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Review
. 2020 Jul;19(7):102575.
doi: 10.1016/j.autrev.2020.102575. Epub 2020 May 5.

SARS-CoV-2 infection among patients with systemic autoimmune diseases

Giacomo Emmi  1 , Alessandra Bettiol  2 , Irene Mattioli  1 , Elena Silvestri  1 , Gerardo Di Scala  1 , Maria Letizia Urban  1 , Augusto Vaglio  3 , Domenico Prisco  1
Affiliations
Review

SARS-CoV-2 infection among patients with systemic autoimmune diseases

Giacomo Emmi et al. Autoimmun Rev. 2020 Jul.

Abstract

Objectives: This study aimed to evaluate the prevalence of clinically overt SARS-CoV-2 infection (COVID-19) among patients with systemic autoimmune diseases residing in Tuscany, and to compare it with that observed in the general Tuscan population.

Methods: In this cross-sectional study, Tuscan outpatients with systemic autoimmune diseases followed at a tertiary referral centre were telephonically interviewed between April 1st-14th 2020 to collect demographic and clinical data, information on ongoing immunomodulating/immunosuppressive treatments, and on the presence of symptoms suspected of SARS-CoV-2 or of a confirmed infection.

Results: 458 patients were interviewed [74% female, median age 56 years (IQR 43-68)]; 56% of them were receiving corticosteroids, 44% traditional disease-modifying anti-rheumatic drugs (DMARDs), of whom 23% hydroxychloroquine, 5% colchicine, while 41% were on biologic DMARDs (of whom 9% on tocilizumab). Thirteen patients reported symptoms suggesting SARS-CoV-2 infection. Of them, 7 had undergone nasopharyngeal swab and only one was positive and developed severe SARS-CoV-2 complications. Within our cohort, the prevalence of SARS-CoV-2 infection was therefore 0.22% (0.01-1.21%), comparable to that observed in the general population of Tuscany [0.20% (0.20-0.21%), p = .597].

Conclusions: Patients with systemic autoimmune diseases do not seem to carry an increased risk of SARS- CoV-2 infection as compared to the general population.

Keywords: COVID-19; Hydroxychloroquine; Immunosuppressants; Systemic autoimmune diseases; Tocilizumab.

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Conflict of interest statement

Declaration of Competing Interest None declared.

Figures

Fig. 1
Fig. 1
Flow chart of SARS-CoV-2 cases in patients with systemic autoimmune diseases and in the general population of Tuscany.
Fig. 2
Fig. 2
Reported symptoms suspected of SARS-CoV-2 and results nasopharyngeal swab tests, and details of the main clinical events and treatments of the single case with confirmed SARS-CoV-2 infection found in our cohort. HCQ: hydroxychloroquine.
See this image and copyright information in PMC

Comment in

  • Risk of COVID-19 in celiac disease patients.
    Zingone F, D'Odorico A, Lorenzon G, Marsilio I, Farinati F, Savarino EV. Zingone F, et al. Autoimmun Rev. 2020 Oct;19(10):102639. doi: 10.1016/j.autrev.2020.102639. Epub 2020 Aug 13. Autoimmun Rev. 2020. PMID: 32801048 Free PMC article. No abstract available.

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