A multidisciplinary registry of patients with autoimmune and immune-mediated diseases with symptomatic COVID-19 from a single center

Sarmiento-Monroy, Juan C.; Espinosa, Gerard; Londoño, Maria-Carlota; Meira, Fernanda; Caballol, Berta; Llufriu, Sara; Carrasco, Josep Lluis; Moll-Udina, Aina; Quintana, Luis F.; Giavedoni, Priscila; Ramírez, Julio; Inciarte-Mundo, Jose; Solana, Elisabeth; Blanco, Yolanda; Martinez-Hernandez, Eugenia; Sepúlveda, Maria; Llorenç, Victor; Prieto-González, Sergio; Espígol-Frigolé, Georgina; Milisenda, Jose C.; Cid, Maria C.; Mascaró, Jose M.; Blanco, Isabel; Barberá, Joan Albert; Sibila, Oriol; Gratacos-Ginès, Jordi; Adán, Alfredo; Agustí, Alvaro; Sanmartí, Raimon; Panés, Julian; Cervera, Ricard; Vila, Jordi; Soriano, Alex; Gómez-Puerta, José A.

BACKGROUND AND AIM: There is increasing interest regarding SARS-CoV-2 infection in patients with autoimmune and immune-mediated inflammatory diseases (AI/IMID) with some discrepancies in different cohorts about their risk and outcomes. The aim was to describe a multidisciplinary cohort of patients with AI/IMID and symptomatic SARS-CoV-2 infection in a single tertiary center and analyze sociodemographic, clinical, and therapeutic factors associated with poor outcomes. METHODS: A retrospective observational study was conducted from the 1st of March until May 29th, 2020 in a University tertiary hospital in Barcelona, Spain. Patients with an underlying AI/IMID and symptomatic SARS-CoV-2 infection were identified in our local SARS-CoV-2 infection database. Controls (2:1) were selected from the same database and matched by age and gender. The primary outcome was severe SARS-CoV-2 infection, which was a composite endpoint including admission to the intensive care unit (ICU), need for mechanical ventilation (MV), and/or death. Several covariates including age, sex, and comorbidities among others were combined into a multivariate model having severe SARS-CoV-2 as the dependent variable. Also, a sensitivity analysis was performed evaluating AID and IMID separately. RESULTS: The prevalence of symptomatic SARS-CoV-2 infection in a cohort of AI/IMID patients was 1.3%. Eighty-five patients with AI/IMID and symptomatic SARS-CoV-2 were identified, requiring hospitalization in 58 (68%) cases. A total of 175 patients admitted for SARS-CoV-2 (58 with AI/IMID and 117 matched-controls) were analyzed. In logistic regression analysis, a significant inverse association between AI/IMID group and severe SARS-CoV-2 (OR 0.28; 95% CI 0.12–0.61; p = 0.001), need of MV (OR 0.20; IC 95% 0.05–0.71; p = 0.014), and ICU admission (OR 0.25; IC 95% 0.10–0.62; p = 0.003) was found. CONCLUSIONS: Patients with AI/IMID who require admission for SARS-CoV-2 infection have a lower risk of developing severe disease, including the need to stay in the ICU and MV.