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Impact of Risk Factors on COVID-19 Outcomes in Unvaccinated People With Rheumatic Diseases

2024-02Artigo científico Acesso aberto
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dc.contributor.authorYazdany, Jinoos
dc.contributor.authorWare, Anna
dc.contributor.authorWallace, Zachary S.
dc.contributor.authorBhana, Suleman
dc.contributor.authorGrainger, Rebecca
dc.contributor.authorHachulla, Eric
dc.contributor.authorRichez, Christophe
dc.contributor.authorCacoub, Patrice
dc.contributor.authorHausmann, Jonathan S.
dc.contributor.authorLiew, Jean W.
dc.contributor.authorSirotich, Emily
dc.contributor.authorJacobsohn, Lindsay
dc.contributor.authorStrangfeld, Anja
dc.contributor.authorMateus, Elsa F.
dc.contributor.authorHyrich, Kimme L.
dc.contributor.authorGossec, Laure
dc.contributor.authorCarmona, Loreto
dc.contributor.authorLawson-Tovey, Saskia
dc.contributor.authorKearsley-Fleet, Lianne
dc.contributor.authorSchaefer, Martin
dc.contributor.authorRibeiro, Sandra Lucia Euzebio
dc.contributor.authorAl-Emadi, Samar
dc.contributor.authorHasseli, Rebecca
dc.contributor.authorMüller-Ladner, Ulf
dc.contributor.authorSpecker, Christof
dc.contributor.authorSchulze-Koops, Hendrik
dc.contributor.authorBernardes, Miguel
dc.contributor.authorFraga, Vanessa Machado
dc.contributor.authorRodrigues, Ana Maria
dc.contributor.authorSparks, Jeffrey A.
dc.contributor.authorLjung, Lotta
dc.contributor.authorDi Giuseppe, Daniela
dc.contributor.authorTidblad, Liselotte
dc.contributor.authorWise, Leanna
dc.contributor.authorDuarte-García, Alí
dc.contributor.authorUgarte-Gil, Manuel F.
dc.contributor.authorColunga-Pedraza, Iris Jazmín
dc.contributor.authorMartínez-Martínez, Marco Ulises
dc.contributor.authorAlpizar-Rodriguez, Deshire
dc.contributor.authorXavier, Ricardo Machado
dc.contributor.authorIsnardi, Carolina A.
dc.contributor.authorPera, Mariana
dc.contributor.authorPons-Estel, Guillermo
dc.contributor.authorIzadi, Zara
dc.contributor.authorGianfrancesco, Milena A.
dc.contributor.authorCarrara, Greta
dc.contributor.authorScirè, Carlo Alberto
dc.contributor.authorZanetti, Anna
dc.contributor.authorMachado, Pedro M.
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.pblWiley-Blackwell
dc.date.accessioned2025-01-23T21:24:36Z
dc.date.available2025-01-23T21:24:36Z
dc.date.issued2024-02
dc.descriptionFunding Information: Supported by the American College of Rheumatology and European Alliance of Associations for Rheumatology. Dr. Duarte‐García's work was supported by the Rheumatology Research Foundation Scientist Development Award and the Centers for Disease Control and Prevention. Dr. Machado's was supported by the NIHR University College London Hospitals Biomedical Research Centre. Publisher Copyright: © 2023 American College of Rheumatology.
dc.description.abstractObjective: Approximately one third of individuals worldwide have not received a COVID-19 vaccine. Although studies have investigated risk factors linked to severe COVID-19 among unvaccinated people with rheumatic diseases (RDs), we know less about whether these factors changed as the pandemic progressed. We aimed to identify risk factors associated with severe COVID-19 in unvaccinated individuals in different pandemic epochs corresponding to major variants of concern. Methods: Patients with RDs and COVID-19 were entered into the COVID-19 Global Rheumatology Alliance Registry between March 2020 and June 2022. An ordinal logistic regression model (not hospitalized, hospitalized, and death) was used with date of COVID-19 diagnosis, age, sex, race and/or ethnicity, comorbidities, RD activity, medications, and the human development index (HDI) as covariates. The main analysis included all unvaccinated patients across COVID-19 pandemic epochs; subanalyses stratified patients according to RD types. Results: Among 19,256 unvaccinated people with RDs and COVID-19, those who were older, male, had more comorbidities, used glucocorticoids, had higher disease activity, or lived in lower HDI regions had worse outcomes across epochs. For those with rheumatoid arthritis, sulfasalazine and B-cell–depleting therapy were associated with worse outcomes, and tumor necrosis factor inhibitors were associated with improved outcomes. In those with connective tissue disease or vasculitis, B-cell–depleting therapy was associated with worse outcomes. Conclusion: Risk factors for severe COVID-19 outcomes were similar throughout pandemic epochs in unvaccinated people with RDs. Ongoing efforts, including vaccination, are needed to reduce COVID-19 severity in this population, particularly in those with medical and social vulnerabilities identified in this study.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1182995
dc.identifier.doi10.1002/acr.25220
dc.identifier.issn2151-464X
dc.identifier.otherPURE: 76242674
dc.identifier.otherPURE UUID: b1c86db8-bdc8-4bc2-b626-b95a3e5c4c8a
dc.identifier.otherScopus: 85176146594
dc.identifier.otherPubMed: 37643903
dc.identifier.otherWOS: 001099069300001
dc.identifier.urihttp://hdl.handle.net/10362/177852
dc.identifier.urlhttps://www.scopus.com/pages/publications/85176146594
dc.language.isoeng
dc.peerreviewedyes
dc.subjectRheumatology
dc.subjectSDG 3 - Good Health and Well-being
dc.titleImpact of Risk Factors on COVID-19 Outcomes in Unvaccinated People With Rheumatic Diseasesen
dc.title.subtitleA Comparative Analysis of Pandemic Epochs Using the COVID-19 Global Rheumatology Alliance Registryen
dc.typejournal article
degois.publication.firstPage274
degois.publication.issue2
degois.publication.lastPage287
degois.publication.titleArthritis Care and Research
degois.publication.volume76
dspace.entity.typePublication
rcaap.rightsopenAccess

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