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Submitted: 13 Jan 2021
Accepted: 02 Mar 2021
ePublished: 01 Apr 2021
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Immunopathol Persa. 2021;7(2): e34.
doi: 10.34172/ipp.2021.34
  Abstract View: 185
  PDF Download: 69

Original

The severity of symptoms and outcomes of patients admitted with rheumatic diseases and COVID-19; a prospective cohort study in Iran

Mansour Salesi 1 ORCID logo, Ramin Sami 1 ORCID logo, Somayeh Haji Ahmadi 2 ORCID logo, Nilufar Khademi 1 ORCID logo, Mehrnegar Dehghan 1 ORCID logo, Soheila Jalali 3 ORCID logo, Marjan Mansourian 4 ORCID logo, Huriyeh Hashemi 1 * ORCID logo

1 Departman of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Epidemiology and Biostatistics, School of Health Isfahan University of Medical Sciences, Isfahan, Iran
4 Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
*Correspondence to Huriyeh Hashemi, Email: h.hashemi@med.mui.ac.ir, Hashemihurie@gmail.com

Abstract

Introduction: In severe COVID-19 patients, a pre-inflamatory condition leads to a cytokine storm syndrome. This may signify the need for using immunomodulatory drugs. Patients with rheumatic diseases (RDs) are prone to severe infectious diseases.

Objectives: Whether the presence of the RD itself or the use of its drugs in patients with COVID-19 increases the severity of symptoms and outcomes remains largely unknown.

Patients and Methods: In a prospective cohort study conducted in Khorshid hospital of Isfahan, Iran, 219 patients with COVID-19 were enrolled and divided into two groups of patients with a positive history for RD (n=19) and those without this history (NRD, n=200). The severity of symptoms and outcomes was compared between the groups.

Results: Shortness of breath (P=0.001), cough (P=0.019), and weakness (P=0.001) were significantly higher in the RD than the NRD group after, but not before, recovery. All the patients in the RD group had comorbid diseases (hypertension, diabetes mellitus, ischemic heart disease, and cerebrovascular disease), the number of which was significantly higher than that of the NRD group (P<0.001). The Charlson Comorbidity Index (CCI) was used to predict 10-year survival in patients with multiple comorbidities. It was significantly lower in the RD group as opposed to the NRD group (P<0.001). Logistic regression also showed a non-significantly higher chance of the composite outcome (ICU admission, death status, and intubation status) in the RD group as opposed to the NRD group, both before and after adjustment for confounding factors. However, no difference was found between the RD patient who received corticosteroid as a treatment (RD-CS) and those who did not (RD-NCS).

Conclusion: The results showed an increased risk for severe forms of COVID-19 in RD patients. This risk is possibly attributable to a high prevalence of comorbidities in these patients.

Keywords: COVID-19, Rheumatic diseases, Severity, Outcome
Citation: Salesi M, Sami R, Haji Ahmadi S, Khademi N, Dehghan M, Jalali S, Mansourian M, Hashemi H. The severity of symptoms and outcomes of patients admitted with rheumatic diseases and COVID-19; a prospective cohort study in Iran. Immunopathol Persa. 2021;7(2):e34. DOI:10.34172/ ipp.2021.34.
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