Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study

BackgroundPatients with rheumatic diseases who receive long-term treatment with steroids, immunosuppressants, or biologics are more susceptible to infection with pathogens than the general population. In order to explore the differences in clinical features and prognosis of Corona Virus Disease 2019...

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Main Authors: Yihua Fan, Yiwen Wang, Juanli Du, Rui Wu, Jianbin Li, Changhong Xiao, Qing Li, Mi Zhou, Ying Liu, Di Zhang, Bei Wang, Songwei Li, Zhina Zhao, Xinliang Lyu, Yuanhao Wu, Yan Liu, Xiaomei Ning, Zhiteng Li, Shujiao Yu, Ensheng Chen, Guangzhao Zhu, Yuxing Zhao, Juan Liu, Yuquan Liu, Dongyi He, Wei Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2024.1439242/full
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author Yihua Fan
Yihua Fan
Yihua Fan
Yiwen Wang
Yiwen Wang
Juanli Du
Rui Wu
Jianbin Li
Changhong Xiao
Qing Li
Mi Zhou
Ying Liu
Di Zhang
Bei Wang
Songwei Li
Zhina Zhao
Xinliang Lyu
Yuanhao Wu
Yuanhao Wu
Yan Liu
Yan Liu
Xiaomei Ning
Xiaomei Ning
Zhiteng Li
Shujiao Yu
Ensheng Chen
Guangzhao Zhu
Yuxing Zhao
Yuxing Zhao
Juan Liu
Yuquan Liu
Dongyi He
Wei Liu
Wei Liu
author_facet Yihua Fan
Yihua Fan
Yihua Fan
Yiwen Wang
Yiwen Wang
Juanli Du
Rui Wu
Jianbin Li
Changhong Xiao
Qing Li
Mi Zhou
Ying Liu
Di Zhang
Bei Wang
Songwei Li
Zhina Zhao
Xinliang Lyu
Yuanhao Wu
Yuanhao Wu
Yan Liu
Yan Liu
Xiaomei Ning
Xiaomei Ning
Zhiteng Li
Shujiao Yu
Ensheng Chen
Guangzhao Zhu
Yuxing Zhao
Yuxing Zhao
Juan Liu
Yuquan Liu
Dongyi He
Wei Liu
Wei Liu
author_sort Yihua Fan
collection DOAJ
description BackgroundPatients with rheumatic diseases who receive long-term treatment with steroids, immunosuppressants, or biologics are more susceptible to infection with pathogens than the general population. In order to explore the differences in clinical features and prognosis of Corona Virus Disease 2019 (COVID-19) infection between patients with rheumatic diseases and the general population (family members), a retrospective investigative study was used to analyze the differences between the two populations.MethodsThe study was conducted in 13 Grade A Tertiary hospitals in China to investigate the clinical symptoms and prognostic factors of patients with rheumatic diseases who were infected with COVID-19 for the first time and their families.ResultsA total of 2,889 participants were included in this study, including 1,530 patients with rheumatic diseases and 1,359 family members. In terms of clinical symptoms, the complete recovery time from COVID-19 for patients with rheumatic disease patients was 13 days (8.00, 18.00), which was shorter than that of family members (16 days, 11.00, 20.00). The risk of developing moderate to severe cases of COVID-19 was lower in patients with rheumatic disease than in their family members (OR=0.511, P=0.0026). Compared with non-use of non-steroidal anti-inflammatory drugs (NSAIDs), the risk of developing mild cases of COVID-19 was 0.595 times greater with pre-infection use of NSAIDs (P = 0.0003). The use of glucocorticoids and Chinese herbal decoctions before infection increased the probability of developing mild cases of COVID-19 (OR=1.537, 1.773, P<0.05). The risk of developing moderate to severe cases with disease-modifying anti-rheumatic drugs (DMARDs) used before infection was 0.350 times that without such drugs (P<0.001). In terms of prognosis, compared with family members, the complete recovery time of patients with rheumatic diseases was reduced by 2.241 days on average (P<0.001), and the complete recovery time of patients with mild rheumatism was reduced by 4.178 days on average (P<0.001). There was no significant difference in the complete recovery time from COVID-19 in patients with severe rheumatism compared with their family members (P=0.1672). The use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions during the infection period could shorten the recovery time of COVID-19 symptoms (P<0.05).ConclusionsCompared with their family members, patients with rheumatic diseases had milder symptoms after infection with COVID-19, which was related to the use of glucocorticoids, DMARDs, and Chinese herbal decoctions before infection. During the COVID-19 infection phase, the use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions might shorten the recovery time from symptoms of COVID-19.Chinese clinical trial registryChiCTR2300072679
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spelling doaj-art-fe7cde0968874326a36c70346dee06b12025-08-20T02:49:22ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-12-011510.3389/fimmu.2024.14392421439242Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective studyYihua Fan0Yihua Fan1Yihua Fan2Yiwen Wang3Yiwen Wang4Juanli Du5Rui Wu6Jianbin Li7Changhong Xiao8Qing Li9Mi Zhou10Ying Liu11Di Zhang12Bei Wang13Songwei Li14Zhina Zhao15Xinliang Lyu16Yuanhao Wu17Yuanhao Wu18Yan Liu19Yan Liu20Xiaomei Ning21Xiaomei Ning22Zhiteng Li23Shujiao Yu24Ensheng Chen25Guangzhao Zhu26Yuxing Zhao27Yuxing Zhao28Juan Liu29Yuquan Liu30Dongyi He31Wei Liu32Wei Liu33Department of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Rheumatism and Immunity, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaDepartment of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Rheumatology and Immunology, Xi’an No.5 Hospital, Xi’an, Shaanxi, ChinaDepartment of Immunology and Rheumatology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Immunology and Rheumatology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Rheumatology, Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, Guangdong, ChinaRheumatology Department, Qinghai Provincial Hospital of Traditional Chinese Medicine, Xining, Qinghai, ChinaDepartment