Clinical course of COVID-19 infection in inflammatory rheumatologic patients: a monocentric Belgian experience

Pistone, Aureliano; Tant, Laure; Soyfoo, Muhammad S

OBJECTIVES: Little is known about the incidence and consequences of COVID-19 infection in patients with rheumatic diseases. To improve our knowledge in this field, we collected data from patients with inflammatory rheumatic diseases, who developed COVID-19 infection. PATIENTS AND METHODS: We performed a monocentric observational longitudinal study and collected retrospectively data from patients with inflammatory rheumatic diseases who developed a confirmed or suspected COVID-19 infection between 3rd March and 10th June 2020. RESULTS: A total of 23 patients developed COVID-19 infection. Seven patients needed hospitalization (female 57%, mean age 59 ± 9 years) and sixteen patients were followed as outpatients (female 80%, mean age 50 ± 14 years). All hospitalized patients had more than one comorbidity. At the time of infection, all patients were on immunosuppressive therapy consisting of either csDMARDs and/or biotherapy with and without corticosteroids. A minority received corticosteroids only. The most common symptoms of COVID-19 infected patients were fever, dyspnoea, cough, and fatigue. Polymerase Chain Reaction (PCR) and chest computed tomography (CT) were performed in all hospitalized patients to confirm the diagnosis (100% positive PCR, 71% positive CT). All outclinic patients were clinically diagnosed (confirmed by PCR in only one). The mean length of hospital stay was 21 ± 19 days. Three patients developed an Acute Respiratory Distress Syndrome including one who died. CONCLUSIONS: A limited number of patients with inflammatory rheumatic diseases suffered from COVID-19 infection. Two patients needed mechanical ventilation and survived, while one patient died. All patients with severe form of infection had at least one comorbidity.