Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and COVID-19: The Clinical Course and Prognosis of 15 Patients From a Tertiary Care Center
JCR: Journal of Clinical Rheumatology, 2022•journals.lww.com
Objective The aim of this study was to evaluate incidence rates, prognoses, and disease-
related factors associated with poor outcomes in patients with antineutrophil cytoplasmic
antibody-associated vasculitis (AAV) who had coronavirus disease (COVID-19). Methods
Patients with AAV were questioned for a history of COVID-19 in the outpatient setting.
Cumulative clinical findings and treatment history were obtained from the patients' medical
records. The clinical, laboratory, and imaging findings of inpatients with COVID-19 were …
related factors associated with poor outcomes in patients with antineutrophil cytoplasmic
antibody-associated vasculitis (AAV) who had coronavirus disease (COVID-19). Methods
Patients with AAV were questioned for a history of COVID-19 in the outpatient setting.
Cumulative clinical findings and treatment history were obtained from the patients' medical
records. The clinical, laboratory, and imaging findings of inpatients with COVID-19 were …
Abstract
Objective
The aim of this study was to evaluate incidence rates, prognoses, and disease-related factors associated with poor outcomes in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) who had coronavirus disease (COVID-19).
Methods
Patients with AAV were questioned for a history of COVID-19 in the outpatient setting. Cumulative clinical findings and treatment history were obtained from the patients' medical records. The clinical, laboratory, and imaging findings of inpatients with COVID-19 were recorded. The data of patients who developed symptomatic COVID-19 and/or died of the disease were used for comparison.
Results
Eighty-nine patients (47.2% female; mean age, 56±12.5 years) were included. The diagnosis was granulomatosis with polyangiitis in 56 patients (62.9%) and microscopic polyangiitis in 33 (37.1%). Sixty-one (68.2%) and 21 patients (23.6%) had renal and peripheral nerve involvement, respectively. Ten patients had a history of diffuse alveolar hemorrhage. Fifteen patients (16.9%) had COVID-19, including 9 (60%) with severe pneumonia. Twelve patients (85.7%) were hospitalized, 6 (42.9%) were admitted to the intensive care unit, and 5 (35.7%) died. All deceased patients had hypogammaglobulinemia (IgG levels< 700 mg/dL) during hospital admission. Symptomatic COVID-19 was associated with higher disease activity, glucocorticoid and rituximab treatments, and glomerular filtration rate< 30 mL/min. A history of peripheral nerve involvement, higher organ damage scores, and hypogammaglobulinemia was associated with mortality.
Conclusions
The prognosis was poor in our patients with AAV who had COVID-19, especially those with severe multisystem involvement. Hypogammaglobulinemia was associated with mortality. Serum IgG level monitoring in patients with AAV would be beneficial during the COVID-19 pandemic.
Lippincott Williams & Wilkins
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