of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Rheumatology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaDepartment of Rheumatology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China0Department of Rheumatology and Immunology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China1Department of Rheumatism and Immunity, Henan Provincial Hospital of Chinese Medicine, Zhengzhou, Henan, China2Department of Rheumatism and Immunity, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China3Rheumatology Department, Inner Mongolia Hospital of Traditional Chinese Medicine, Hohhot, Inner Mongolia Autonomous Region, ChinaDepartment of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Rheumatology and Immunology, Xi’an No.5 Hospital, Xi’an, Shaanxi, ChinaDepartment of Immunology and Rheumatology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Rheumatology, Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, Guangdong, ChinaRheumatology Department, Qinghai Provincial Hospital of Traditional Chinese Medicine, Xining, Qinghai, ChinaDepartment of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China0Department of Rheumatology and Immunology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China3Rheumatology Department, Inner Mongolia Hospital of Traditional Chinese Medicine, Hohhot, Inner Mongolia Autonomous Region, China4Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Rheumatism and Immunity, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaBackgroundPatients with rheumatic diseases who receive long-term treatment with steroids, immunosuppressants, or biologics are more susceptible to infection with pathogens than the general population. In order to explore the differences in clinical features and prognosis of Corona Virus Disease 2019 (COVID-19) infection between patients with rheumatic diseases and the general population (family members), a retrospective investigative study was used to analyze the differences between the two populations.MethodsThe study was conducted in 13 Grade A Tertiary hospitals in China to investigate the clinical symptoms and prognostic factors of patients with rheumatic diseases who were infected with COVID-19 for the first time and their families.ResultsA total of 2,889 participants were included in this study, including 1,530 patients with rheumatic diseases and 1,359 family members. In terms of clinical symptoms, the complete recovery time from COVID-19 for patients with rheumatic disease patients was 13 days (8.00, 18.00), which was shorter than that of family members (16 days, 11.00, 20.00). The risk of developing moderate to severe cases of COVID-19 was lower in patients with rheumatic disease than in their family members (OR=0.511, P=0.0026). Compared with non-use of non-steroidal anti-inflammatory drugs (NSAIDs), the risk of developing mild cases of COVID-19 was 0.595 times greater with pre-infection use of NSAIDs (P = 0.0003). The use of glucocorticoids and Chinese herbal decoctions before infection increased the probability of developing mild cases of COVID-19 (OR=1.537, 1.773, P<0.05). The risk of developing moderate to severe cases with disease-modifying anti-rheumatic drugs (DMARDs) used before infection was 0.350 times that without such drugs (P<0.001). In terms of prognosis, compared with family members, the complete recovery time of patients with rheumatic diseases was reduced by 2.241 days on average (P<0.001), and the complete recovery time of patients with mild rheumatism was reduced by 4.178 days on average (P<0.001). There was no significant difference in the complete recovery time from COVID-19 in patients with severe rheumatism compared with their family members (P=0.1672). The use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions during the infection period could shorten the recovery time of COVID-19 symptoms (P<0.05).ConclusionsCompared with their family members, patients with rheumatic diseases had milder symptoms after infection with COVID-19, which was related to the use of glucocorticoids, DMARDs, and Chinese herbal decoctions before infection. During the COVID-19 infection phase, the use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions might shorten the recovery time from symptoms of COVID-19.Chinese clinical trial registryChiCTR2300072679https://www.frontiersin.org/articles/10.3389/fimmu.2024.1439242/fullcorona virus disease 2019rheumatismclinical characteristicretrospective investigationclinical study
spellingShingle Yihua Fan
Yihua Fan
Yihua Fan
Yiwen Wang
Yiwen Wang
Juanli Du
Rui Wu
Jianbin Li
Changhong Xiao
Qing Li
Mi Zhou
Ying Liu
Di Zhang
Bei Wang
Songwei Li
Zhina Zhao
Xinliang Lyu
Yuanhao Wu
Yuanhao Wu
Yan Liu
Yan Liu
Xiaomei Ning
Xiaomei Ning
Zhiteng Li
Shujiao Yu
Ensheng Chen
Guangzhao Zhu
Yuxing Zhao
Yuxing Zhao
Juan Liu
Yuquan Liu
Dongyi He
Wei Liu
Wei Liu
Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study
Frontiers in Immunology
corona virus disease 2019
rheumatism
clinical characteristic
retrospective investigation
clinical study
title Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study
title_full Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study
title_fullStr Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study
title_full_unstemmed Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study
title_short Clinical characteristics and prognostic factors of COVID-19 in rheumatic patients and their family members: a retrospective study
title_sort clinical characteristics and prognostic factors of covid 19 in rheumatic patients and their family members a retrospective study
topic corona virus disease 2019
rheumatism
clinical characteristic
retrospective investigation
clinical study
url https://www.frontiersin.org/articles/10.3389/fimmu.2024.1439242/full
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