Hospitalizations for infections in primary Sjögren’s syndrome patients: a nationwide incidence study
Creators: name: Goulabchand, Radjiv
name: Makinson, Alain
name: Morel, Jacques
name: Witkowski-Durand-Viel, Philine
name: Nagot, Nicolas
name: Loubet, Paul
name: Roubille, Camille
name: Noel, Danièle
name: Morquin, David
name: Henry, Kim
name: Mura, Thibault
name: Guilpain, Philippe
Publisher: name: Taylor & Francis
Year: 2023
Subjects: subject: Medicine
subject: Microbiology
subject: FOS: Biological sciences
subject: Biotechnology
subject: Immunology
subject: FOS: Clinical medicine
subject: Cancer
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Virology
subject: Computational Biology

description: Primary Sjögren’s syndrome (pSS) is an autoimmune disease with increased risk of infections. Here, we assessed whether pSS patients were at higher risk of hospitalization for community and opportunistic infections. We selected newly hospitalized pSS patients between 2011 and 2018, through a nationwide population-based retrospective study using the French Health insurance database. We compared the incidence of hospitalization for several types of infections (according to International Classification for Disease codes, ICD-10) between pSS patients and an age- and sex-matched (1:10) hospitalized control group. We calculated adjusted Hazard Ratios (aHR, 95% CI) adjusted on socio-economic status, past cardiovascular or lung diseases and blood malignancies factors. We compared 25 661 pSS patients with 252 543 matched patients. The incidence of hospitalizations for a first community infection was increased in pSS patients [aHR of 1.29 (1.22–1.31), <i>p</i> &lt; .001]. The incidence of hospitalization for bronchopulmonary infections was increased in pSS patients [aHR of 1.50 (1.34–1.69), <i>p</i> &lt; .001, for pneumonia]. Hospitalizations for pyelonephritis and intestinal infections were increased [aHR of 1.55 (1.29–1.87), <i>p</i> &lt; .001 and 1.18 (1.08–1.29), <i>p</i> &lt; .001, respectively]. Among opportunistic infections, only zoster, and mycobacteria infections (tuberculosis and non-tuberculous) were at increased risk of hospitalization [aHR of 3.32 (1.78–6.18), <i>p</i> &lt; .001; 4.35 (1.41–13.5), <i>p</i> = .011 and 2.54 (1.27–5.06), <i>p</i> = .008, respectively]. pSS patients are at higher risk of hospitalization for infections. The increased risk of hospitalization for mycobacterial infections illustrates the potential bilateral relationship between the two conditions. Vaccination against respiratory pathogens and herpes zoster virus may help prevent some hospitalizations in pSS patients.KEY MESSAGESPrimary Sjögren’s syndrome (pSS) increases hospitalization risk for community infections: bronchopulmonary, skin, dental, ear–nose–throat, intestinal infections and pyelonephritis.Hospitalizations for zoster and mycobacterial infections are also increased in this population.Dedicated preventive measures and vaccination campaigns could decrease the burden of infections in pSS patients. Primary Sjögren’s syndrome (pSS) increases hospitalization risk for community infections: bronchopulmonary, skin, dental, ear–nose–throat, intestinal infections and pyelonephritis. Hospitalizations for zoster and mycobacterial infections are also increased in this population. Dedicated preventive measures and vaccination campaigns could decrease the burden of infections in pSS patients.