Clinical features of rheumatic patients infected with COVID-19 in Wuhan, China. Issue 8 (22nd May 2020)

• Record Type: Journal Article
• Authors: Ye, Cong; Cai, Shaozhe; Shen, Guifen; Guan, Hanxiong; Zhou, Liling; Hu, Yangyang; Tu, Wei; Chen, Yu; Yu, Yikai; Wu, Xuefen; Chen, Yuxue; Zhong, Jixin; Dong, Lingli
• Is Part Of: Annals of the rheumatic diseases. Volume 79:Issue 8(2020)
• Page Start: 1007
• Page End: 1013
• Publication Date: 2020-05-22
• Subjects: autoimmune diseases -- autoimmunity -- inflammation; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2020-217627
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objective: The clinical features of rheumatic patients with coronavirus disease 2019 (COVID-19) have not been reported. This study aimed to describe the clinical features of COVID-19 in rheumatic patients and provide information for handling this situation in clinical practice. Methods: This is a retrospective case series study. Deidentified data, including gender, age, laboratory and radiological results, symptoms, signs, and medication history, were collected from 2326 patients diagnosed with COVID-19, including 21 cases in combination with rheumatic disease, in Tongji Hospital between 13 January and 15 March 2020. Results: Length of hospital stay and mortality rate were similar between rheumatic and non-rheumatic groups, while the presence of respiratory failure was more common in rheumatic cases (38% vs 10%, p<0.001). Symptoms of fever, fatigue and diarrhoea were seen in 76%, 43% and 23% of patients, respectively. There were four rheumatic patients who experienced a flare of rheumatic disease during hospital stay, with symptoms of muscle aches, back pain, joint pain or rash. While lymphocytopaenia was seen in 57% of rheumatic patients, only one patient (5%) presented with leucopenia in rheumatic cases. Rheumatic patients presented with similar radiological features of ground-glass opacity and consolidation. Patients with pre-existing interstitial lung disease showed massive fibrous stripes and crazy-paving signs at an early stage. Five rheumatic cases used hydroxychloroquine before the diagnosis of COVID-19 and none progressed to critically ill stage. Conclusions: Respiratory failure was more common in rheumatic patients infected with COVID-19. Differential diagnosis between COVID-19 and a flare of rheumatic disease should be considered. Trial registration number: ChiCTR2000030795.