Течение и исходы COVID-19 у пациентов с иммуновоспалительными ревматическими заболеваниями: предварительные данные регистра НИИР/АРР-COVID-19 и обзор литературы

Представлены материалы Российской базы данных НИИР/АРР-С0УГО-19, включавшей взрослых (старше 18 лет) пациентов с иммуновоспалительными ревматическими заболеваниями (ИВРЗ), перенесших COVID-19 (coronavirus disease 2019), и обзор литературы, касающийся течения и исходов COVID-19 у пациентов с этими заболеваниями. С 17 июля 2020 г. по 23 апреля 2021 г. было получено и проанализировано 156 сообщений. Исследуемая группа была представлена преимущественно женщинами (75%). Средний возраст пациентов составил 52,0±14,8 года, из них 53 (33,9%) пациента — в возрасте 60 лет и старше. Наиболее частыми клиническими проявлениями COVID-19 были лихорадка (62,2%), кашель (40,4%), аносмия (37,8%), одышка (33,3%). В период течения COVID-19 компьютерная томография органов грудной клетки была выполнена у 143 пациентов. При оценке по «эмпирической» визуальной шкале 0-я стадия поражения легких отмечалась у 49 (34,3%) пациентов, 1-я - у 40 (28%), 2-я - у 35 (24,5%), 3-я - у 19 (13,2%), 4-я - у 0. В исследуемой группе благоприятный исход был отмечен у 137 (97,9%) пациентов. Летальный исход зарегистрирован у 3 пациентов. У 131 пациента было оценено влияние перенесенной COVID-19 на течение ИВРЗ: у 52 (39,7%) пациентов течение ИВРЗ ухудшилось, у 1 (0,8%) - улучшилось, у 78 (59,5%) влияния не отмечено. Данные литературы, касающиеся риска инфицирования вирусом SARS-CoV-2, течения и исходов COVID-19 при ревматических и мышечно-скелетных заболеваниях, противоречивы, что диктует необходимость продолжения сбора данных, касающихся ревматологических проблем COVID-19, в российской популяции пациентов с учетом международного опыта.

1. Белов БС, Лила АМ. COVID-19 и ревматология: год спустя. Научно-практическая ревматология. 2021;59(1):31-36. doi: 10.47360/19954484-2021-31-36

2. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet (London, England). 2020;395(10223):470-473. doi: 10.1016/S0140-6736(20)30185-9

3. Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021;19(3):141-154. doi: 10.1038/s41579-020-00459-7

4. Berlin DA, Gulick RM, Martinez FJ. Severe COVID-19. N Engl J Med. 2020;383(25):2451-2460. doi: 10.1056/NEJMcp2009575

5. Weatherhead JE, Clark E, Vogel TP, Atmar RL, Kulkarni PA. Inflammatory syndromes associated with SARS-CoV-2 infection: Dysregulation of the immune response across the age spectrum. J Clin Invest. 2020;130(12):6194-6197. doi: 10.1172/JCI145301

6. Насонов ЕЛ. Коронавирусная болезнь 2019 (COVID-19) и аутоиммунитет. Научно-практическая ревматология. 2021;59(1):5-30. doi: 10.47360/1995-4484-2021-5-30

7. Насонов ЕЛ, Бекетова ТВ, Решетняк ТМ, Лила АМ, Ананьева ЛП, Лисицина ТА, и др. Коронавирусная болезнь 2019 (COVID-19) и иммуновоспалительные ревматические заболевания: на перекрестке проблем тромбовоспаления и аутоиммунитета. Научно-практическая ревматология. 2020;58(4):353-367. doi: 10.47360/1995-4484-2020-353-367

8. Gianfrancesco M, Hyrich KL, Al-Adely S, Carmona L, Danila MI, Gossec L., et al.; COVID-19 Global Rheumatology Alliance. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: Data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2020;79(7):859-866. doi: 10.1136/annrheumdis-2020-217871

