Table 2.
Studies analyzing incidence of coronavirus disease 2019 (COVID-19) infection in systemic autoimmune rheumatic disease (SARD) and case descriptions.
| Study | Cohort | Result |
|---|---|---|
| Emmi et al. ( 33 ) | Italy; 458 SARD pts. (117 SLE, 37 SjS, 17 APS, 64 arthritis, 149 vasculitis, 15 familial Mediterranean fever, 9 recurrent idiopathic pericarditis, 22 others)43% were taking TNFi, 55% glucocorticoids | 7 tested pts., 1 positive—prevalence 0.22% (0.01–1.21%), comparable to that observed in the general population of Tuscany [0.20% (0.20–0.21%)].The patient was admitted to intensive care unit. |
| Zen et al. ( 34 ) | Italy; 916 pts. (397 SLE, 182 ANCA associated vasculitis, 176 SSc, 111 RA, 50 idiopathic inflammatory myopathy) 36% were taking antimalarial drug | 65 tested pts; 2 (0.21%) positive, a proportion similar to that observed in the general population of the Veneto region. |
| Favalli et al. ( 36 ) | Italy; 955 pts. (531 RA, 203 PsA, 181 SpA, and 40 of CTD/vasculitides/autoinflammatory diseases) 55% were taking TNFi | The incidence of confirmed COVID-19 is consistent with the general population (0.62 vs. 0.66%). None of the pts. developed severe respiratory involvement (three were hospitalized) or died. |
| Ferri et al. ( 39 ) | Italy; 1641 pts (695 RA, 208 PsA, 35 AS, 438 SSc, 76 SLE, 64 UCTD, 18 SjS, 19 PM/DM, 88 other) | 11 confirmed COVID-19 (0.67%) significantly higher than general Italian population (0.35%) (p=0.03). Two patients developed severe COVID-19, of them one died. |
| Michelena et al. ( 35 ) | Spain; 959 SARD pts. (RA, PsA, SpA, JIA, autoinflammatory syndromes)—all pts. receiving bDMARD or tsDMARD 74% were taking TNFi | COVID-19 incidence rates were very similar to that of the general population [(0.48% (95% CI 0.09 to 0.87%)] and [0.58% (95% CI 0.56 to 0.60%)]. All 11 pts. recovered, 6 were admitted to hospital, one required intensive care unit. |
| Quartuccio et al. ( 37 ) | Italy; 1051 SARD pts. (362 RA, 275 PsA, 176 AS or non-radiograph. spondyloarthritis, 74 systemic vasculitides, 38 SLE, 19 other chronic inflammatory diseases) 59% were taking TNFi | 3.8/1000 (95% CI 1.5–9.7/1,000) pts. positive by PCR for COVID-1, compared to 2/1,000, 95% CI 1.9–2.1/1,000 in general population (p=0.33). 3/4 pts. were admitted in hospital, none to intensive care unit, all favorable outcome. |
| Favalli et al. ( 40 ) | Italy; 530 pts. (49% RA, 36% SpA/PsA, 10% JIA, 3% CTD, 1 patient with sarcoidosis) 53% were taking TNFi | 3 pts. confirmed COVID-19, one required hospitalization, none died; 10 pts. reported contact with COVID-19 positive-none developed infection. |
| Monti et al. ( 41 ) | Italy; 320 pts. (57% RA, 43% SpA) treated with bDMARD or tsDMARD; 52% treated with TNFi | 4 pts. confirmed COVID-19, four with clinical symptoms and five with contacts, but no symptoms. No death or severe COVID-19.Chronic arthritis pts. treated with bDMARDs or tsDMARDs do not seem to be at increased risk of respiratory or life-threatening complications from SARS-CoV-2 compared with the general population. No relapses of rheumatic disease observed. |
| Conticini et al. ( 42 ) | Italy; 859 SARD pts. (411 RA, 192 PsA, 131 AS, 54 SSc, 6 SLE, 26 vasculitides, 8 sarcoidosis, and 9 other) treated with stable and full dosage of bDMARDs or tsDMARD41% treated with TNFi | 2 pts. diagnosed with COVID-19, one hospitalized and discharged after 3 days, other remained asymptomatic. Pts. treated with bDMARDs or tsDMARDs did not develop life-threatening complications from COVID-19. |
| Jovani et al. ( 43 ) | Spain; 1,037 rheumatic disease pts taking bDMARD/tsDMARD (exact diagnoses and therapy not reported) | 3 pts. were hospitalized due COVID19, none required oxygen supply. 2 pts. developed acute pyelonephritis. |
| So et al. ( 38 ) | Hong Kong; 39,835 rheumatologic disease pts. (exact diagnoses and therapy for cohort not reported) | Incidence 0.0126% of COVID-19 confirmed in rheumatologic disease pts., compared to 0.0142% in the general population All pts. made uneventful recovery without complications or flare of underlying diseases. |
| Tomelleri et al. ( 44 ) | Italy; 162 large vessel vasculitis (67 Takayasu arteritis, 95 giant cell arteritis) 62% taking glucocorticoids, 32% taking tocilizumab | 4 pts. confirmed COVID-19 (incidence 2.5%), 12 pts. with clinical symptoms, 2 pts. were hospitalized, oxygen not needed. None of pts experienced relapse of LVV (until April). |
| Bozzalla Cassione et al. ( 45 ) | Italy; 165 SLE 77% taking hydoxychloroquine, 56% taking prednisolone | 2.5% Incidence higher as compared to the general population (0.76–0.47%). 4 pts. confirmed COVID-19, 8 with clinical symptoms and 7 with contacts no symptoms. 1 pt. required intensive care unit. |
Each study is described by month of paper publication; diagnoses in study cohort are reported (ANCA, anti-neutrophil cytoplasmic antibodies; APS, antiphospholipid syndrome; AS, ankylosing spondylitis; CTD, connective tissue disease; b/tsDMARDs, biological/targeted synthetic disease-modifying antirheumatic drugs; JIA, juvenile idiopathic arthritis; PsA, psoriatic arthritis; Pts., patients; RA, rheumatoid arthritis; SjS, Sjögren syndrome; SLE, systemic lupus erythematosus; PM/DM, polymyositis/dermatomyositis; SpA, spondyloarthritis; SSc, systemic sclerosis; TNFi, TNF inhibitor) and most prevalent therapy taken in study population are described.