Systemic Autoimmune Diseases in Patients Hospitalized with COVID-19 in Spain: A Nation-Wide Registry Study
AuthorMoreno-Torres, Víctor; de Mendoza, Carmen; Mellor-Pita, Susana; Martínez-Urbistondo, María; Durán-del Campo, Pedro; Tutor-Ureta, Pablo; Vázquez-Comendador, José Manuel; Calderón-Parra, Jorge; Múñez-Rubio, Elena; Ramos-Martínez, Antonio; Fernández-Cruz, Ana; Castejón, Raquel; Vargas Núñez, Juan Antonio
10.3390/v14081631Viruses 14.8 (2022) 1631
Funded byThis research was funded by Sociedad Española de Medicina Interna and Instituto de Salud Carlos III (Expedient Number CM19/00223)
ProjectGobierno de España. CM19/00223
SubjectsBehçet’s Disease; COVID-19; Inflammatory Myopathies; Mixed and Undifferentiated Connective Tissue Disease; mortality; Sarcoidosis; SARS-CoV-2; Sjogren’s Syndrome; Systemic Autoimmune Diseases; Systemic Lupus Erythematosus; Systemic Sclerosis; Systemic Vasculitides; Medicina
Rights© 2022 by the authors
Esta obra está bajo una Licencia Creative Commons Atribución 4.0 Internacional.
We aimed to evaluate the clinical outcome of Systemic Autoimmune Diseases (SADs) patients hospitalized with COVID-19 in Spain, before the introduction of SARS-CoV-2 vaccines. A nationwide, retrospective and observational analysis of the patients admitted during 2020, based on the ICD10 codes in the National Registry of Hospital Discharges, was performed. Among 117,694 patients, only 892 (0.8%) presented any type of SAD before COVID-19-related admission: Sjogren’s Syndrome constituted 25%, Systemic Vasculitides 21%, Systemic Lupus Erythematosus 19%, Sarcoidosis 17%, Systemic Sclerosis 11%, Mixed and Undifferentiated Connective Tissue Disease 4%, Behçet’s Disease 4% and Inflammatory Myopathies 2%. The in-hospital mortality rate was higher in SAD individuals (20% vs. 16%, p < 0.001). After adjustment by baseline conditions, SADs were not associated with a higher mortality risk (OR = 0.93, 95% CI 0.78–1.11). Mortality in the SADs patients was determined by age (OR = 1.05, 95% CI 1.04–1.07), heart failure (OR = 1.67, 95% CI 1.10–2.49), chronic kidney disease (OR = 1.29, 95% CI 1.05–1.59) and liver disease (OR = 1.97, 95% CI 1.13–3.44). In conclusion, the higher COVID-19 mortality rate seen in SADs patients hospitalized in Spain in 2020 was related to the higher burden of comorbidities, secondary to direct organ damage and sequelae of their condition. Whilst further studies should evaluate the impact of baseline immunosuppression on COVID-19 outcomes in this population, efforts should be focused on the optimal management of SAD to minimize the impact of the organ damage that has been shown to determine COVID-19 prognosis.
Google Scholar:Moreno-Torres, Víctor - de Mendoza, Carmen - Mellor-Pita, Susana - Martínez-Urbistondo, María - Durán-del Campo, Pedro - Tutor-Ureta, Pablo - Vázquez-Comendador, José Manuel - Calderón-Parra, Jorge - Múñez-Rubio, Elena - Ramos-Martínez, Antonio - Fernández-Cruz, Ana - Castejón, Raquel - Vargas Núñez, Juan Antonio
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