Data documento
07/05/2024

Título
COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data

Autor(es)
Marques CDL, Ribeiro SLE, Albuquerque CP, de Sousa Studart SA, Ranzolin A, de Andrade NPB, Dantas AT, Mota GD, Resende GG, Marinho AO, Angelieri D, Andrade D, Ribeiro FM, Omura F, Silva NA, Rocha Junior L, Brito DE, Fernandino DC, Yazbek MA, Souza MPG, Ximenes AC, Martins ASS, Castro GRW, Oliveira LC, Freitas ABSB, Kakehasi AM, Gomides APM, Reis Neto ET, Pileggi GS, Ferreira GA, Mota LMH, Xavier RM, de Medeiros Pinheiro M.

Palavras chave
COVID-19 - Hospitalization - Psoriatic arthritis - SARS-CoV-2 - Spondyloarthritis

Resumo
Objectives: To evaluate the disease activity before and after COVID-19 and risk factors associated with outcomes, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV) and death in patients with spondylarthritis (SpA). Methods: ReumaCoV Brazil is a multicenter prospective cohort of immune-mediated rheumatic diseases (IMRD) patients with COVID-19 (case group), compared to a control group of IMRD patients without COVID-19. SpA patients enrolled were grouped as axial SpA (axSpA), psoriatic arthritis (PsA) and enteropathic arthritis, according to usual classification criteria. Results: 353 SpA patients were included, of whom 229 (64.9%) were axSpA, 118 (33.4%) PsA and 6 enteropathic arthritis (1.7%). No significant difference was observed in disease activity before the study inclusion comparing cases and controls, as well no worsening of disease activity after COVID-19. The risk factors associated with hospitalization were age over 60 years (OR = 3.71; 95% CI 1.62-8.47, p = 0.001); one or more comorbidities (OR = 2.28; 95% CI 1.02-5.08, p = 0.001) and leflunomide treatment (OR = 4.46; 95% CI 1.33-24.9, p = 0.008). Not having comorbidities (OR = 0.11; 95% CI 0.02-0.50, p = 0.001) played a protective role for hospitalization. In multivariate analysis, leflunomide treatment (OR = 8.69; CI = 95% 1.41-53.64; p = 0.023) was associated with hospitalization; teleconsultation (OR = 0.14; CI = 95% 0.03-0.71; p = 0.01) and no comorbidities (OR = 0.14; CI = 95% 0.02-0.76; p = 0.02) remained at final model as protective factor. Conclusions: Our results showed no association between pre-COVID disease activity or that SARS-CoV-2 infection could trigger disease activity in patients with SpA. Teleconsultation and no comorbidities were associated with a lower hospitalization risk. Leflunomide remained significantly associated with higher risk of hospitalization after multiple adjustments.

Citação
Marques CDL, Ribeiro SLE, Albuquerque CP, de Sousa Studart SA, Ranzolin A, de Andrade NPB, Dantas AT, Mota GD, Resende GG, Marinho AO, Angelieri D, Andrade D, Ribeiro FM, Omura F, Silva NA, Rocha Junior L, Brito DE, Fernandino DC, Yazbek MA, Souza MPG, Ximenes AC, Martins ASS, Castro GRW, Oliveira LC, Freitas ABSB, Kakehasi AM, Gomides APM, Reis Neto ET, Pileggi GS, Ferreira GA, Mota LMH, Xavier RM, de Medeiros Pinheiro M; ReumaCoV-Brasil Registry. COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data. Adv Rheumatol. 2022 Nov 22;62(1):45. doi: 10.1186/s42358-022-00268-x. PMID: 36419163; PMCID: PMC9685130.