1 research outputs found
Recommended from our members
Risk Factors for Severe Outcomes in Patients With Systemic Vasculitis and COVIDâ19: A Binational, RegistryâBased Cohort Study
Funder: Vifor Pharma; Id: http://dx.doi.org/10.13039/501100006484Objective: COVIDâ19 is a novel infectious disease with a broad spectrum of clinical severity. Patients with systemic vasculitis have an increased risk of serious infections and may be at risk of severe outcomes following COVIDâ19. We undertook this study to establish the risk factors for severe COVIDâ19 outcomes in these patients, including the impact of immunosuppressive therapies. Methods: A multicenter cohort was developed through the participation of centers affiliated with national UK and Ireland vasculitis registries. Clinical characteristics and outcomes are described. Logistic regression was used to evaluate associations between potential risk factors and a severe COVIDâ19 outcome, defined as a requirement for advanced oxygen therapy, a requirement for invasive ventilation, or death. Results: The cohort included 65 patients with systemic vasculitis who developed COVIDâ19 (median age 70 years, 49% women), of whom 25 patients (38%) experienced a severe outcome. Most patients (55 of 65 [85%]) had antineutrophil cytoplasmic antibodyâassociated vasculitis (AAV). Almost all patients required hospitalization (59 of 65 [91%]), 7 patients (11%) were admitted to intensive care, and 18 patients (28%) died. Background glucocorticoid therapy was associated with severe outcomes (adjusted odds ratio [OR] 3.7 [95% confidence interval 1.1â14.9]; P = 0.047), as was comorbid respiratory disease (adjusted OR 7.5 [95% confidence interval 1.9â38.2]; P = 0.006). Vasculitis disease activity and nonglucocorticoid immunosuppressive therapy were not associated with severe outcomes. Conclusion: In patients with systemic vasculitis, glucocorticoid use at presentation and comorbid respiratory disease were associated with severe outcomes in COVIDâ19. These data can inform clinical decisionâmaking relating to the risk of severe COVIDâ19 in this vulnerable patient group