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
. 2024 Feb;11(1):201-212.
doi: 10.1007/s40744-023-00632-3. Epub 2024 Jan 6.

Characteristics of COVID-19 and Impact of Disease Activity in Patients with Adult-Onset Still's Disease

Xinyue Hong #  1 , Xiaoming Wang #  2 , Ningqi Dai #  1 , Yue Sun  1 , Honglei Liu  1 , Xiaobing Cheng  1 , Junna Ye  1 , Hui Shi  1 , Qiongyi Hu  1 , Jianfen Meng  1 , Zhuochao Zhou  1 , Chengde Yang  1 , Jialin Teng  1 , Yutong Su  1 , Huihui Chi  3
Affiliations

Characteristics of COVID-19 and Impact of Disease Activity in Patients with Adult-Onset Still's Disease

Xinyue Hong et al. Rheumatol Ther. 2024 Feb.

Abstract

Introduction: This study aimed to characterize the morbidity, hospitalization, and mortality rates among patients with adult-onset Still's disease (AOSD) affected by coronavirus disease 2019 (COVID-19) and explore the impact of COVID-19 on the disease activity of AOSD.

Methods: Data on the clinical and demographic characteristics, COVID-19-related symptoms, and outcomes were retrospectively collected. Patients were stratified according to COVID-19 severity and associations between risk factors and outcomes were analyzed using multivariate logistic regression. The disease activity of patients with AOSD flares after COVID-19 was described.

Results: A total of 188 patients with AOSD were followed up, of whom 75.5% (n = 142) had a confirmed or highly suspected COVID-19. Patients on medium or high-dose oral glucocorticoids or Janus kinase (JAK) inhibitors were at increased risk of developing moderate to severe COVID-19. Six patients suffered flares of AOSD following COVID-19 in a short period; however, the relapse rate was not statistically increased compared with patients without COVID-19.

Conclusion: Patients with AOSD receiving medium or high-dose glucocorticoid therapy or JAK inhibitors had worse COVID-19 outcomes. Further work is needed to explore risk factors affecting COVID-19 outcomes and the impact of COVID-19 on disease activity in AOSD.

Keywords: Adult-onset Still’s disease; COVID-19; Glucocorticoids; JAK inhibitors.

PubMed Disclaimer

Conflict of interest statement

All authors declare they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of COVID-19 infection in patients with AOSD. AOSD adult-onset Still’s disease, COVID-19 coronavirus disease 2019
Fig. 2
Fig. 2
Forest plot of risk factors for the severity of COVID-19 in patients with AOSD. The model was adjusted for age, sex, and body mass index. *p < 0.05. Medium or high-dose glucocorticoid, > 7.5 mg/day of glucocorticoids. AOSD adult-onset Still’s disease, COVID-19 coronavirus disease 2019, DMARDs disease-modifying antirheumatic drugs, bDMARDs biologic DMARDs, tsDMARDs targeted synthetic DMARDs, csDMARDs conventional synthetic DMARDs, JAK Janus kinase, CI confidence interval
See this image and copyright information in PMC

References

    1. Feist E, Mitrovic S, Fautrel B. Mechanisms, biomarkers and targets for adult-onset Still’s disease. Nat Rev Rheumatol. 2018;14(10):603–618. doi: 10.1038/s41584-018-0081-x. - DOI - PMC - PubMed
    1. Giacomelli R, Ruscitti P, Shoenfeld Y. A comprehensive review on adult onset Still’s disease. J Autoimmun. 2018;93:24–36. doi: 10.1016/j.jaut.2018.07.018. - DOI - PubMed
    1. Meng J, Ma Y, Jia J, et al. Cytokine storm in coronavirus disease 2019 and adult-onset Still’s disease: similarities and differences. Front Immunol. 2020;11:603389. doi: 10.3389/fimmu.2020.603389. - DOI - PMC - PubMed
    1. Sefik E, Qu R, Junqueira C, et al. Inflammasome activation in infected macrophages drives COVID-19 pathology. Nature. 2022;606(7914):585–593. doi: 10.1038/s41586-022-04802-1. - DOI - PMC - PubMed
    1. Bamidis AD, Koehler P, di Cristanziano V, et al. First manifestation of adult-onset Still’s disease after COVID-19. Lancet Rheumatol. 2021;3(5):e319–e321. doi: 10.1016/S2665-9913(21)00072-2. - DOI - PMC - PubMed

LinkOut - more resources