1Sarah Alkabbani,2Amel Ginawi, 3Nada Hassan
1Mohammed Bin Rashid University Of Medicine And Health Sciences, 2Mediclinic City Hospital, 3Rheumatology department, Mediclinic Parkview Hospital, Dubai, UAE
According to the literature, patients with rheumatic disease receiving immunosuppressants are at a higher risk of acquiring infections. However, this may not apply to COVID-19 infection according to the global rheumatology alliance provider registry. There is no evidence that underlying rheumatic disease or its treatment pose an extra risk factor for severity of COVID- 19. In fact, hydroxychloroquine was used, and interleukin-6 inhibitors are currently used to treat COVID-19.
To understand the behaviour of COVID-19 in rheumatic patients by exploring the demographics, epidemiology, and outcome in rheumatic patient who contracted covid-19 before the vaccination era.
Material(s) and Method(s):
This is a retrospective observational study reporting the epidemiology of patients with different rheumatic diseases who contracted COVID-19 infection in two Mediclinic Hospitals in Dubai. Data of patients who attended the rheumatology clinic were collected via patients’ electronic medical records. This included age, sex, nationality, body mass index, co-morbidities, rheumatic diagnosis, presenting symptoms, complications, and medications.
A total of 28 patients were identified, with the majority being females (68%). Median age was 45 years (22-70), and 2 patients above 64 years (6%). Seven patients (25%) were obese, 5 (16%) were hypertensive, 3 (10%) were asthmatic, 5 (17%) were smokers and one patient (3%) was diabetic.
Majority of patients (80%) had mild to moderate disease with myalgia, fever, and headache being the predominant symptoms. Two patients needed hospitalisation, one with a diagnosis of systemic lupus erythematosus and another with antiphospholipid antibody syndrome. The most
common rheumatic diagnoses were rheumatoid arthritis (43%), systemic lupus erythematosus (14%), ankylosing spondylitis (11%), and enteropathic arthritis (7%). Medications included Hydroxychloroquine alone or in combination (29%), Adalimumab (25%), Tofacitinib (25%), and Methotrexate (21%). No patient received prior B cell depletion therapy.
We observed full recovery in all patients with the majority having mild/moderate symptoms. The median time to full recovery was 14 days (7-90 days). Although our data is from a small sample, it reflected similar experiences of other centers where patients with rheumatic diseases were not at any additional risk of severe COVID-19 disease compared to the general population.