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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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COVID-19 outcomes in giant cell arteritis and polymyalgia rheumatica versus rheumatoid arthritis: A national,

Matheus Vieira1, Cloé Comarmond2, Julien Labreuche3

  • 1Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France; Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, France; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), France; INSERM 959, Groupe Hospitalier, AP-HP, Paris, France.

Journal of Autoimmunity
|August 4, 2022
PubMed

Insights

Giant cell arteritis and polymyalgia rheumatica (GCA/PMR) patients faced worse COVID-19 outcomes. However, this increased risk was mainly due to common risk factors, not the vasculitis itself.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Epidemiology

Background:

  • Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are inflammatory conditions.
  • The impact of GCA/PMR on COVID-19 severity and outcomes is not fully understood.
  • Rheumatoid arthritis (RA) serves as a relevant comparator group due to shared inflammatory pathways and patient demographics.

Purpose of the Study:

  • To investigate if GCA/PMR are independent risk factors for severe COVID-19.
  • To compare COVID-19 outcomes in GCA/PMR patients versus RA patients.
  • To describe the clinical course and evolution of GCA/PMR patients post-COVID-19.

Main Methods:

  • An observational, national, French, multicenter cohort study (NCT04353609) included adult patients with confirmed GCA, PMR, or RA who contracted COVID-19.
  • Patients on rituximab were excluded.
  • Multinomial logistic regression models were used to compare COVID-19 severity and mortality between GCA/PMR and RA groups, adjusting for confounding factors.

Main Results:

  • The cohort comprised 674 patients: 45 GCA, 47 PMR, and 582 RA.
  • GCA/PMR patients were older and had more comorbidities (hypertension, diabetes, cardiovascular disease) than RA patients.
  • Unadjusted analyses showed significantly higher odds of severe COVID-19 (OR=3.32) and death (OR=3.20) in GCA/PMR patients compared to RA, though these were attenuated after adjustment.

Conclusions:

  • Patients with GCA/PMR experienced more severe COVID-19 and higher mortality rates compared to RA patients.
  • The heightened risk observed in GCA/PMR patients appears primarily attributable to established risk factors prevalent in the general population, rather than the underlying vasculitic conditions themselves.
Abstract

Keywords:
COVID-19Giant cell arteritisPolymyalgia rheumaticaRheumatoid arthritisSARS-CoV-2

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