JournalTOCs

Rheumatology
Journal Prestige (SJR): 2.344

Citation Impact (citeScore): 4
Number of Followers: 33

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1462-0324 - ISSN (Online) 1462-0332
Published by Oxford University Press

[419 journals]

Shielding reduced incidence of COVID-19 in patients with inflammatory
arthritis but vulnerability is associated with increased mortality
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  Authors: Cooksey R; Underwood J, Brophy S, et al.
  Abstract: AbstractObjectivesInvestigate whether individuals with inflammatory arthritis (IA), their treatments and shielding status affect the risk of adverse outcomes from COVID-19 for the entire population of Wales, UK.MethodsRetrospective, population-based cohort study using linked, anonymized electronic health data from SAIL Databank, including primary/secondary care, rheumatology, Office for National Statistics Mortality and COVID-19 laboratory data. Individuals aged 18 years and over testing positive for COVID-19 between March 2020 and May 2021 with READ Codes present for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis formed the study cases.ResultsA total of 1966 people with IA and 166 602 without tested positive for COVID-19. The incidence rate was 3.5% (1966/56 914) in IA, vs 6% in the general population (166 602/2 760 442), (difference: 2.5%, 95% CI: 2.4%, 2.7%, P ≤0.001). In an adjusted Cox proportional hazard model, IA was not associated with higher mortality (HR: 0.56, 95% CI: 0.18, 1.64, P=0.286). Significant risk factors included shielding (HR: 1.52, 95% CI: 1.40, 1.64, P ≤0.001), hospitalization for previous infections (HR: 1.20, 95% CI: 1.12, 1.28, P ≤0.001), hospitalizations one year pre-pandemic (HR: 1.34, 95% CI: 1.25, 1.44, P ≤0.001) and glucocorticoid use (HR: 1.17, 95% CI: 1.09, 1.25, P ≤0.001).ConclusionsIndividuals with IA had a lower incidence of COVID-19, probably due to shielding. IA was not associated with increased mortality following COVID-19 infection; being vulnerable (shielded), comorbidities and other factors were associated with increased risk. These key risk factors can identify individuals with IA at greater risk from COVID-19 and advised to shield during high community prevalence.
  PubDate: Sat, 14 May 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac283
  Issue No: Vol. 61, No. SI2 (2022)
Baseline factors associated with self-reported disease flares following
COVID-19 vaccination among adults with systemic rheumatic disease: results
from the COVID-19 global rheumatology alliance vaccine survey
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  Authors: Rider L; Parks C, Wilkerson J, et al.
  Abstract: AbstractObjectiveTo examine the frequency of, and risk factors for, disease flare following COVID-19 vaccination in patients with systemic rheumatic disease (SRD).MethodsAn international study was conducted from 2 April to 16 August 2021, using an online survey of 5619 adults with SRD for adverse events following COVID-19 vaccination, including flares of disease requiring a change in treatment. We examined risk factors identified a priori based on published associations with SRD activity and SARS-CoV-2 severity, including demographics, SRD type, comorbidities, vaccine type, cessation of immunosuppressive medications around vaccination and history of reactions to non-COVID-19 vaccines, using multivariable logistic regression.ResultsFlares requiring a change in treatment following COVID-19 vaccination were reported by 4.9% of patients. Compared with rheumatoid arthritis, certain SRD, including systemic lupus erythematosus (OR 1.51, 95% CI 1.03, 2.20), psoriatic arthritis (OR 1.95, 95% CI 1.20, 3.18) and polymyalgia rheumatica (OR 1.94, 95% CI 1.08, 2.48) were associated with higher odds of flare, while idiopathic inflammatory myopathies were associated with lower odds for flare (OR 0.54, 95% CI 0.31–0.96). The Oxford-AstraZeneca vaccine was associated with higher odds of flare relative to the Pfizer-BioNTech vaccine (OR 1.44, 95% CI 1.07, 1.95), as were a prior reaction to a non-COVID-19 vaccine (OR 2.50, 95% CI 1.76, 3.54) and female sex (OR 2.71, 95% CI 1.55, 4.72).ConclusionSRD flares requiring changes in treatment following COVID-19 vaccination were uncommon in this large international study. Several potential risk factors, as well as differences by disease type, warrant further examination in prospective cohorts.