9. Strangfeld A, Schafer M, Gianfrancesco MA, Lawson-Tovey S, Liew JW, Mateurs EF, et al.; COVID-19 Global Rheumatology Alliance. Factors associated with COVID-19-related death in people with rheumatic diseases: Results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2021;80(7):930-942. doi: 10.1136/annrheumdis-2020-219498

10. Sparks JA, Wallace ZS, Seet AM, Gianfrancesco MA, Izadi Z, Hyrich KL, et al.; COVID-19 Global Rheumatology Alliance. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: Results from the COVID-19 Global Rheumatology Alliance physician registry. Ann Rheum Dis. 2021;80(9):1137-1146. doi: 10.1136/annrheumdis-2021-220418

11. Gianfrancesco M, Hyrich KL, Yazdany J, Machado PM, Robinson PC. COVID-19 Global Rheumatology Alliance Registry, anti-IL-6 therapy, shared decision-making and patient outcomes. Response to: ‘Correspondence on ‘Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry' by Gianfrancesco et al. Compassionate use of tocilizumab in severe COVID-19 with hyperinflammation prior to advent of clinical trials - A real-world district general hospital experience' by Khan et al, ‘Comment on ‘Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 global rheumatology alliance physician-reported registry' by Gianfrancesco M, et al' by Andreica et al and ‘COVID-19 outcomes in patients with systemic autoimmune diseases treated with immunomodulatory drugs' by Ansarin et al. Ann Rheum Dis. 2020 Aug 12:annrheum-dis-2020-218713. doi: 10.1136/annrheumdis-2020-218713

12. Haberman RH, Castillo R, Chen A, Yan D, Ramirez D, Sekar V, et al.; NYU WARCOV Investigators. COVID-19 in patients with inflammatory arthritis: A prospective study on the effects of comorbidities and disease-modifying antirheumatic drugs on clinical outcomes. Arthritis Rheumatol. 2020;72(12):1981-1989. doi: 10.1002/art.41456

13. Fernandez-Gutierrez B, Leon L, Madrid A, Rodriguez-Rodriguez L, Freites D, Font J, et al. Hospital admissions in inflammatory rheumatic diseases during the peak of COVID-19 pandemic: Incidence and role of disease-modifying agents. Ther Adv Musculoskelet Dis. 2021;13:1759720X20962692. doi: 10.1177/1759720X20962692

14. Topless RK, Phipps-Green A, Leask M, Dalbeth N, Stamp LK, Robinson PC, et al. Gout, rheumatoid arthritis, and the risk of death related to coronavirus disease 2019: An analysis of the UK biobank. ACR Open Rheumatol. 2021;3(5):333-340. doi: 10.1002/acr2.11252

15. Costantino F, Bahier L, Tarancdn LC, Leboime A, Vidal F, Bessalah L, et al. COVID-19 in French patients with chronic inflammatory rheumatic diseases: Clinical features, risk factors and treatment adherence. Joint Bone Spine. 2021;88(1):105095. doi: 10.1016/j.jbspin.2020.105095

16. Ferri C, Giuggioli D, Raimondo V, L'Andolina M, Tavoni A, Cecchetti R, et al. COVID-19 & ASD Italian Study Group. COVID-19 and rheumatic autoimmune systemic diseases: Report of a large Italian patients series. Clin Rheumatol. 2020;39(11):3195-3204. doi: 10.1007/s10067-020-05334-7

17. Conway R, Nikiphorou E, Demetriou CA, Low C, Leamy K, Ryan JG, et al. COVID-19 Global Rheumatology Alliance. Predictors of hospitalization in patients with rheumatic disease and COVID-19 in Ireland: Data from the COVID-19 global rheumatology alliance registry. Rheumatol Adv Pract. 2021;5(2):rkab031. doi: 10.1093/rap/rkab031

