Print Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Mistry N, Agarwal A. Mistry N, & Agarwal A Mistry, Neel, and Arnav Agarwal. Presence of rheumatic and musculoskeletal comorbidities were not associated with significant alterations in COVID-19 pneumonia-related clinical outcomes. 2 Minute Medicine, 21 September 2020. McGraw-Hill, 2020. AccessSurgery. https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=553233§ionid=250163233APA Citation Mistry N, Agarwal A. Mistry N, & Agarwal A Mistry, Neel, and Arnav Agarwal. (2020). Presence of rheumatic and musculoskeletal comorbidities were not associated with significant alterations in covid-19 pneumonia-related clinical outcomes. (2020). 2 minute medicine. McGraw-Hill. https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=553233§ionid=250163233.MLA Citation Mistry N, Agarwal A. Mistry N, & Agarwal A Mistry, Neel, and Arnav Agarwal. "Presence of rheumatic and musculoskeletal comorbidities were not associated with significant alterations in COVID-19 pneumonia-related clinical outcomes." 2 Minute Medicine McGraw-Hill, 2020, https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=553233§ionid=250163233. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Clip Full Chapter Figures Only Tables Only Videos Only Supplementary Content Top Presence of rheumatic and musculoskeletal comorbidities were not associated with significant alterations in COVID-19 pneumonia-related clinical outcomes by Neel Mistry, Arnav Agarwal, MD Listen +Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission. +1. There were no significant differences in symptom duration, length of hospital stay, and chest X-ray score between patients hospitalized for COVID-19 pneumonia with rheumatic and musculoskeletal diseases, compared to controls without these comorbidities. +2. Major risk factors for hospital admission and mortality included older age and pre-existing comorbidities (i.e. arterial hypertension and obesity). +Evidence Rating Level: 3 (Average) Study Rundown: + +The novel coronavirus has caused significant morbidity and mortality globally, with Lombardy, Italy being among the most affected. This study assessed the trajectory of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in 117 patients with rheumatic and musculoskeletal diseases who were admitted to the Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili of Brescia in Lombardy. The study also used a case-control design to compare patients with confirmed COVID-19 pneumonia with concurrent rheumatic and musculoskeletal diseases with age, sex and month of admission-matched in-patients with COVID-19 pneumonia without the same comorbidities. Study results showed that there were no significant differences in duration of COVID-19 symptoms, length of hospital stay, and X-ray Brixia score among patients with rheumatic and musculoskeletal diseases who were hospitalized for COVID-19 pneumonia (cases) compared to their counterparts without rheumatic or musculoskeletal comorbidities (controls). The study was limited by a small sample size and single-centre study design, potentially limiting generalizability of findings. Nonetheless, the study is the largest single-centre observational and case-control cohort of rheumatology patients with COVID-19 and shed light on next steps in this field. +Click here to read the study in The Lancet Rheumatology +Relevant Reading: GM-CSF blockade with mavrilimumab in severe COVID-19 pneumonia and systemic hyperinflammation: a single-centre, prospective cohort study In-depth [prospective cohort and case-control study]: + +In this single-centre analysis in Lombardy, 117 (8%) patients with rheumatologic and musculoskeletal diseases were identified with confirmed (n=65) or suspected (n=52) COVID-19 between February 24 and May 1 2020. Using telephone and outpatient clinic-based surveys, data regarding the occurrence of SARS-CoV-2 infection symptoms, confirmed COVID-19 testing and demographic variables were collected. A case-control study with age, sex and month of hospital-matched controls not having rheumatologic or musculoskeletal disease was subsequently conducted, evaluating differences in disease course, radiologic findings, biomarkers of hyperinflammation and treatments received. +Overall, confirmed cases, relative to their suspected COVID-19 counterparts, were older (median age 57 years vs. 68 years, p=0.001], and had higher rates of arterial hypertension (27% vs. 51%, odds ratio [OR] 2.8, 95% confidence intervals [CI] 1.3 to 6.1, p=0.031) and obesity (2% vs. 17%, OR 11.0, 95% CI 1.3 to 83.4, p=0.0059). No differences were observed between confirmed and suspected cases with respect to use of glucocorticoids, conventional disease modifying antirheumatic drugs (DMARDs), and biologic agents. Among confirmed cases, 72% (47 of 65) were hospitalized; these patients were generally older than non-hospitalized confirmed cases (median age 70 years (IQR 60.5 to 76.0) vs. 54 years (IQR 47.0 to 73.8.), p=0.036]. +In the case-control study, 26 COVID-19 patients with rheumatic or musculoskeletal disease were matched to 62 COVID-19 infected controls without the same comorbidities, by age, sex, and month of hospital admission. Although no significant differences were noted for onset of COVID-19 symptoms, duration of hospital stay, and X-ray score, cases had more profound lymphopenia than controls (810 cells per mm3 vs. 560 cells per mm3, p=0.021). Rheumatoid arthritis (35%) comprised the majority of rheumatologic and musculoskeletal ailments among cases, followed by Still’s disease (12%), and polymyalgia rheumatica (12%). Intravenous or oral glucocorticoids were administered for 65% of cases, while tocilizumab was used for the remaining 25%. No significant differences in therapy were otherwise noted during hospital admission between cases and controls. +©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.