  PubDate: Sat, 23 Apr 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac249
  Issue No: Vol. 61, No. SI2 (2022)
Reactivation in major organ involvement following SARS-CoV-2 mRNA
vaccination in Behçet’s syndrome patient receiving immunosuppressive
therapy
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  Authors: Yıldırım R; Üsküdar Cansu D, Dinler M, et al.
  Abstract: Rheumatology key messageNovel mRNA-based vaccines may trigger reactivation of major organ involvement in Behçet’s syndrome.
  PubDate: Tue, 19 Apr 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac246
  Issue No: Vol. 61, No. SI2 (2022)
Impact of COVID-19 and COVID-19 vaccination on high-risk patients with
antiphospholipid syndrome: a nationwide survey
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  Authors: Pengo V; Del Ross T, Tonello M, et al.
  Abstract: AbstractObjectivesPatients with APS and triple-positive for aPL are at high risk of recurrent events. As COVID-19 and COVID-19 vaccination may induce thrombotic complications, the objective of the study was to assess the course of COVID-19 and adverse events after vaccination in these patients.MethodsThis is a nationwide multicentre survey conducted in nine APS referral centres by means of a questionnaire. Included patients are thrombotic APS with triple-positive aPL confirmed 12 weeks apart. Reference specialist physicians used a four-graded scale of severity for COVID-19 [from 0 (asymptomatic) to 3 (hospitalization in intensive care unit)] and a six-graded scale for adverse reactions to vaccination [from 0 (transient local injection site sign/symptoms) to 5 (potentially life-threatening reactions)]. Outcomes were considered within a 30-day period.ResultsOut of 161 patients interviewed, 18 (11%) had COVID-19. All of them fully recovered without any progression to severe disease nor thromboembolic event. A total of 146 patients received the first (92%) and 129 (80%) the second dose of vaccine; side effects were minimal and, in most cases (83% after the first and 68% after the second vaccination) limited to a sore arm. Fifteen patients (9%) were unvaccinated. Most of them raised doubts on the need for vaccination, complained of poor safety and in general were reluctant about COVID-19 vaccination.ConclusionPatients with triple-positive thrombotic APS did not suffer from severe COVID-19 outcomes. Importantly, COVID-19 vaccination was well tolerated. These data may reassure patients and physicians and contribute to reducing hesitancy in unvaccinated patients.
  PubDate: Tue, 12 Apr 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac224
  Issue No: Vol. 61, No. SI2 (2022)
Humoral response to coronavirus disease-19 vaccines is dependent on dosage
and timing of rituximab in patients with rheumatoid arthritis
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  Authors: van der Togt C; Ten Cate D, den Broeder N, et al.
  Abstract: AbstractObjectivesHumoral response to vaccines in RA patients treated with rituximab (RTX) in standard dosages (≥1000 mg) is decreased. Ultra-low dosages (500 or 200 mg) may have better response. Also, timing after latest RTX infusion may be an important variable. We aimed to investigate the influence of RTX dosage and timing on response to COVID-19 vaccination in RA patients.MethodsA single-centre observational study (n = 196) investigated the humoral response, measured by total Ig anti-COVID-19 assay (positive response ≥1.1), 2–6 weeks after complete COVID-19 vaccination. A multivariable logistic regression model was built to study the effect of RTX dosage and time between latest rituximab and vaccination on response, adjusting for age and methotrexate use.ResultsAfter two-dose vaccination, the response rate was significantly better for patients receiving 200 mg (n = 31, 45%) rituximab compared with 1000 mg (n = 98, 26%; odds ratio 3.07, 95% CI 1.14–8.27) and for each additional month between latest rituximab and vaccination (OR 1.67, 1.39–2.01).ConclusionBoth increased time between latest rituximab infusion and complete vaccination, and 200 mg as latest dose were associated with a better response to COVID-19 vaccination and should be considered when trying to increase vaccine response after rituximab in RA patients.Trial registrationNetherlands Trial Register, https://www.trialregister.nl/, NL9342.
  PubDate: Mon, 04 Apr 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac206
  Issue No: Vol. 61, No. SI2 (2022)
Increased antibody response after SARS-CoV-2 mRNA-based vaccination in
rituximab-treated patients with previous COVID-19 infection
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  Authors: Avouac J; Ghossan R, Al Tabaa O, et al.
