Mete PEKDİKER, Mete KARA, Emrah KOÇ, Gezmiş KİMYON

Aksiyel spondiloartritli hastalarda COVİD-19 sıklığı ve ilişkili faktörler

Amaç: Kronik hastalığa sahip bireylerde COVİD-19’un ağır seyri romatolojik hastalıkların tedavisinde endişeye yol açmıştır. Bu yüzden çalışmamızda aksiyel spondiloartritli (aSpa) hastalarda COVİD-19 sıklığı ve şiddeti ile ilişkili faktörleri tanımlamayı amaçladık. Gereç ve yöntem: Üç tersiyer merkezde izlenen ve en az altı aydır tedavilerini düzenli kullanan aSpa’lı hastalar çalışmaya dahil edildi. Hastalık süresi, radyolojik şiddet ve tedavi gibi aSpa ilişkili değişkenler ile COVİD-19 sonuçları arasındaki ilişkiyi değerlendirdik. Bulgular: Ortalama hastalık süresi 109 ay olan toplam 833 hasta analiz edildi; %64,5’inde ankilozan spondilit ve %35,5’inde non-radyografik aSpa tanısı mevcutken hastaların %59,4’ü biyolojik ajanlarla tedavi edilmekteydi. Çalışma grubumuzda COVİD-19 sıklığı %23 (n:192) olup sadece beş olguda (%0,5) yoğun bakım ünitesi öyküsü vardı. İleri yaş, hipertansiyon (HT) ve diabetes mellitus (DM) yüksek çözünürlüklü bilgisayarlı tomografisinde (YÇBT) tutulum olan hastalarda anlamlı olarak daha fazlaydı (p:0,02, p:0,01 ve p<0,001). Hastaneye yatış gerektiren hastalarda ise ileri yaş, HT, DM ve 10 yıldan uzun hastalık süresi anlamlı olarak daha fazlaydı (p:0,03, p:0,011, p<0,001 ve p:0,014). Çok değişkenli regresyon analizinde sadece DM hem YÇBT’de akciğer tutulumu (p:0,029) hem de hospitalizasyon (p:0,001) için bağımsız bir risk faktörü olarak bulundu. Sonuç: Homojen bir hasta grubu ile yaptığımız çalışmamızın sonuçları biyolojik ajanların COVİD-19 ilişkili kötü sonuçlar üzerine etkisini olmadığını göstermiştir; çalışmamızda sadece DM, aSpa’lı hastalarda daha ciddi COVİD-19 sonuçları ile ilişkiliydi.

Anahtar Kelimeler:

COVID-19, aksiyel spondiloartrit, ankilozan spondilit, radyografik olmayan aksiyel spondiloartrit, şeker hastalığı

Factors associated with frequency and severity of COVID-19 in patients with axial spondyloarthritis

Purpose: The severe course of COVID-19 in individuals with chronic diseases has led to concerns in managing rheumatic diseases during the pandemic; therefore, we aimed to define the factors associated with the frequency and severity of COVID-19 in patients with axial spondyloarthritis (axSpa) in this study. Materials and methods: Patients with axSpa who were followed up in three tertiary hospitals and used their treatment regularly for at least six months were included. We assessed the relationship between axSpa-associated variables such as disease duration time, radiological severity, treatment and COVID-19 outcomes. Results: A total of 833 patients with a mean disease duration of 109 months were analyzed; 64.5% of them had ankylosing spondylitis, 35.5% had non-radiographic axSpa, and 59.4% of patients were treated with a biologic agent. The frequency of COVID-19 was 23% (n:192); only five patients (0.5%) had a history of intensive care unit. Advanced age, hypertension (HT), and diabetes mellitus (DM) were found to be significantly more common in those with involvement in high-resolution computed tomography (HRCT) (p:0.02, p:0.01, and p<0.001). In hospitalized individuals, female gender, HT, DM, and disease lasting longer than 10 years were significantly higher (p:0.03, p:0.011, p<0.001, and p:0.014). Only DM was found as an independent risk factor for both pulmonary involvement in HRCT (p:0.029) and hospitalization (p:0.001). Conclusion: We conducted our study with a homogenous study population and our results suggested that biological agents did not affect poor COVID-19 outcomes; only DM was associated with a more severe COVID-19 course in patients with axSpa.

Keywords:

COVID-19, axial spondyloarthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, diabetes mellitus,

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