Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization

Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization Publisher

Azizi H¹ ; Karimi H¹ ; Kazemi M² ; Rezaei SS² ; Parsaei A¹ ; Aghaali M³ ; Vafaeimanesh J⁴ ; Torabi P¹ ; Amini B¹ ; Masoumi M²

Show Affiliations

1. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
2. Clinical Research of Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Beheshti Blvd, Qom, Iran
3. Department of Community Medicine, School of Medicine, Qom University of Medical Sciences, Qom, Iran
4. Department of Internal Medicine, School of Medicine, Qom University of Medical Sciences, Qom, Iran

Source: Rheumatology and Therapy Published:2023

Abstract

Introduction: SARS-CoV-2 causes more severe symptoms in most chronic diseases, and rheumatic disease is no exception. This study aims to investigate whether there is an association between the use of immunomodulatory medications, including conventional disease-modifying agents (csDMARDs), glucocorticoids, and biologic DMARDs, and outcomes such as hospitalization and lung involvement in patients with rheumatic disease with COVID-19. Methods: We performed a cross-sectional study on 177 COVID-19 cases with rheumatologic diseases using immunomodulatory drugs as their regular treatment. All patients were evaluated regarding their initial chest computed tomography (CT) scan, COVID-19 symptoms, and comorbidities. We ran predictive models to find variables associated with chest CT-scan involvement and hospitalization status. Results: CT findings showed lung involvement in 87 patients with chest CT-scan severity score (C-ss) of less than 8 in 59 (33%) and more than 8 in 28 (16%) of our patients. Of all patients, 76 (43%) were hospitalized. Hospitalized patients were significantly older and had more comorbidities (P = 0.02). On multivariate analysis, older age [odds ratio (OR) 1.90, 95% confidence interval (CI) 1.31–3.08] and comorbidity (OR 2.75, 95% CI 1.06–3.66) were significantly associated with higher odds of hospitalization (P = 0.03). On multivariate analysis, older age (OR 1.15, 95% CI 0.94–2.01), pulmonary diseases (OR 2.05, 95% CI 1.18–3.32), and treatment with csDMARDs (OR 1.88, 95% CI 0.37–1.93) were associated with higher C-ss (P = 0.039). Conclusions: This study found that advanced age and comorbidities, similar to the general population, are risk factors for hospitalization in patients with COVID-19 with rheumatic disorders. Administration of csDMARDs, older age, and pulmonary disorders were linked to increased risk of COVID-19 pneumonia in these individuals. © 2022, The Author(s).

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Nima Rezaei (23)

Seyed Ahmad Seyed Alinaghi (9)

Style	Citing Format
MLA	Azizi H, et al.. "Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization." Rheumatology and Therapy, vol. 10, no. 1, 2023, pp. 249-259.
APA	Azizi H, Karimi H, Kazemi M, Rezaei SS, Parsaei A, Aghaali M, Vafaeimanesh J, Torabi P, Amini B, Masoumi M (2023). Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization. Rheumatology and Therapy, 10(1), 249-259.
Chicago	Azizi H, Karimi H, Kazemi M, Rezaei SS, Parsaei A, Aghaali M, Vafaeimanesh J, Torabi P, Amini B, Masoumi M. "Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization." Rheumatology and Therapy 10, no. 1 (2023): 249-259.
Harvard	Azizi H et al. (2023) 'Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization', Rheumatology and Therapy, 10(1), pp. 249-259.
Vancouver	Azizi H, Karimi H, Kazemi M, Rezaei SS, Parsaei A, Aghaali M, et al.. Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization. Rheumatology and Therapy. 2023;10(1):249-259.
BibTex	@article{ author = {Azizi H and Karimi H and Kazemi M and Rezaei SS and Parsaei A and Aghaali M and Vafaeimanesh J and Torabi P and Amini B and Masoumi M}, title = {Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization}, journal = {Rheumatology and Therapy}, volume = {10}, number = {1}, pages = {249-259}, year = {2023} }
RIS	TY - JOUR AU - Azizi H AU - Karimi H AU - Kazemi M AU - Rezaei SS AU - Parsaei A AU - Aghaali M AU - Vafaeimanesh J AU - Torabi P AU - Amini B AU - Masoumi M TI - Covid-19 in Patients With Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization JO - Rheumatology and Therapy VL - 10 IS - 1 SP - 249 EP - 259 PY - 2023 ER -

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