  Abstract: Rheumatology key messageIn this real-world study, incidence rates of MACE, cancer, thrombosis and zoster were similar in RA patients using tofacitinib or etanercept as first-line b/tsDMARDs.
  PubDate: Thu, 31 Mar 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac201
  Issue No: Vol. 61, No. SI2 (2022)
An uncomfortable truth: the long-term impact of COVID-19 on the
clinician–patient relationship
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  Authors: Rutter M; Pearce F, Lanyon P.
  Abstract: Versus Arthritis Clinical Research FellowshipLupus UK and Scleroderma and Raynaud’s UKNIHR Advanced FellowshipVifor Pharma10.13039/501100006484
  PubDate: Wed, 23 Mar 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac193
  Issue No: Vol. 61, No. SI2 (2022)
Temporal trends in COVID-19 outcomes in people with rheumatic diseases in
Ireland: data from the COVID-19 Global Rheumatology Alliance registry
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  Authors: Conway R; Nikiphorou E, Demetriou C, et al.
  Abstract: AbstractObjectivesAlthough evidence is accumulating globally, data on outcomes in rheumatic disease and COVID-19 in Ireland are limited. We used data from the COVID-19 Global Rheumatology Alliance (C19-GRA) to describe time-varying COVID-19 outcomes for people with rheumatic disease in Ireland.MethodsData entered into the C19-GRA provider registry from Ireland between 24 March 2020 and 9 July 2021 were analysed. Differences in the likelihood of hospitalization and mortality according to demographic and clinical variables were investigated using Chi-squared test or Fisher’s exact test, as appropriate. Trends in odds of hospitalization and mortality over time were investigated using logistic regression with the time period as a categorical variable.ResultsOf 212 cases included, 59.4% were female and median age was 58.0 years (range 13–96). Of the 212 cases, 92 (43%) were hospitalized and 22 (10.4%) died. Increasing age, a diagnosis of gout, ever smoking, glucocorticoid use, having comorbidities and specific comorbidities of cancer, cardiovascular and pulmonary disease were more common in those hospitalized. A diagnosis of inflammatory arthritis, csDMARD and/or b/tsDMARD use were less frequent in those hospitalized. Increasing age, a diagnosis of gout, ever smoking, having comorbidities and specific comorbidities of obesity, cardiovascular and pulmonary disease were more common in those who died. Odds of hospitalization or mortality did not change over time.ConclusionNo temporal trend was observed in either COVID-19-related hospitalization or mortality outcomes for people with rheumatic disease in Ireland.
  PubDate: Tue, 08 Mar 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac142
  Issue No: Vol. 61, No. SI2 (2022)
Antibody responses to inactivated and mRNA SARS-CoV-2 vaccines in familial
Mediterranean fever patients treated with interleukin-1 inhibitors
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  Authors: Ugurlu S; Akcin R, Ayla A, et al.
  Abstract: Rheumatology key messageBoth BNT162b2 and CoronaVac were immunogenic in FMF patients who were on IL-1 inhibitors and treatment cessation before vaccination was not needed.
  PubDate: Tue, 08 Mar 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac123
  Issue No: Vol. 61, No. SI2 (2022)
Chronic pain is associated with higher risk of developing and being
hospitalized for COVID-19: a Mendelian randomization study
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  Authors: Zhao S; Holmes M, Alam U.
  Abstract: National Institute for Health Research Clinical LectureshipUK Medical Research Council10.13039/501100000265British Heart Foundation Intermediate Clinical Research FellowshipFS/18/23/33512National Institute for Health Research Oxford Biomedical Research CentrePain Relief Foundation10.13039/501100000323
  PubDate: Mon, 07 Mar 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac135
  Issue No: Vol. 61, No. SI2 (2022)
Safety of the BNT162b2 mRNA COVID-19 vaccine in patients with familial
Mediterranean fever
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  Authors: Shechtman L; Lahad K, Livneh A, et al.
