Semin Arthritis Rheu:类风湿性关节炎患者感染新冠的预后

2021-09-09 xiangting MedSci原创

RA 队列的VTE和脓毒症风险始终升高,表明 RA 是一个独立的危险因素。

自2020年以来,很多风湿病患者不幸感染新冠病毒。近日一项发表在风湿病权威期刊Semin Arthritis Rheu上的研究分析了与一般人群相比,类风湿性关节患者 (RA)感染新冠病毒(COVID-19)的

这是一项比较队列研究,使用美国多中心研究网络 (TriNetX) 提取 2020 年 1 月 20 日至 2021 年 4 月 11 日所有确诊新冠的成年 RA 患者和非 RA 新冠患者的数据。 确诊新冠后的 30 天内评估预后。倾向评分匹配时对包括人口学和合并症在内的基线特征进行控制。

研究共纳入 9730 名确诊新冠的RA 患者和 656,979 名非RA新冠患者。在匹配前,RA 队列的死亡率(RR:2.11,95%CI:1.90 至 2.34)、住院率(RR:1.60,1.55 至 1.66)、ICU 入住率(RR:1.86,1.71 至 2.05)、机械通气(RR:1.62,1.44 至 1.82)、重症COVID-19(RR:1.89,1.74 至 2.06)、急性肾损伤(RR:2.13,1.99 至 2.29)、肾脏替代疗法/血液透析(RR:1.40,1.03 至 1.89)、急性呼吸窘迫综合征-ARDS(RR:1.76,1.53 至 2.02)、缺血性卒中(RR:2.62,2.24 至 3.07)、静脉血栓栓塞-VTE(RR:2.30,2.07 至 2.56)和脓毒症风险(RR:1.97,1.81 至 2.13)均高于非 RA新冠患者。匹配后,RA队列只有VTE(RR:1.18,1.01 至 1.38)和脓毒症风险(RR:1.27,1.12 至 1.43)高于非RA队列。男性、黑人和使用糖皮质激素增加了不良结局的风险。与肿瘤坏死因子抑制剂 (TNFi) 相比,使用利妥昔单抗或白介素6抑制剂 (IL-6i) 患者的住院风险更高,而使用Janus 激酶抑制剂 (JAKi) 、阿巴西普或TNFi 的住院风险没有显著差异。

                                       RA队列和非RA队列匹配前后的结局风险比较

这项研究发现在匹配前,RA 队列所有不良结局的风险均高于非 RA 队列,然而匹配后的大多数不良结局没有差异,这意味着风险归因于调整后的因素。然而,RA 队列的VTE和脓毒症风险始终升高,表明 RA 是一个独立的危险因素。男性、黑人和使用糖皮质激素与 RA 患者感染COVID-19的不良结局相关。与TNFi相比,使用利妥昔单抗或 IL-6i 与住院风险升高相关。

原始出处:

Rahul Raiker. Outcomes of COVID-19 in patients with rheumatoid arthritis: A multicenter research network study in the United States. Semin Arthritis Rheu. September 2021.

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    2021-09-29 13f0c37dm61暂无昵称

    新形势下的类风湿患者

    0

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    2021-09-11 lmm397
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    2021-09-11 zhaojie88
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    2021-09-09 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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    2021-09-09 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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