リウマチ性関節炎におけるCOVID-19:流行,入院,およびCOVID-19パンデミック前後の全因死亡リスク
Mohammad Movahedi1, Xiuying Li2, Angela Cesta2
1UHN, Toronto General Hospital Research Institute, Toronto, and Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Canada.
Clinical and experimental rheumatology
|September 2, 2025
まとめ
COVID-19は,リウマチ性関節炎 (RA) の女性を不釣り合いに影響し,入院と死亡リスクが増加しました. 先進的なRA治療法とベースラインの特徴は,パンデミック中の結果に影響を与えました.
科学分野:
- リウマトロジ
- 感染症
- エピデミオロジー
背景:
- COVID-19はサイトカインストームを引き起こし,リウマチ性関節炎 (RA) と似た免疫調節療法が必要になります.
- RA患者のCOVID-19の影響を理解することは,併発症と治療戦略の管理に不可欠です.
研究 の 目的:
- RA患者のCOVID-19の流行,入院,緊急診療所 (ED) の訪問率を決定する.
- COVID-19 パンデミック中のRA患者の死亡リスクに対するRA治療と患者の特徴の影響を評価する.
主な方法:
- オンタリオ・ベスト・プラクティス・リサーチ・イニシアチブ (OBRI) と臨床評価科学研究所 (ICES) を通じてリンクされたオンタリオの医療記録を利用した.
- 2020年1月から2022年3月までのCOVID-19感染,ED訪問,入院,集中治療室 (ICU) 入院を分析した.
- パンデミック発生前と後の全原因死亡リスクの比較
主要な成果:
- 2,969人のRA患者のうち,20.1%がCOVID-19に感染し,18.1%が入院またはED訪問を必要とした.
- 女性 (81.9%) および生物学的薬 (52.5%) またはジャヌスキナーゼ阻害剤 (JAKi) (13.4%) を服用した患者は,より高いCOVID-19感染率を示した.
- 死亡リスクの上昇は,高齢者 (> 80 歳),喫煙,特にパンデミック後の疾患の増加と関連していました. JAKiの使用は,流行前の死亡率の低下と関連していました.
結論:
- COVID-19の罹患率は女性,若年患者,併発症患者,および先進的なRA治療法を使用している患者で高かった.
- RA患者におけるパンデミック関連死亡率は,高齢者,経口ステロイド使用,喫煙,および疾患活性の上昇によって引き起こされた.
関連する概念動画
01:23Rheumatic Heart Disease I: Introduction
38
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
38
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
57
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
57
01:21Rheumatic Heart Disease III: Medical Management
31
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
31
01:11Genome-wide Association Studies-GWAS
14.1K
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
14.1K
01:20Rheumatic Heart Disease IV: Nursing Management
36
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
36
01:08Prevalence and Incidence
790
In statistical epidemiology and health sciences, two essential metrics—prevalence and incidence—are fundamental for understanding disease dynamics within a population. These measures enable public health officials, epidemiologists, and researchers to assess the burden of diseases, allocate resources effectively, and design impactful public health policies and interventions.
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
790