18. D'Silva KM, Jorge A, Cohen A, McCormick N, Zhang Y, Wallace ZS, Choi HK. COVID-19 outcomes in patients with systemic autoimmune rheumatic diseases compared to the general population: A US multicenter, comparative cohort study. Arthritis Rheumatol. 2021;73(6):914-920. doi: 10.1002/art.41619

19. England DR, Roiul P, Yang Y, Lalil AC, Michaud K, et al. Risk of COVID-19 in rheumatoid arthritis: A National Veterans affairs matched cohort study in at-risk individuals. Arthritis Rheum. 2021;10.1002/art.41800. doi: 10.1002/art.41800

20. Marques CDL, Kakehasi AM, Pinheiro MM, Mota LMH, Albuquerque CP, Silva CR, et al. High levels of immunosuppression are related to unfavorable outcome in hospitalized patients with rheumatic disease and COVID-19: First results of ReumaCoV Brasil Registry. RMD Open. 2021;7e0011461. doi: 10.1136/tmo-dopen-2020-001461

21. Cordtz R, Lindhardsen J, Soussi BG, Vela J, Uhrenholt L, Westermann R, et al. Incidence and severeness of COVID-19 hospitalization in patients with inflammatory rheumatic disease: A nationwide cohort study from Denmark. Rheumatology (Oxford). 2021;60(SI):I59-I67. doi: 10.1093/rheumatology/keaa897

22. Attauabi M, Seidelin JB, Felding OK, Wewer MD, Vinther Arp LK, Sarikaya MZ, et al. Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies - A Danish population-based cohort study. J Autoimmun. 2021;118:102613. doi: 10.1016/j.jaut.2021.102613

23. Hsu TY-T, D'Silva KD, Patel NJ, Wang J, Mueller AA, Fu X, et al. Laboratory trends, hyperinflammation, and clinical outcomes for patients with a systemic rheumatic disease admitted to hospital for COVID-19: A retrospective, comparative cohort study. Lancet Rheumatol 2021;3(9):e638-e647. doi: 10.1016/S2665-9913(21)00140-5

24. FAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors. Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: Data from the French RMD COVID-19 cohort of 694 patients. Ann Rheum Dis. 2020;80(4):527-538. doi: 10.1136/annrheumdis-2020-218310

25. Tan EH, Sena AG, Prats-Uribe A, You SC, Ahmed WU, Kostka K, et al. COVID-19 in patients with autoimmune diseases: Characteristics and outcomes in a multinational network of cohorts across three countries. Rheumatology (Oxford). 2021;60(SI):SI37-SI50. doi: 10.1093/rheumatology/keab250

26. Hasseli R, Mueller-Ladner U, Hoyer BF, Krause A, Lorenz HM, Pfeil A, et al. Older age, comorbidity, glucocorticoid use and disease activity are risk factors for COVID-19 hospitalisation in patients with inflammatory rheumatic and musculoskeletal diseases. RMD Open. 2021;7(1):e001464. doi: 10.1136/rmdopen-2020-001464

27. Gamboa-Cdrdenas RV, Barzola-Cerrdn S, Toledo-Neira D, Redtegui-Sokolova C, Pimentel-Quiroz V, Zevallos-Miranda F, et al. Predictors of hospitalization for COVID-19 in patients with autoimmune rheumatic diseases: Results from a community cohort follow-up. Clin Rheumatol. 2021;40(11):4725-4734. doi: 10.1007/s10067-021-05833-1

28. Esatoglu SN, Tascilar K, Babaoglu H, Bes C, Yurttas B, Akar S, et al.; Turkish Society for Rheumatology COVID-19 Registry Investigators. COVID-19 among patients with inflammatory rheumatic diseases. Front Immunol. 2021;12:651715. doi: 10.3389/fimmu.2021.651715

29. Pablos JL, Galindo M, Carmona L, Lledd A, Retuerto M, Blanco R, et al. RIER investigators group. Clinical outcomes of hospitalised patients with COVID-19 and chronic inflammatory and autoimmune rheumatic diseases: A multicentric matched cohort study. Ann Rheum Dis. 2020;79(12):1544-1549 . doi: 10.1136/annrheumdis-2020-218296

