Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic disease-modifying anti-rheumatic drugs

Xabier Michelena¹, Helena Borrell², Mireia López-Corbeto³, María López-Lasanta⁴, Estefanía Moreno⁵, María Pascual-Pastor⁶, Alba Erra⁷, Mayte Serrat⁸, Esther Espartal⁹, Susana Antón¹⁰, Gustavo Adolfo Añez¹¹, Raquel Caparrós-Ruiz¹², Andrea Pluma¹³, Ernesto Trallero-Araguás¹⁴, Mireia Barceló-Bru¹⁵, Miriam Almirall¹⁶, Juan José De Agustín¹⁷, Jordi Lladós¹⁸, Antonio Julià¹⁹, Sara Marsal²⁰

Affiliations

¹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. Electronic address: medxm@leeds.ac.uk.
² Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: hborrell@vhebron.net.
³ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: mireia.lopez@vhir.org.
⁴ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: maria.alopez@vhir.org.
⁵ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: emoreno@vhebron.net.
⁶ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: maria.pascual@vhebron.net.
⁷ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: maerra@vhebron.net.
⁸ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: mserrat@vhebron.net.
⁹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: eespartal@vhebron.net.
¹⁰ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: santon@vhebron.net.
¹¹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: gustavo.anez@vhir.org.
¹² Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: rcaparros@vhebron.net.
¹³ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: apluma@vhebron.net.
¹⁴ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: etrallero@vhebron.net.
¹⁵ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: mbarcelo@vhebron.net.
¹⁶ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: malmirall@vhebron.net.
¹⁷ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: jjagor@hotmail.com.
¹⁸ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: jordi.llados@vhir.org.
¹⁹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: toni.julia@vhir.org.
²⁰ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: sara.marsal@vhir.org.

PMID: 32425260
PMCID: PMC7229730
DOI: 10.1016/j.semarthrit.2020.05.001

Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic disease-modifying anti-rheumatic drugs

Xabier Michelena et al. Semin Arthritis Rheum. 2020 Aug.

. 2020 Aug;50(4):564-570.

doi: 10.1016/j.semarthrit.2020.05.001. Epub 2020 May 16.

Authors

Affiliations

¹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. Electronic address: medxm@leeds.ac.uk.
² Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: hborrell@vhebron.net.
³ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: mireia.lopez@vhir.org.
⁴ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: maria.alopez@vhir.org.
⁵ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: emoreno@vhebron.net.
⁶ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: maria.pascual@vhebron.net.
⁷ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: maerra@vhebron.net.
⁸ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: mserrat@vhebron.net.
⁹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: eespartal@vhebron.net.
¹⁰ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: santon@vhebron.net.
¹¹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: gustavo.anez@vhir.org.
¹² Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: rcaparros@vhebron.net.
¹³ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: apluma@vhebron.net.
¹⁴ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: etrallero@vhebron.net.
¹⁵ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: mbarcelo@vhebron.net.
¹⁶ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: malmirall@vhebron.net.
¹⁷ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: jjagor@hotmail.com.
¹⁸ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: jordi.llados@vhir.org.
¹⁹ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: toni.julia@vhir.org.
²⁰ Rheumatology Department, Rheumatology Research Group, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: sara.marsal@vhir.org.

PMID: 32425260
PMCID: PMC7229730
DOI: 10.1016/j.semarthrit.2020.05.001

Abstract

Objectives: To investigate the incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases receiving targeted biologic and synthetic disease modifying anti-rheumatic drugs (tDMARDs) and to explore the possible effect of these treatments in the clinical expression of COVID-19.

Methods: A cross-sectional study comprising of a telephone survey and electronic health records review was performed including all adult and paediatric patients with rheumatic diseases treated with tDMARDs in a large rheumatology tertiary centre in Barcelona, Spain. Demographics, disease activity, COVID-19 related symptoms and contact history data were obtained from the start of the 2020 pandemic. Cumulative incidence of confirmed cases (SARS-CoV-2 positive PCR test) was compared to the population estimates for the same city districts from a governmental COVID-19 health database. Suspected cases were defined following WHO criteria and compared to those without compatible symptoms.

Results: 959 patients with rheumatic diseases treated with tDMARDs were included. We identified 11 confirmed SARS-CoV-2 positive cases in the adult cohort and no confirmed positive cases in the paediatric cohort. COVID-19 incidence rates of the rheumatic patient cohort were very similar to that of the general population [(0.48% (95% CI 0.09 to 0.87%)] and [0.58% (95% CI 0.56 to 0.60%)], respectively. We found significant differences in tDMARDs proportions between the suspected and non-suspected cases (p=0.002).

Conclusion: Adult and paediatric patients with rheumatic diseases on tDMARDs do not seem to present a higher risk of COVID-19 or a more severe disease outcome when compared to general population.

Keywords: COVID-19; Epidemiology; Pediatric rheumatology; Rheumatic diseases; Targeted disease modifying anti-rheumatic drugs.

PubMed Disclaimer

Conflict of interest statement

XM received speaker fees from Novartis and Sanofi-Genzyme. HB received speaker fees from Lilly, MSD and Pfizer. RCR received speaker fees from MSD. ETA received speaker fees from Roche and Bristol-Myer-Squib outside this work. SM received speaker fees, grant and honoraria from Roche and Bristol-Myer-Squib outside this work. MLC, MLL, EM, MPP, AED, MSL, EE, SA, GAS, APS, MBB, MAB, JDD, JL and AJ have nothing to disclose

Comment in

Patients with juvenile idiopathic arthritis on TNF inhibitors exposed to COVID-19 family members.
Marino A, Romano M, Gattinara M, Cimaz R. Marino A, et al. Semin Arthritis Rheum. 2020 Dec;50(6):1214-1215. doi: 10.1016/j.semarthrit.2020.09.012. Epub 2020 Oct 2. Semin Arthritis Rheum. 2020. PMID: 33059294 Free PMC article. No abstract available.

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Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic disease-modifying anti-rheumatic drugs

Affiliations

Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic disease-modifying anti-rheumatic drugs

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

References

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LinkOut - more resources

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Miscellaneous