Does the impact of COVID-19 on patients with systemic sclerosis change over time?

ObjectiveThe outcome of patients with COVID-19 improved over the pandemic, including patients with systemic rheumatic diseases. However, data on patients with systemic sclerosis (SSc) are lacking. This study aimed to assess the outcome of patients with both SSc and COVID-19 over several waves.MethodsPatients with both SSc and COVID-19 who were registered in the European Scleroderma Trials and Research group (EUSTAR) were collected between April 2020 and April 2021. Patients were assigned to waves 1, 2, or 3 depending on the date of their COVID-19 diagnosis. Primary endpoints were death, intensive care unit stay, or ventilatory support (severe outcome). Subgroup analyses of patients who were hospitalized or died were conducted. General and SSc-specific characteristics and treatment were compared over the waves. Descriptive statistics and multivariate logistic regression were applied.ResultsA total of 333 patients were included; 57 patients (17%) had a severe outcome, and 30 patients (9%) died. Compared to wave 1, significantly fewer patients with SSc suffered from severe COVID-19 in waves 2 and 3 (28.2% vs 9.8% and 12.7%; P P P = 0.001), and fewer patients died (15.7% vs 5.0% and 7.5%; P = 0.011). Patients were significantly younger, more often men, had less frequent arterial hypertension, and less SSc cardiac involvement over waves 1 to 3. Patients received significantly less medium to high doses of corticosteroids as they did SSc treatment.ConclusionThe outcome of patients with both SSc and COVID-19 improved significantly over time because of intrinsic and extrinsic factors.Pathophysiology and treatment of rheumatic disease

Does the impact of COVID‐19 on patients with systemic sclerosis change over time?

Objective Outcome of COVID-19 patients improved over the pandemic, including patients with systemic rheumatic diseases. However, data on systemic sclerosis (SSc) patients are lacking. This study aimed to assess the outcome of SSc patients with COVID-19 over several waves. Methods SSc patients with COVID-19 registered in the European Scleroderma Trials and Research group (EUSTAR) were collected between April 2020 and April 2021. Patients were assigned to wave 1 to 3 depending on date of COVID-19. Primary endpoints were death, intensive care unit stay or ventilatory support (severe outcome). Subgroup analyses of patients who were hospitalized or died were conducted. General and SSc-specific characteristics and treatment were compared over the waves. Descriptive statistics and multivariate logistic regression were applied. Results 333 patients were included; 57 patients (17%) had a severe outcome, and 30 patients died (9%). Compared to wave 1, significantly fewer SSc patients suffered from severe COVID-19 in wave 2 and 3 (28.2% vs. 9.8% and 12.7%; p<0.001), less patients required hospitalization (46.7% vs. 19.6% and 25.5%; p<0.001) or ventilatory support (24.0% vs. 8.7% and 10.9%; p=0.001) and fewer patients died (15.7% vs. 5.0% and 7.5%; p=0.011). Patients were significantly younger, more often male, had less frequently arterial hypertension and less SSc cardiac involvement over wave 1 to 3. Patients received significantly less medium to high dose corticosteroids as SSc treatment. Conclusions Outcome of SSc patients with COVID-19 improved significantly over time, due to intrinsic and extrinsic factors