30. Montero F, Martinez-Barrio J, Serrano-Benavente B, Gonzdlez T, Rivera J, Collada JM, et al. Coronavirus disease 2019 (COVID-19) in autoimmune and inflammatory conditions: Clinical characteristics of poor outcomes. Rheumatol Int. 2020;40(10):1593-1598. doi: 10.1007/s00296-020-04676-4

31. Freites Nunez DD, Leon L, Mucientes A, Rodriguez-Rodriguez L, Font Urgelles J, Madrid Garcia A, et al. Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis. 2020;79(11):1393-1399. doi: 10.1136/annrheumdis-2020-217984

32. Mena-Vdzquez N, Manrique Arija S, Rojas-Gimdnez M, Raya-Alvarez E, Velloso-Feijod ML, Ldpez-Medina C, et al. Hospitalization and mortality from COVID-19 of patients with rheumatic inflammatory diseases in Andalusia. Reumatol Clin (Engl Ed). 2021:S2173-5743(21)00162-3. doi: 10.1016/j.reumae.2021.02.006

33. Bakasis AD, Mavragani CP, Boki KA, Tzioufas AG, Vlachoyiannopoulos PG, Stergiou IE, et al. COVID-19 infection among autoimmune rheumatic disease patients: Data from an observational study and literature review. J Autoimmun. 2021;123:102687. doi: 10.1016/j.jaut.2021.102687

34. Serling-Boyd N, D'Silva KM, Hsu TY, Wallwork R, Fu X, Gravallese EM, et al. Coronavirus disease 2019 outcomes among patients with rheumatic diseases 6 months into the pandemic. Ann Rheum Dis. 2021;80(5):660-666. doi: 10.1136/annrheumdis-2020-219279

35. Scirfe CA, Carrara G, Zanetti A, Landolfi G, Chighizola C, Alunno A, et al.; Italian Registry of the Italian Society for Rheumatology (CONTROL-19). COVID-19 in rheumatic diseases in Italy: First results from the Italian registry of the Italian Society for Rheumatology (CONTROL-19). Clin Exp Rheumatol. 2020;38(4):748-753.

36. Raiker R, DeYoung C, Pakhchanian H, Ahmed S, Kavadichanda C, Gupta L, et al. Outcomes of COVID-19 in patients with rheumatoid arthritis: A multicenter research network study in the United States. Semin Arthritis Rheum. 2021;51(5):1057-1066. doi: 10.1016/j.semarthrit.2021.08.010

37. Alzahrani ZA, Alghamdi KA, Almaqati AS. Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases. Rheumatol Int. 2021;41(6):1097-1103. doi: 10.1007/s00296-021-04857-9

38. Schmajuk G, Montgomery AD, Leonard S, Li J, Gianfrancesco M, Seet A, et al. Factors associated with hospitalization and death after COVID-19 diagnosis among patients with rheumatic disease: An analysis of veterans affairs data. ACR Open Rheumatol. 2021;3(11):796-803. doi: 10.1002/acr2.11328

39. Bertoglio IM, de Lucena JM, Daffre D, Aikawa NE, Silva CA, et al. Poor prognosis of COVID-19 acute respiratory distress syndrome in lupus erythematosus: Nation-wide cross-sectional oioulation study of 252199 patients. ACR Open Rheumatol. 2021;3(11):804-811. doi: 10.1002/acr2.11329

40. Raiker R, Pakhchanian H, DeYoung C, Gupta L, Karde§ S, Ahmed S, et al. Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network. J Autoimmun. 2021 Oct 9:102730. doi: 10.1016/j.jaut.2021.102730

