Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Nov 22;62(1):45.
doi: 10.1186/s42358-022-00268-x.

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

Claudia Diniz Lopes Marques  1 , Sandra Lúcia Euzébio Ribeiro  2 , Cleandro P Albuquerque  3 , Samia Araujo de Sousa Studart  4 , Aline Ranzolin  5 , Nicole Pamplona Bueno de Andrade  6 , Andrea T Dantas  1 , Guilherme D Mota  7 , Gustavo G Resende  8 , Adriana O Marinho  9 , Danielle Angelieri  10 , Danieli Andrade  11 , Francinne M Ribeiro  12 , Felipe Omura  13 , Nilzio A Silva  14 , Laurindo Rocha Junior  15 , Danielle E Brito  16 , Diana C Fernandino  17 , Michel A Yazbek  18 , Mariana P G Souza  19 , Antonio Carlos Ximenes  20 , Ana Silvia S Martins  21 , Glaucio Ricardo W Castro  22 , Lívia C Oliveira  23 , Ana Beatriz S B Freitas  24 , Adriana M Kakehasi  8 , Ana Paula M Gomides  25 , Edgard Torres Reis Neto  7 , Gecilmara S Pileggi  7 , Gilda A Ferreira  8 , Licia Maria H Mota  26   27 , Ricardo M Xavier  6 , Marcelo de Medeiros Pinheiro  28 ; ReumaCoV-Brasil Registry
Affiliations
Multicenter Study

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

Claudia Diniz Lopes Marques et al. Adv Rheumatol. .

Abstract

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.

Keywords: COVID-19; Hospitalization; Psoriatic arthritis; SARS-CoV-2; Spondyloarthritis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Forrest plot from the bivariate regression model for hospitalization in spondyloarthritis patients with COVID-19
Fig. 2
Fig. 2
Disease activity in axial spondyloarthritis patients comparing cases and controls, and before and after COVID-19 in those with COVID-19, according to the BASDAI (A, E), ASDAS-ESR (B, F), ASDAS-CRP (C, G) and according to the physician global assessment (PGA)
Fig. 3
Fig. 3
Disease activity in psoriatic arthritis patients comparing cases and controls (A) and before and after COVID-19 in those with COVID-19 (B), according to the physician global assessment (PGA)
See this image and copyright information in PMC

References

    1. Marques CDL. Covid-19 and rheumatic diseases: it is time to better understand this association. J Rheumatol. 2021;48:318–320. doi: 10.3899/jrheum.201541. - DOI - PubMed
    1. Mehta B, Pedro S, Ozen G, Kalil A, Wolfe F, Mikuls T, et al. Serious infection risk in rheumatoid arthritis compared with non-inflammatory rheumatic and musculoskeletal diseases: a US national cohort study. RMD Open. 2019;5:e000935. doi: 10.1136/rmdopen-2019-000935. - DOI - PMC - PubMed
    1. Au K, Reed G, Curtis JR, Kremer JM, Greenberg JD, Strand V, et al. High disease activity is associated with an increased risk of infection in patients with rheumatoid arthritis. Ann Rheum Dis. 2011;70:785–791. doi: 10.1136/ard.2010.128637. - DOI - PubMed
    1. Martinez A, Pacheco-Tena C, Vazquez-Mellado J, Burgos-Vargas R. Relationship between disease activity and infection in patients with spondyloarthropathies. Ann Rheum Dis. 2004;63:1338–1340. doi: 10.1136/ard.2003.011882. - DOI - PMC - PubMed
    1. Bezzio C, Saibeni S, Variola A, Allocca M, Massari A, Gerardi V, et al. Outcomes of covid-19 in 79 patients with ibd in Italy: an ig-ibd study. Gut. 2020;69:1213–1217. doi: 10.1136/gutjnl-2020-321411. - DOI - PubMed

Publication types