  Abstract: AbstractObjectivesEvidence suggests a possible association between the COVID-19 vaccine and autoimmune disease flares or new onset of various autoinflammatory manifestations, such as pericarditis and myocarditis. The objective of this study was to assess the safety of an mRNA-based BNT162b2 anti-COVID-19 vaccine in individuals with FMF, a prototypic autoinflammatory disease.MethodsPatients participating in this study fulfilled the criteria for diagnosis of FMF, were older than 18 years and received at least one dose of the vaccine. Data on baseline characteristics, features of FMF, post-vaccination side effects, and disease flares were acquired using electronic medical files and telephone interviews.ResultsA total of 273 FMF patients were recruited for the study. >95% were vaccinated with two doses of the vaccine. The rates of local reactions following the first and second vaccine doses were 65.5% and 60%, respectively, and 26% and 50.4%, respectively, for systemic adverse events. These rates are lower than those reported for the general population from real-world and clinical trial settings. Postvaccination FMF activity remained stable in most patients. None of the patients reported an attack of pericarditis or myocarditis, considered the most serious vaccine-associated adverse events. Patients with a more active FMF disease and patients harboring the M694V mutation had a significantly higher rate of post-vaccination systemic side effects and attacks.ConclusionThe BNT162b2 mRNA COVID-19 vaccine is safe in patients with FMF. Our results support the administration of this vaccine to FMF patients according to guidelines applicable to the general population.
  PubDate: Thu, 03 Mar 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac131
  Issue No: Vol. 61, No. SI2 (2022)
Humoral and cellular response to COVID-19 vaccination in patients with
autoimmune inflammatory rheumatic diseases under real-life conditions
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  Authors: Krasselt M; Wagner U, Nguyen P, et al.
  Abstract: AbstractObjectivesSuccessful vaccination is key to overcoming the COVID-19 pandemic. Immunosuppressive medication is known to potentially compromise vaccination responses, and expansion of our knowledge on vaccination efficacy in patients with autoimmune inflammatory rheumatic diseases (AIIRD) is therefore of utmost importance.MethodsWe conducted a single-centre observational study and evaluated the efficacy of approved COVID-19 vaccines in 303 adult AIIRD patients. Serum levels of IgG antibodies against the S1 subunit of SARS-CoV-2 spike proteins (anti-S IgG) were measured at least two weeks after vaccination. In a subgroup of patients without humoral response, T-cell responses were determined using an interferon-γ gamma release assay.ResultsOverall seropositivity rate was 78.5% and was significantly lower in patients under immunosuppressive therapy (75.7 vs 93.2%, P = 0.009). No difference regarding the vaccination type was observed. Glucocorticoids, mycophenolate-mofetil, TNF inhibitors, tocilizumab, abatacept and rituximab were all associated with non-response after proper vaccination. The risk was highest under RTX therapy (OR 0.004, 95% CI 0.001, 0.023, P < 0.0001). A strong negative correlation was observed between time since vaccination with an mRNA vaccine and anti-S antibody levels (r=–0.6149, P < 0.0001). In patients without humoral response, a T-cell response was found in 50%.ConclusionsCOVID-19 vaccination in patients with AIIRD is effective using any approved vaccine. Humoral response might be impaired depending on the individual immunosuppressive medication. The risk of non-response is highest under rituximab therapy. Anti-S IgG antibody levels wane over time after mRNA vaccination. Importantly, 50% of humoral non-responders showed a T-cellular response, suggesting T-cell-mediated protection to a certain extent.
  PubDate: Thu, 10 Feb 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac089
  Issue No: Vol. 61, No. SI2 (2022)
Can SARS-CoV-2 vaccinations induce auto-inflammatory diseases'
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  Authors: van Laar J.
  Abstract: Recently, Tagini et al. [1] elaborated on symptoms occurring 15 days after a second sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccination in a young woman presenting with new-onset symptoms compatible with Behçet’s disease (BD). The obvious question arises whether these observations have a casual relation with the vaccination.
  PubDate: Mon, 10 Jan 2022 00:00:00 GMT
  DOI: 10.1093/rheumatology/keac008
  Issue No: Vol. 61, No. SI2 (2022)
SARS-CoV-2 vaccine in patients with systemic sclerosis: impact of disease
subtype and therapy
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  Authors: Sampaio-Barros P; Medeiros-Ribeiro A, Luppino-Assad A, et al.