41. Bachiller-Corral J, Boteanu A, Garcia-Villanueva MJ, de la Puente C, Revenga M, Diaz-Miguel MC, et al. Risk of severe COVID-19 infection in patients with inflammatory rheumatic diseases. J Rheumatol. 2021;48(7):1098-1102. doi: 10.3899/jrheum.200755

42. Regierer AC, Hasseli R, Schafer M, Hoyer BF, Krause A, Lorenz HM, et al. TNFi is associated with positive outcome, but JAKi and rituximab are associated with negative outcome of SARS-CoV-2 infection in patients with RMD. RMD Open. 2021;7(3):e001896. doi: 10.1136/rmdopen-2021-001896

43. Bower H, Frisell T, Di Giuseppe D, Delcoigne B, Ahlenius GM, Baecklund E, et al. ARTIS Study Group. Impact of the COVID-19 pandemic on morbidity and mortality in patients with inflammatory joint diseases and in the general population: A nationwide Swedish cohort study. Ann Rheum Dis. 2021;80(8):1086-1093. doi: 10.1136/annrheumdis-2021-219845

44. Peach E, Rutter M, Lanyon P, Grainge MJ, Hubbard R, Aston J, et al. Risk of death among people with rare autoimmune diseases compared with the general population in England during the 2020 COVID-19 pandemic. Rheumatology (Oxford). 2021;60(4):1902-1909. doi: 10.1093/rheumatology/keaa855

45. Rutter M, Lanyon PC, Grainge MJ, Hubbard R, Peach E, Bythell M, et al. COVID-19 infection, admission and death amongst people with rare autoimmune rheumatic disease in England. Results from the RECORDER project. Rheumatology (Oxford). 2021 Oct 26:keab794. doi: 10.1093/rheumatology/keab794

46. Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430-436. doi: 10.1038/s41586-020-2521-4

47. Wegrzyn L, Winthrop K, Kim S, Ye Y, Huisingh C, Krueger W, et al. Real world population-based assessment of COVID-19 out-comes among rheumatoid arthritis patients using biologic or synthetic DMARDs. Ann Rheum Dis. 2021;80(Suppl 1):886.

48. Chuo C-Y, Yau V, Madhavan S, Tsai L, Chia J. Risk of severe COVID-19 outcomes among patients with rheumatoid arthritis in the United States. medRxiv. 2021.07.09.21260106. doi: 10.1101/2021.07.09.21260106

49. Akiyama S, Hamdeh S, Micic D, Sakuraba A. Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: A systematic review and meta-analysis. Ann Rheum Dis. 2020 Oct 13:annrheumdis-2020-218946. doi: 10.1136/annrheumdis-2020-218946

50. Wang Q, Liu J, Shao R, Han X, Su C, Lu W. Risk and clinical outcomes of COVID-19 in patients with rheumatic diseases compared with the general population: A systematic review and meta-analysis. Rheumatol Int. 2021;41(5):851-861. doi: 10.1007/s00296-021-04803-9

51. Yang H, Xu J, Shi L, Duan G, Wang Y. Correspondence on «Prevalence and clinical outocome of COVIF-19 in patients with autoimmune diseases: A systemic reviews and meta-analysis». Ann Rheum Dis. 2021;0:1-3. doi: 10.1136/annrheumdis-2020-219821

52. Baillet A, Gossec L, Carmona L, Wit Md, van Eijk-Hustings Y, Bertheussen H, et al. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: A EULAR initiative. Ann Rheum Dis. 2016;75(6):965-973. doi: 10.1136/annrheumdis-2016-209233

53. Гордеев АВ, Галушко ЕА, Насонов ЕЛ. Концепция мульти-морбидности в ревматологической практике. Научно-практическая ревматология. 2014;52(4):362-365. doi: 10.14412/1995-4484-2014362-365

54. Yousefghahari B, Navari S, Sadeghi M, Soleimaniamiri S, Soleimaniamiri M, Heidari B, et al. Risk of COVID-19 infection in patients with rheumatic disease taking disease-modifying anti-rheumatic drugs. Clin Rheumatol. 2021;40(10):4309-4315. doi: 10.1007/s10067-021-05779-4

