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DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study

OBJECTIVE: To describe disease-modifying antirheumatic drug (DMARD) disruption, rheumatic disease flare/activity, and prolonged COVID-19 symptom duration among COVID-19 survivors with systemic autoimmune rheumatic diseases (SARDs). METHODS: We surveyed patients with SARDs after confirmed COVID-19 at...

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Autores principales: Di Iorio, Michael, Cook, Claire E., Vanni, Kathleen M.M., Patel, Naomi J., D’Silva, Kristin M., Fu, Xiaoqing, Wang, Jiaqi, Prisco, Lauren C., Kowalski, Emily, Zaccardelli, Alessandra, Martin, Lily W., Qian, Grace, Hsu, Tiffany Y-T., Wallace, Zachary S., Sparks, Jeffrey A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cold Spring Harbor Laboratory 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8845434/
https://www.ncbi.nlm.nih.gov/pubmed/35169813
http://dx.doi.org/10.1101/2022.02.08.22270696
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author Di Iorio, Michael
Cook, Claire E.
Vanni, Kathleen M.M.
Patel, Naomi J.
D’Silva, Kristin M.
Fu, Xiaoqing
Wang, Jiaqi
Prisco, Lauren C.
Kowalski, Emily
Zaccardelli, Alessandra
Martin, Lily W.
Qian, Grace
Hsu, Tiffany Y-T.
Wallace, Zachary S.
Sparks, Jeffrey A.
author_facet Di Iorio, Michael
Cook, Claire E.
Vanni, Kathleen M.M.
Patel, Naomi J.
D’Silva, Kristin M.
Fu, Xiaoqing
Wang, Jiaqi
Prisco, Lauren C.
Kowalski, Emily
Zaccardelli, Alessandra
Martin, Lily W.
Qian, Grace
Hsu, Tiffany Y-T.
Wallace, Zachary S.
Sparks, Jeffrey A.
author_sort Di Iorio, Michael
collection PubMed
description OBJECTIVE: To describe disease-modifying antirheumatic drug (DMARD) disruption, rheumatic disease flare/activity, and prolonged COVID-19 symptom duration among COVID-19 survivors with systemic autoimmune rheumatic diseases (SARDs). METHODS: We surveyed patients with SARDs after confirmed COVID-19 at Mass General Brigham to investigate post-acute sequelae of COVID-19. We obtained data on demographics, clinical characteristics, COVID-19 symptoms/course, and patient-reported measures. We examined baseline predictors of prolonged COVID-19 symptom duration (defined as lasting ≥28 days) using logistic regression. RESULTS: We analyzed surveys from 174 COVID-19 survivors (mean age 52 years, 81% female, 80% White, 50% rheumatoid arthritis) between March 2021 and January 2022. Fifty-one percent of 127 respondents on any DMARD reported a disruption to their regimen after COVID-19 onset. For individual DMARDs, 56-77% had any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41%. Global patient-reported disease activity was worse at the time of survey than before COVID-19 (mean 6.6±2.9 vs. 7.6±2.3, p<0.001). Median time to COVID-19 symptom resolution was 14 days (IQR 9,29). Prolonged symptom duration of ≥28 days occurred in 45%. Hospitalization for COVID-19 (OR 3.54, 95%CI 1.27-9.87) and initial COVID-19 symptom count (OR 1.38 per symptom, 95%CI 1.17-1.63) were associated with prolonged symptom duration. Respondents experiencing prolonged symptom duration had higher RAPID3 scores (p=0.007) and more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms. CONCLUSION: DMARD disruption, SARD flare, and prolonged symptom duration were common in this prospective study of COVID-19 survivors, suggesting substantial impact on SARDs after acute COVID-19.
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spelling pubmed-88454342022-02-16 DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study Di Iorio, Michael Cook, Claire E. Vanni, Kathleen M.M. Patel, Naomi J. D’Silva, Kristin M. Fu, Xiaoqing Wang, Jiaqi Prisco, Lauren C. Kowalski, Emily Zaccardelli, Alessandra Martin, Lily W. Qian, Grace Hsu, Tiffany Y-T. Wallace, Zachary S. Sparks, Jeffrey A. medRxiv Article OBJECTIVE: To describe disease-modifying antirheumatic drug (DMARD) disruption, rheumatic disease flare/activity, and prolonged COVID-19 symptom duration among COVID-19 survivors with systemic autoimmune rheumatic diseases (SARDs). METHODS: We surveyed patients with SARDs after confirmed COVID-19 at Mass General Brigham to investigate post-acute sequelae of COVID-19. We obtained data on demographics, clinical characteristics, COVID-19 symptoms/course, and patient-reported measures. We examined baseline predictors of prolonged COVID-19 symptom duration (defined as lasting ≥28 days) using logistic regression. RESULTS: We analyzed surveys from 174 COVID-19 survivors (mean age 52 years, 81% female, 80% White, 50% rheumatoid arthritis) between March 2021 and January 2022. Fifty-one percent of 127 respondents on any DMARD reported a disruption to their regimen after COVID-19 onset. For individual DMARDs, 56-77% had any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41%. Global patient-reported disease activity was worse at the time of survey than before COVID-19 (mean 6.6±2.9 vs. 7.6±2.3, p<0.001). Median time to COVID-19 symptom resolution was 14 days (IQR 9,29). Prolonged symptom duration of ≥28 days occurred in 45%. Hospitalization for COVID-19 (OR 3.54, 95%CI 1.27-9.87) and initial COVID-19 symptom count (OR 1.38 per symptom, 95%CI 1.17-1.63) were associated with prolonged symptom duration. Respondents experiencing prolonged symptom duration had higher RAPID3 scores (p=0.007) and more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms. CONCLUSION: DMARD disruption, SARD flare, and prolonged symptom duration were common in this prospective study of COVID-19 survivors, suggesting substantial impact on SARDs after acute COVID-19. Cold Spring Harbor Laboratory 2022-02-09 /pmc/articles/PMC8845434/ /pubmed/35169813 http://dx.doi.org/10.1101/2022.02.08.22270696 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which allows reusers to copy and distribute the material in any medium or format in unadapted form only, for noncommercial purposes only, and only so long as attribution is given to the creator.
spellingShingle Article
Di Iorio, Michael
Cook, Claire E.
Vanni, Kathleen M.M.
Patel, Naomi J.
D’Silva, Kristin M.
Fu, Xiaoqing
Wang, Jiaqi
Prisco, Lauren C.
Kowalski, Emily
Zaccardelli, Alessandra
Martin, Lily W.
Qian, Grace
Hsu, Tiffany Y-T.
Wallace, Zachary S.
Sparks, Jeffrey A.
DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study
title DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study
title_full DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study
title_fullStr DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study
title_full_unstemmed DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study
title_short DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study
title_sort dmard disruption, disease flare, and prolonged symptom duration after acute covid-19 among participants with rheumatic disease: a prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8845434/
https://www.ncbi.nlm.nih.gov/pubmed/35169813
http://dx.doi.org/10.1101/2022.02.08.22270696
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