Post-COVID-19 condition in patients with autoimmune rheumatic diseases: the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study

Abstract: Comment Post-COVID-19 condition in patients with autoimmune rheumatic diseases: the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study As COVID-19 gradually becomes endemic in many parts of the world, a silent epidemic of post-COVID-19 condition is emerging. Post-COVID-19 condition comprises a constellation of long-term sequelae defined as the persistence or new appearance of symptoms 3 months after a SARS-CoV-2 infection.1 Patients with autoimmune rheumatic diseases and other autoimmune diseases are at increased risk for developing severe COVID-19,2 and might also be at higher risk of developing more severe long-term COVID-19 sequelae compared with the general population.3 However, post-COVID-19 condition is poorly understood in these patients, and the knowledge of specific risk factors for post-COVID-19 condition and of its effects on mental and physical function is scarce and remains an unmet need. With data from the second COVID-19 Vaccination in Autoimmune Diseases (COVAD) international, multicentre electronic patient survey, which involved 157 collaborators from 106 countries,4 we analysed the prevalence and predictors of post-COVID-19 condition, the association between the condition and disease flares, and its on physical and mental function in patients with rheumatic and non-rheumatic autoimmune diseases compared with healthy controls. We circulated a validated patient questionnaire via collaborating centres, patient support groups, and social media platforms to collect data on demographics, type of autoimmune disease, treatment history, comorbidities, SARS-CoV-2 infection history and COVID-19 disease course, COVID-19 vaccination history, disease flares, current symptom status, and patient reported outcomes (including fatigue visual analogue scale, pain visual analogue scale, PROMIS10a global mental and physical function, and quality of life; appendix pp 1–2). Post-COVID-19 condition was defined as the persistence of any symptom beyond 3 months after SARS-CoV-2 infection, per the WHO definition. Participants provided informed consent to participate and ethical approval was obtained from the Institutional Ethics Committee of the Sanjay Gandhi Postgraduate Institute of Medical Sciences (Lucknow, India). www.thelancet.com/rheumatology Vol 5 May 2023 Questionnaires were submitted by 12 358 individuals between Jan 31 and May 21, 2022. Questionnaires with incomplete entries (4692 [38·0%]) were excluded. Of the 7666 (62·0%) individuals who submitted complete questionnaires, 2640 (34·4%) reported having a positive SARS-CoV-2 test. 1677 (63·5%) of these 2640 respondents completed the survey more Univariate OR (95% CI) See Online for appendix Multivariable* p value OR (95% CI) p value Demographics Age ·· 0·013 1·0 (0·9–1·0) 0·48 Female sex 2·0 (0·9–4·4) 0·050 2·1 (0·8–4·9) 0·089 Country by HDI ·· 0·051 0·8 (0·7–1·1) 0·20 White 1·7 (1·1–2·8) 0·018 1·3 (0·6–2·4) 0·41 Mixed ethnicity 0·9 (0·9–0·9) 0·028 ·· 0·99 Asian ethnicity 0·5 (0·2–1·4) 0·26 ·· ·· Hispanic ethnicity 0·9 (0·5–1·9) 0·99 ·· ·· African American ethnicity 0·9 (0·3–2·0) 0·80 ·· ·· Disease duration ·· 0·43 ·· ·· Any comorbidities 3·3 (1·90–5·5) <0·0001 2·0 (1·1–3·6) 0·026 AID comorbidity 2·3 (1·4–3·9) 0·0006 1·4 (0·7–2·5) 0·25 Asthma 2·6 (1·5–4·7) <0·0001 1·3 (0·6–2·6) 0·41 Chronic kidney disease 2·0 (0·8–4·7) 0·10 ·· ·· Chronic liver disease† 11·6 (2·5–52·8) <0·0001 ·· ·· Chronic obstructive..