55. Jung SY, Kim MS, Kim MC, Choi SH, Chung JW, Choi ST. Effect of hydroxychloroquine pre-exposure on infection with SARS-CoV-2 in rheumatic disease patients: A population-based cohort study. Clin Microbiol Infect. 2021;27(4):611-617. doi: 10.1016/j.cmi.2020.12.003

56. Guillaume D, Magalie B, Sina E, Imfene SM, Fr6d6ric V, Mathieu D, et al. Antirheumatic drug intake influence on occurrence of COVID-19 infection in ambulatory patients with immune-mediated inflammatory diseases: A cohort study. Rheumatol Ther. 2021 Sep 16:1-9. doi: 10.1007/s40744-021-00373-1

57. Moradi S, Masoumi M, Mohammadi S, Vafaeimanesh J, Mohseni M, Mahdavi H, et al. Prevalence of coronavirus disease 2019 in rheumatic patients and evaluation of the effect of diseasemodifying anti-rheumatic drugs. Intern Emerg Med. 2021;16(4):919-923. doi: 10.1007/s11739-020-02535-5

58. Hooijberg F, Boekel L, Vogelzang EH, Leeuw M, Boers M, van Vollenhofen R, et al. Patients with rheumatic diseases adhere to COVID-19 isolation measures more strictly than the general population. Lancet Rheumatol. 2020;2(10):e583-e585. doi: 10.1016/S2665-9913(20)30286-1

59. Zhu Y, Zhong J, Dong L. Epidemiology and clinical management of rheumatic autoimmune diseases in the COVID-19 pandemic: A review. Front Med (Lausanne). 2021;8:725226. doi: 10.3389/fmed.2021.725226

60. Ioannou GN, Locke E, Green P, Berry K, O'Hare AM, Shah JA, et al. Risk factors for hospitalization, mechanical ventilation, or death among 10 131 US veterans with SARS-CoV-2 infection. JAMA Netw Open. 2020;3(9):e2022310. doi: 10.1001/jamanet-workopen.2020.22310

61. Насонов ЕЛ, Авдеева АС. Деплеция В-клеток при иммуново-спалительных ревматических заболеваниях и коронавирусная болезнь 2019 (COVID-19). Научно-практическая ревматология. 2021;59(4):384-393. doi: 10.47360/1995-4484-2021-384-393

62. Schafer M, Strangfeld A, Hyrich KL, Carmona L, Gianfrancesco M, Lawson-Tovey S, et al. Response to: ‘Correspondence on ‘Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician reported registry'' by Mulhearn et al. Ann Rheum Dis. 2021 Mar 1:annrheum-dis-2021-220134. doi: 10.1136/annrheumdis-2021-220134

63. Sawalha AH, Zhao M, Coit P, Lu Q. Epigenetic dysregulation of ACE2 and interferon-regulated genes might suggest increased COVID-19 susceptibility and severity in lupus patients. Clin Immunol. 2020;215:108410. doi: 10.1016/j.clim.2020.108410

64. Насонов ЕЛ, Попкова ТВ, Панафидина ТА. Проблемы ранней системной красной волчанки в период пандемии COVID-19. Научно-практическая ревматология. 2021;59(2):119-128. doi: 10.47360/1995-4484-2021-119-128

65. Gupta S, Nakabo S, Chu J, Hasni S, Kaplan MJ. Association between anti-interferon-alpha autoantibodies and COVID-19 in systemic lupus erythematosus. medRxiv. 2020;2020.10.29.20222000. doi: 10.1101/2020.10.29.20222000

66. Bastard P, Rosen LB, Zhang Q, Michailidis E, Hoffmann HH, Zhang Y, et al. Autoantibodies against type I IFNs in patients with life-threatening COVID-19. Science. 2020;370(6515):eabd4585. doi: 10.1126/science.abd4585