Pandemic of the century: COVID-19 in inflammatory rheumatic diseases of a national cohort with 3,532 patients
Fatma Yurdakul1
, Hatice Bodur2, Ahmet Kıvanç Cengiz3, Yunus Durmaz4, Mehmet Tuncay Duruöz5, Taciser Kaya6, Sertaç Ketenci3, Nihan Cüzdan7, Tuba Güler1, Zafer Günendi8, Selda Sarıkaya9, Erhan Çapkın10, Mustafa Erkut Önder11, Meltem Alkan Melikoğlu12, Rengin Güzel13, Nesrin Şen14, Ata Bora Ayna15, Özgür Akgül16, Erhan Eser17, Şebnem Ataman18
1Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
2Department of Physical Medicine and Rehabilitation, Medicine Faculty of Yıldırım Beyazıt University, Ministry of Health Ankara City Hospital, Ankara, Türkiye
3Department of Physical Medicine and Rehabilitation, Medicine Faculty of Ondokuz Mayıs University, Samsun, Türkiye
4Rheumatology Clinic, Karabük Training and Research Hospital, Karabük, Türkiye
5Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Marmara University, Istanbul, Türkiye
6Department of Physical Medicine and Rehabilitation, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Türkiye
7Department of Physical Medicine and Rehabilitation, Medicine Faculty of Hatay Mustafa Kemal University, Hatay, Türkiye
8Department of Physical Medicine and Rehabilitation, Medicine Faculty of Gazi University, Ankara, Türkiye
9Department of Physical Medicine and Rehabilitation, Medicine Faculty of Bülent Ecevit Üniversitesi, Zonguldak, Türkiye
10Department of Physical Medicine and Rehabilitation, Medicine Faculty of Karadeniz Technical University, Trabzon, Türkiye
11Department of Rheumatology, Aksaray University Training and Research Hospital, Aksaray, Türkiye
12Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Atatürk University, Erzurum, Türkiye
13Department of Physical Medicine and Rehabilitation, Medicine Faculty of Çukurova University, Adana, Türkiye
14Rheumatology Clinic, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Türkiye
15Rheumatology Clinic, Çekirge State Hospital, Bursa, Türkiye
16Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Manisa Celal Bayar University, Manisa, Türkiye
17Department of Public Health, Medicine Faculty of Manisa Celal Bayar University, Manisa, Türkiye
18Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medicine Faculty of Ankara University, Ankara, Türkiye
Keywords: Disease-modifying antirheumatic drugs, hospitalization, mortality rate, rheumatic diseases, severe acute respiratory syndrome coronavirus 2.
Abstract
Objectives: This study aimed to assess the clinical outcomes and risk factors for severe coronavirus disease 2019 (COVID-19) in patients with inflammatory rheumatic disease (IRD) of a national cohort.
Patients and methods: The multicenter cross-sectional study was carried out between July 15, 2020, and February 28, 2021. Data collection was provided from a national network database system, and 3,532 IRD patients (2,359 males, 1,173 females; mean age: 48.7±13.9 years; range; 18 to 90 years) were analyzed. Demographics, clinics about rheumatic disease, comorbidities, smoking status, being infected with COVID-19, and the course of the infection were questioned by rheumatology specialists.
Results: One hundred seventeen patients were infected with COVID-19, the hospitalization rate due to COVID-19 was 58.9%, and the mortality rate was 1.7%. There was no difference between the COVID-19 positive and negative groups in terms of rheumatic disease activities and receiving drugs. It was observed that patients with COVID-19 had worse compliance with isolation rules, and bacillus Calmette-Guérin (BCG) vaccination was less common. The mean age and the rate of smoking of hospitalized COVID-19 patients were higher than those without hospitalization.
Conclusion: In this cohort, in which real-life data were analyzed, COVID-19 rates in IRD patients were similar to the general population for the same period. Compliance with the isolation rules and BCG vaccination attracted attention as components that reduce the risk of COVID-19 infection. The risk factors for hospitalization were older age and smoking.
Citation: Yurdakul F, Bodur H, Cengiz AK, Durmaz Y, Duruöz MT, Kaya T. Pandemic of the century: COVID-19 in inflammatory rheumatic diseases of a national cohort with 3,532 patients. Arch Rheumatol 2024;39(2):203-212. doi: 10.46497/ ArchRheumatol.2024.10313.
The study protocol was approved by the Ankara City Hospital Ethics Committee (date: 02.07.2020, no: 02.07.2020/E1-20- 455). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Substantial contributions to study conception and design: H.B., F.G.Y.; Substantial contributions to acquisition of data: F.G.Y., H.B., A.K.C., Y.D., M.T.D., T.K., S.K., N.C., T.G., Z.G., S.S., E.Ç., M.E.Ö., M.A.M., R.G., N.., A.B.A., Ö.A., E.E., .A.; Substantial contributions to analysis and interpretation of data: H.B., F.G.Y., T.G.; Drafting the article or revising it critically for important intellectual content: F.G.Y., H.B., A.K.C., Y.D., M.T.D., T.K., S.K., N.C., T.G., Z.G., S.S., E.Ç., M.E.Ö., M.A.M., R.G., N.., A.B.A., Ö.A., E.E., .A.; Final approval of the version of the article to be published: F.G.Y., H.B., A.K.C., Y.D., M.T.D., T.K., S.K., N.C., T.G., Z.G., S.S., E.Ç., M.E.Ö., M.A.M., R.G., N.., A.B.A., Ö.A., E.E., .A.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.