  Abstract: AbstractObjectiveTo analyse the safety, immunogenicity and factors affecting antibody response to Severe Acute Respiratory Syndrome–Coronavirus–2 (SARS-CoV-2) vaccination in patients with SSc.MethodsThis is a phase 4 prospective study within a larger trial of two doses of inactivated SARS-CoV-2 vaccine (CoronaVac) in 51 SSc patients compared with 153 controls. Anti-SARS-CoV-2-IgG and neutralizing antibodies (NAb) were assessed at each vaccine shot (D0/D28) and 6 weeks after the second dose(D69), only in individuals with negative baseline IgG/NAb and those who did not have coronavirus-19(COVID19) during follow-up. Vaccine safety was also assessed in all participants.ResultsPatients and controls had comparable median ages [48(38.5–57) vs 48(38–57) years, P =0.945]. Patients had mostly diffuse SSc (68.6%) and the majority (74.5%) had interstitial lung disease. Most patients were under immunosuppressive therapy (72.5%), mainly MMF (52.9%). After full vaccination (D69), anti-SARS-CoV-2-IgG frequency (64.1% vs 94.2%, P < 0.001) and NAb positivity (53.8% vs 76.9%; P =0.006) were moderate, although lower than controls. The first dose response (D28) was low and comparable for both seroconvertion rates (SC) (P =0.958) and NAb positivity (P =0.537). SSc patients under MMF monotherapy vs other (no therapy/other DMARDs) had lower immunogenicity (SC: 31.3% vs 90%, P < 0.001) and NAb(18.8% vs 85%, P < 0.001). Multiple regression analysis confirmed that MMF use, but not disease subtype, is associated with insufficient seroconversion [odds ratio (OR)=0.056(95% CI: 0.009, 0.034), P =0.002] and NAb positivity [OR = 0.047(95% CI: 0.007, 0.036), P =0.002]. No moderate/severe side-effects were observed.ConclusionCoronaVac has an excellent safety profile and moderate response to anti-SARS-CoV-2 vaccine in SSc. Vaccine antibody response is not influenced by disease subtype and is greatly affected by MMF, reinforcing the need for additional strategies to up-modulate vaccine response in this subgroup of patients.Trial registrationClinicalTrials.gov, https://clinicaltrials.gov, NCT04754698
  PubDate: Sat, 11 Dec 2021 00:00:00 GMT
  DOI: 10.1093/rheumatology/keab886
  Issue No: Vol. 61, No. SI2 (2021)
Risk factors of impaired humoral response to COVID-19 vaccination in
rituximab-treated patients
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  Authors: Avouac J; Miceli-Richard C, Combier A, et al.
  Abstract: AbstractObjectiveTo identify which factors influence humoral response to coronavirus disease 2019 (COVID-19) vaccination in rituximab (RTX)-treated patients.MethodsThis was an observational, prospective, usual care study including consecutive patients with inflammatory rheumatic diseases in maintenance therapy with RTX. All patients received a two-dose regimen COVID-19 vaccination. Serum IgG antibody levels against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike proteins were measured at the time of the new RTX infusion.ResultsFrom the recruited patients, 16/45 (36%) produced antibodies reaching the assay cut-off value of 15 AU/ml and 29/45 (64%) had a negative serology. Within RTX-treated patients, 25 (56%) had undetectable B cells. Negative serology was associated with undetectable B cells (24/25 vs 5/20, P < 0.001). Moreover, SARS-CoV-2 spike antibodies correlated with CD19 counts (r = 0.86, P < 0.001). The effect of RTX and MTX was additive in terms of seroconversion rates (23% vs 50% in patients receiving RTX in monotherapy, P = 0.12) and SARS-CoV-2 spike antibody levels [3.80 (95% CI 3.80, 7.50) vs 75 (95% CI 3.8, 353) AU/ml in patients receiving RTX in monotherapy; P = 0.025]. Multivariate analyses including demographics, disease characteristics, gammaglobulin levels, RTX and other therapies used, CD19 counts, and the time between the last RTX infusion and vaccination identified detectable B cells as the only variable independently associated with seropositivity [odds ratio 35.2 (95% CI 3.59, 344.20)].ConclusionsB cell depletion is the main independent contributing factor of antibody response to SARS-CoV-2 vaccination in RTX-treated patients. Monitoring CD19 may be of interest to identify the most appropriate period to perform vaccination.
