diarrhea (3.4%). 87.24% complied with the confinement measures. 4.94% reported contact with people with symptoms suspicious of COVID-19. No patient required hospital care.
A total of 25 were selected for serological testing based on reported symptoms compatible with COVID-19 disease. The remaining 330 patients reported no symptoms or had symptoms not attributable to infection. Peak incidence of reported symptoms occurred in March (n = 10). All patients tested negative for IgM and only one patient was positive for IgG.
Conclusion: Patients with RD showed a high level of compliance to confinement measures. COVID-19 was extremely low among patients with RD treated with biological agents or JAK inhibitors. Confinement measures are key to prevent SARS-Cov-2 transmission.
To cite this abstract in AMA style:Pavez Perales C, Leal Rodriguez S, De la Rubia Navarro M, Gonzalez Mazario R, Grau Garcia E, Alcañiz Escandell C, Chalmeta Verdejo I, Fragio Gil J, Gonzalez Puig L, Ivorra Cortes J, Martinez Cordellat I, Negueroles Albuixech R, Oller Rodriguez J, Ortiz Sanjuan F, Vicens Bernabeu E, Roman Ivorra J. Serological Evidence of SARS-CoV-2 in Symptomatic Patients Under Biological Treatment in a Rheumatology Service [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/serological-evidence-of-sars-cov-2-in-symptomatic-patients-under-biological-treatment-in-a-rheumatology-service/. Accessed September 19, 2021.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/serological-evidence-of-sars-cov-2-in-symptomatic-patients-under-biological-treatment-in-a-rheumatology-service/