[COVID-19 and inflammatory rheumatic diseases].

Area of Science:

• Rheumatology
• Infectious Diseases
• Immunology

Background:

• COVID-19 poses significant risks, particularly for older adults and those with comorbidities.
• Inflammatory rheumatic diseases (IRD) and their treatments, such as glucocorticoids (GC) and rituximab, can influence COVID-19 severity.
• Understanding risk factors and treatment implications is crucial for managing IRD patients during the pandemic.

Purpose of the Study:

• To identify independent risk factors for severe COVID-19 outcomes in hospitalized patients.
• To evaluate the impact of specific immunosuppressive therapies on COVID-19 course and outcomes.
• To assess COVID-19 vaccine effectiveness and safety in patients with inflammatory rheumatic diseases.

Main Methods:

• Retrospective analysis of hospitalized COVID-19 patients.
• Identification of independent risk factors including age, comorbidities, and medication use.
• Review of existing literature and preliminary data on rituximab, Janus kinase inhibitors, and COVID-19 vaccines in IRD patients.

Main Results:

• Older age, cardiovascular comorbidities, chronic lung diseases, and GC use (>10 mg daily) are independent risk factors for severe COVID-19.
• High disease activity in IRD independently predicts COVID-19 hospitalization.
• Rituximab treatment is associated with increased hospitalization and mortality rates in IRD patients with COVID-19.
• COVID-19 vaccines show no increased risk of disease flares or adverse events in the general population; data for IRD patients is pending.
• Janus kinase inhibitors' impact on COVID-19 is under investigation.

Conclusions:

• Careful consideration of glucocorticoid use is warranted, with exploration of immunomodulatory alternatives.
• Disease activity in IRD is a critical factor for COVID-19 hospitalization risk.
• Rituximab treatment necessitates careful risk-benefit assessment regarding COVID-19, potentially involving treatment modification.
• While COVID-19 vaccines appear safe, strategic decisions regarding rituximab timing around vaccination may optimize immune response and disease control.