  PubDate: Tue, 02 Nov 2021 00:00:00 GMT
  DOI: 10.1093/rheumatology/keab815
  Issue No: Vol. 61, No. SI2 (2021)
Impact of the COVID-19 pandemic on juvenile idiopathic arthritis
presentation and research recruitment: results from the CAPRI registry
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  Authors: Dushnicky M; Campbell C, Beattie K, et al.
  Abstract: AbstractObjectiveThe COVID-19 pandemic has disrupted healthcare delivery and clinical research worldwide, with data from areas most affected demonstrating an impact on rheumatology care. This study aimed to characterize the impact of the pandemic on the initial presentation of JIA and JIA-related research in Canada.MethodsData collected from the Canadian Alliance of Pediatric Rheumatology Investigators JIA Registry from the year pre-pandemic (11 March 2019 to 10 March 2020) was compared with data collected during the first year of the pandemic (11 March 2020 to 10 March 2021). Outcomes included time from symptom onset to first assessment, disease severity at presentation and registry recruitment. Proportions and medians were used to describe categorical and continuous variables, respectively.ResultsThe median time from symptom onset to first assessment was 138 (IQR 64–365) days pre-pandemic vs 146 (IQR 83–359) days during the pandemic. The JIA category frequencies remained overall stable (44% oligoarticular JIA pre-pandemic, 46.8% pandemic), except for systemic JIA (12 cases pre-pandemic, 1 pandemic). Clinical features, disease activity (cJADAS10), disability (CHAQ) and quality of life (JAQQ) scores were similar between the two cohorts. Pre-pandemic, 225 patients were enrolled, compared with 111 in the pandemic year, with the greatest decrease from March to June 2020.ConclusionsWe did not observe the anticipated delay in time to presentation or increased severity at presentation, suggesting that, within Canada, care adapted well to provide support to new patient consults without negative impacts. The COVID-19 pandemic was associated with an initial 50% decrease in registry enrolment but has since improved.
  PubDate: Fri, 29 Oct 2021 00:00:00 GMT
  DOI: 10.1093/rheumatology/keab812
  Issue No: Vol. 61, No. SI2 (2021)
Seroprevalence and clinical outcomes of SARS-CoV-2 in paediatric patients
with rheumatic disease
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  Authors: Walters H; Mian Z, Thomas L, et al.
  Abstract: AbstractObjectivesImmunosuppressed paediatric patients with rheumatic disease (RD) may be at risk for severe or critical disease related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Data remain scarce on coronavirus disease 2019 (COVID-19) outcomes in paediatric RD patients. The aim of this study was to determine the seroprevalence of SARS-CoV-2 IgG and to describe COVID-19 outcomes in immunosuppressed paediatric RD patients.MethodsPatients diagnosed with RD before age 18 years and treated with at least one immunosuppressive medication for at least 3 months were enrolled from a tertiary paediatric rheumatology practice in New York and also underwent routine SARS-CoV-2 IgG testing from May to November 2020. A total of 571 patients were screened and 262 were enrolled. SARS-CoV-2 IgG-positive subjects were assessed for symptoms of COVID-19 infection. SARS-CoV-2 PCR results were recorded where available. Demographic, diagnostic, medication and outcome data were collected.ResultsOf 262 subjects (186 female), 35 (13%) were SARS-CoV-2 IgG positive; 17 (49%) had symptoms suggestive of COVID-19. Of the 17 patients who had SARS-CoV-2 PCR testing, 11 (65%) were PCR positive, 7 of whom were IgG positive. Most SARS-CoV-2 IgG-positive subjects were not PCR tested. The most common symptoms in IgG- and/or PCR-positive subjects were fever, fatigue and cough. No SARS-CoV-2 IgG- or PCR-positive subject developed severe or critical COVID-19 or required hospitalization.ConclusionsThis is the first report of clinical outcomes of SARS-CoV-2 infection and seroprevalence of SARS-CoV-2 IgG in a large cohort of paediatric RD patients. Most SARS-CoV-2 IgG-positive subjects had no symptoms of COVID-19 infection. Symptomatic subjects all had mild COVID-19 symptoms, suggesting that the risk of severe or critical COVID-19 in immunosuppressed paediatric RD patients is minimal.
  PubDate: Sat, 02 Oct 2021 00:00:00 GMT
  DOI: 10.1093/rheumatology/keab730
  Issue No: Vol. 61, No. SI2 (2021)