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Multicenter Study
. 2021 Jun 18;60(6):2946-2957.
doi: 10.1093/rheumatology/keaa748.

SARS-CoV-2 infection in patients with primary Sjögren syndrome: characterization and outcomes of 51 patients

Pilar Brito-Zerón  1   2 , Sheila Melchor  3 , Raphaèle Seror  4 , Roberta Priori  5 , Roser Solans  6 , Belchin Kostov  7   8   9 , Chiara Baldini  10 , Francesco Carubbi  11 , Jose Luis Callejas  12 , Pablo Guisado-Vasco  13 , Gabriela Hernández-Molina  14 , Sandra G Pasoto  15 , Valeria Valim  16 , Antoni Sisó-Almirall  7   8   17 , Xavier Mariette  18 , Patricia Carreira  3 , Manuel Ramos-Casals  1   17   19 ; Sjögren Big Data Consortium, Members of the EULAR-SS Task Force Big Data Consortium who contributed to this study
Collaborators, Affiliations
Multicenter Study

SARS-CoV-2 infection in patients with primary Sjögren syndrome: characterization and outcomes of 51 patients

Pilar Brito-Zerón et al. Rheumatology (Oxford). .

Abstract

Objective: To analyse the prognosis and outcomes of SARS-CoV-2 infection in patients with primary SS.

Methods: We searched for patients with primary SS presenting with SARS-CoV-2 infection (defined following and according to the European Centre for Disease Prevention and Control guidelines) among those included in the Big Data Sjögren Registry, an international, multicentre registry of patients diagnosed according to the 2002/2016 classification criteria.

Results: A total of 51 patients were included in the study (46 women, mean age at diagnosis of infection of 60 years). According to the number of patients with primary SS evaluated in the Registry (n = 8211), the estimated frequency of SARS-CoV-2 infection was 0.62% (95% CI 0.44, 0.80). All but two presented with symptoms suggestive of COVID-19, including fever (82%), cough (57%), dyspnoea (39%), fatigue/myalgias (27%) and diarrhoea (24%), and the most frequent abnormalities included raised lactate dehydrogenase (LDH) (88%), CRP (81%) and D-dimer (82%) values, and lymphopenia (70%). Infection was managed at home in 26 (51%) cases and 25 (49%) required hospitalization (five required admission to ICU, four died). Compared with patients managed at home, those requiring hospitalization had higher odds of having lymphopenia as laboratory abnormality (adjusted OR 21.22, 95% CI 2.39, 524.09). Patients with comorbidities had an older age (adjusted OR 1.05, 95% CI 1.00, 1.11) and showed a risk for hospital admission six times higher than those without (adjusted OR 6.01, 95% CI 1.72, 23.51) in the multivariate analysis.

Conclusion: Baseline comorbidities were a key risk factor for a more complicated COVID-19 in patients with primary SS, with higher rates of hospitalization and poor outcomes in comparison with patients without comorbidities.

Keywords: COVID-19; Primary SS; SARS-Cov-2; comorbidities; outcomes.

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Figures

<sc>Fig</sc>. 1
Fig. 1
Individual outcomes of the 51 patients with primary SS ordered from the youngest to the oldest age at diagnosis of infection C: cardiovascular disease; K: chronic kidney disease; N: neoplasia; O: obesity; P: chronic pulmonary disease.
<sc>Fig</sc>. 2
Fig. 2
Distribution of the main outcomes (at home management, hospitalization, intensive care unit, death) by age decades
See this image and copyright information in PMC

References

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    1. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int (14 September 2020, date last accessed).

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