COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series
, COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series
, at al., Clinical Rheumatology, doi:0.1007/s10067-020-05334-7
Analysis of 1641 systemic autoimmune disease patients showing csDMARD (HCQ etc.) RR 0.37, p
csDMARDs include HCQ, CQ, and several other drugs, so the effect of HCQ/CQ alone could be higher.
This study also confirms that the risk of COVID-19 for systemic autoimmune disease patients is much higher overall, OR 4.42, p
<0.001 (this is the observed real-world risk which takes into account factors such as these patients potentially being more careful to avoid exposure).
(results are for "definite + highly suspected" cases and the main result is presented in the paper as the OR for not taking csDMARDs, we have converted this to RR for taking csDMARDs).
risk of COVID-19 case, 63.0% lower, RR 0.37, p = 0.01, treatment 9 of 994 (0.9%), control 16 of 647 (2.5%), NNT 64.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ferri et al., 27 Aug 2020, retrospective, Italy, peer-reviewed, survey, 29 authors.
Abstract: Clinical Rheumatology (2020) 39:3195–3204
COVID-19 and rheumatic autoimmune systemic diseases: report
of a large Italian patients series
Clodoveo Ferri 1,2 & Dilia Giuggioli 1 & Vincenzo Raimondo 2 & Massimo L’Andolina 3 & Antonio Tavoni 4 &
Riccardo Cecchetti 5 & Serena Guiducci 6 & Francesco Ursini 7 & Maurizio Caminiti 8 & Giuseppe Varcasia 9 &
Pietro Gigliotti 10 & Roberta Pellegrini 11 & Domenico Olivo 12 & Michele Colaci 13 & Giuseppe Murdaca 14 &
Raffaele Brittelli 2 & Giuseppa Pagano Mariano 8 & Amelia Spinella 1 & Silvia Bellando-Randone 6 & Vincenzo Aiello 2 &
Silvia Bilia 4 & Daiana Giannini 4 & Tommaso Ferrari 9 & Rodolfo Caminiti 2 & Veronica Brusi 7 & Riccardo Meliconi 7 &
Poupak Fallahi 15 & Alessandro Antonelli 16 & for the COVID-19 & ASD Italian Study Group
Received: 26 May 2020 / Revised: 13 July 2020 / Accepted: 17 July 2020 / Published online: 27 August 2020
# The Author(s) 2020
Introduction Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune
systemic diseases. We investigated the clinical-epidemiological findings of 1641 autoimmune systemic disease Italian patients
during the Covid-19 pandemic.
Method This observational multicenter study included 1641 unselected patients with autoimmune systemic diseases from three
Italian geographical areas with different prevalence of Covid-19 [high in north (Emilia Romagna), medium in central (Tuscany),
and low in south (Calabria)] by means of telephone 6-week survey. Covid-19 was classified as (1) definite diagnosis of Covid-19
disease: presence of symptomatic Covid-19 infection, confirmed by positive oral/nasopharyngeal swabs; (2) highly suspected
Covid-19 disease: presence of highly suggestive symptoms, in absence of a swab test.
Results A significantly higher prevalence of patients with definite diagnosis of Covid-19 disease, or with highly suspected Covid19 disease, or both the conditions together, was observed in the whole autoimmune systemic disease series, compared to “Italian
general population” (p = .030, p = .001, p = .000, respectively); and for definite + highly suspected diagnosis of Covid-19 disease,
in patients with autoimmune systemic diseases of the three regions (p = .000, for all comparisons with the respective regional
general population). Moreover, significantly higher prevalence of definite + highly suspected diagnosis of Covid-19 disease was
found either in patients with various “connective tissue diseases” compared to “inflammatory arthritis group” (p < .000), or in
* Alessandro Antonelli
UOD Reumatologia, Grande Ospedale Metropolitano, Reggio
U.O.S. Reumatologia, Ospedale Castrovillari, Cosenza, Italy
U.O.T. Specialistica Ambulatoriale ASP 201, Cosenza, Italy
Rheumatology Unit, School of Medicine, University of Modena &
RE, Modena, Italy
U.O.C. Medicina Interna “M.Valentini” P.O. Annunziata,
Rheumatology Clinic ‘Madonna dello Scoglio’ Cotronei,
Rheumatology Outpatient Clinic, San Giovanni di Dio Hospital,
Rheumatology Unit, University of Catania, Catania, Italy
Department of Internal Medicine, San Martino Policlinic Hospital,
University of Genoa, Genoa, Italy
Department of Translational Research and New Technologies in
Medicine and Surgery, School of Medicine, University of Pisa,
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.