164. Increased Incidence of New and Relapsed Small Vessel Vasculitides During the COVID-19 Pandemic
Creators: name: Williams1, Simon
name: Thong1, Daniel
name: Zaw Tun1
name: Noshaba Naz1
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background: </strong>In small vessel vasculitis autoimmunity develops in genetically susceptible individuals after an inciting event or exposure. Observational studies have found associations between viral and bacterial infections with systemic vasculitides. There have been case reports of concurrent ANCA associated vasculitis in patients that have tested positive for COVID-19 infection. We aimed to investigate the incidence of vasculitis in our centre over a year’s period during the pandemic and compare it to a corresponding period before the pandemic. <strong>Method: </strong>Data was collected on all patients that were diagnosed with new or relapsed vasculitis between April 2019 and March 2020 and compared to those diagnosed between April 2018 and March 2019. <strong>Results: </strong>During the period 2019/2020 there was a total of 22 cases comprising 15 new diagnoses and 7 relapses whereas in the year 2018/2019 there were 9 cases made up of 7 new cases and 2 relapses. The demographics and clinical data of these patients are summarised in Table 1. Out of the 15 new cases diagnosed during the pandemic, 7 had a covid-19 test prior to their diagnosis of vasculitis, all of which were negative. After their diagnosis of vasculitis, 2 of them subsequently had a positive covid-19 test, 6 had a negative covid-19 test and 7 were not tested. Out of the 7 relapses during the pandemic, 4 were tested for covid-19 prior to their vasculitis relapse. All 4 of them tested negative. After their relapse 2 tested positive for COVID-19, 2 of them tested negative and 3 of them were not tested. Three of the patients with a new diagnosis of vasculitis during the pandemic died. The causes of death were unknown for two of them and COVID-19 for the remaining one. The death from COVID-19 occurred after their vasculitis diagnosis and induction treatment.Two of the patients that relapsed during the pandemic died. The causes of death were vasculitis for 1 of them and COVID-19 for the other. <strong>Conclusion</strong><strong>:</strong> There was 2.4 times the number of patients with new or relapsed cases of vasculitis in 2019/2020 compared to 2018/2019. Interestingly there were more cases of pANCA vasculitis during the pandemic compared to year before (8 cases versus 1). Whilst we hypothesised that the COVID-19 pandemic could partially explain the increase all the patients that were tested for COVID-19 prior to their diagnosis of vasculitis tested negative. However due to limited testing capacity in the early stages of the pandemic a substantial number of patients were not tested for COVID-19. In addition we did not have access to serum COVID-19 antibody testing that might have identified past infections. This study shows an increase in vasculitis incidence during the pandemic. It is possible that the presence of the virus in the environment could induce immunological effects in susceptible individuals without causing clinically apparent COVID-19 disease. Other factors such as lifestyle changes as a result of the pandemic can also be considered for the focus of future research. <strong>Disclosures:</strong> None Table 1 2018/2019 2019/2020 2018/2019 2019/2020 New Diagnoses 7 15 Relapses 2 7 Age, Mean 69 72 Age, Mean 53 65 Female, n 5 8 Female, n 1 2 C-ANCA 4 6 C-ANCA 2 7 P-ANCA 1 8 P-ANCA 0 0 GBM 2 1 GBM 0 0 Immunosuppression Immunosuppression Cyclophosphamide 6 13 Cyclophosphamide 0 3 Rituximab 1 2 Rituximab 2 4 COVID-19 Status COVID-19 Status Pre-Diagnosis Pre-Diagnosis Positive N/A 0 Positive N/A 0 Negative N/A 7 Negative N/A 4 Not Tested N/A 8 Not Tested N/A 3 Post-Diagnosis Post-Diagnosis Positive N/A 2 Positive N/A 2 Negative N/A 6 Negative N/A 2 Not Tested N/A 7 Not Tested N/A 3