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Multicenter Study
. 2021;27(41):4245-4252.
doi: 10.2174/1381612827666210903103935.

Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments

Clodoveo Ferri  1 , Dilia Giuggioli  1 , Vincenzo Raimondo  2 , Massimo L'Andolina  3 , Lorenzo Dagna  4 , Antonio Tavoni  5 , Francesco Caso  6 , Francesco Ursini  7 , Piero Ruscitti  8 , Maurizio Caminiti  9 , Rosario Foti  10 , Valeria Riccieri  11 , Serena Guiducci  12 , Roberta Pellegrini  13 , Elisabetta Zanatta  14 , Giuseppe Varcasia  15 , Domenico Olivo  16 , Pietro Gigliotti  17 , Giovanna Cuomo  18 , Giuseppe Murdaca  19 , Riccardo Cecchetti  20 , Rossella De Angelis  21 , Nicoletta Romeo  22 , Francesca Ingegnoli  23 , Franco Cozzi  24 , Veronica Codullo  25 , Ilaria Cavazzana  26 , Michele Colaci  27 , Giuseppina Abignano  28 , Maria De Santis  29 , Ennio Lubrano  30 , Enrico Fusaro  31 , Alessandra Della Rossa  32 , Amelia Spinella  1 , Federica Lumetti  1 , Giacomo De Luca  4 , Silvia Bellando-Randone  12 , Elisa Visalli  10 , Ylenia Dal Bosco  10 , Giorgio Amato  10 , Daiana Giannini  5 , Silvia Bilia  5 , Francesco Masini  18 , Greta Pellegrino  11 , Erika Pigatto  24 , Elena Generali  29 , Giuseppa Pagano Mariano  9 , Giorgio Pettiti  22 , Giovanni Zanframundo  25 , Raffaele Brittelli  2 , Vincenzo Aiello  2 , Rodolfo Caminiti  2 , Daniela Scorpiniti  2 , Tommaso Ferrari  15 , Corrado Campochiaro  4 , Veronica Brusi  7 , Micaela Fredi  33 , Liala Moschetti  26 , Fabio Cacciapaglia  34 , Laura Gragnani  35 , Monica Monti  35 , Serena Lorini  35 , Sabrina Rosaria Paparo  36 , Francesca Ragusa  36 , Valeria Mazzi  37 , Giusy Elia  37 , Silvia Martina Ferrari  36 , Ilenia Di Cola  8 , Marta Vadacca  38 , Sebastiano Lorusso  38 , Simone Barsotti  32 , Maria Letizia Aprile  27 , Tasso Marco  6 , Mario Miccoli  36 , Silvia Bosello  39 , Marco Matucci-Cerinic  12 , Salvatore D'Angelo  28 , Andrea Doria  14 , Franco Franceschini  26 , Riccardo Meliconi  7 , Florenzo Iannone  34 , Roberto Giacomelli  38 , Anna Linda Zignego  40 , Poupak Fallahi  41 , Alessandro Antonelli  37
Affiliations
Multicenter Study

Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments

Clodoveo Ferri et al. Curr Pharm Des. 2021.

Abstract

Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations.

Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic.

Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing).

Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003).

Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave.

Keywords: Covid-19; SARS-CoV-2; arthritis; autoimmune systemic diseases; connective tissue diseases; interstitial lung disease.; rheumatic diseases; systemic sclerosis.

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