161. Systemic vasculitides in the time of COVID-19 pandemic
Creators: name: Alojzija Hocevar1, 2
name: Matija Tomšič1, 2
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background: </strong>COVID-19 pandemic significantly affected our routine rheumatological practice and the management of systemic vasculitides. To provide the best care for patients, daily practice has had to be adjusted overnight. We aimed to evaluate how successful we were in the management of systemic vasculitides during pandemic. <strong>Methods: </strong>We analysed medical records of patients diagnosed with a systemic vasculitis before (Jan/2010-Feb/2020; overall 122 months) and during COVID-19 pandemic (Mar/2020 – Sep/2021; overall 19 months) at our secondary/tertiary medical centre. Variations in the frequency, delays to diagnosis (the symptom duration time until diagnosis) and the baseline activity of the most commonly diagnosed vasculitides, i.e. giant cell arteritis (GCA), IgA vasculitis, ANCA associated vasculitis (AAV) and cryoglobulinemic vasculitis (CryoV) were recorded. Disease activity/severity was assessed by the Birmingham vasculitis activity score (version 3) for small vessel vasculitides, and by assessing the development of permanent ischemic complications (permanent vision defect and/or ischemic stroke) in GCA. <strong>Results: </strong>During the pandemic period, we diagnosed 122 new adult cases of GCA, IgAV, AAV, and CryoV (51, 33, 32, and 6 cases, respectively). Whereas the frequency per year of new GCA, IgAV and CryoV cases was comparable to pre-pandemic period, we diagnosed AAV nearly 3-times more frequently during the pandemic compared to average pre-pandemic year. Table 1 shows the median (interquartile range) symptom duration time and disease activity at presentation. In spite of the COVID-19 pandemic, neither was the symptom duration time longer nor was the baseline disease activity higher compared to the pre-pandemic decade. <strong>Conclusions:</strong> The frequency of AAV increased during COVID-19 pandemic. Despite a lockdown during pandemic, we did not record any significant delay in diagnosing systemic vasculitides. <strong>Disclosures:</strong> Authors have no conflict of interest to declare. <strong>Table 1. </strong>Characteristics of vasculitides before and during COVID 19 pandemic Vasculitis No. of patients Symptom duration time<sup> #</sup> (weeks) Disease activity/severity* Jan/2010 - Feb/2020 Mar/2020 - Sep/2021 Jan/2010 - Feb/2020 Mar/2020 - Sep/2021 Jan/2010 - Feb/2020 Mar/2020 - Sep/2021 GCA 341 51 4.3 (2.9 – 8.6) 3.0 (1.9 – 6.3) 11.1% 11.8% IgAV 310 33 1.1 (0.7 – 2.4) 1.3 (0.7 – 2.0) 8 (3 – 14) 6 (2 – 10) AAV 117 32 12.9 (5.6 – 36.4) 11.8 (4.3 – 26.8) 16 (11 – 22) 12 (6 – 19) CryoV 57 6 25.7 (4.3 – 51.4) 7.5 (2.0 – 22.5) 11 (4 –19) 5 (2 – 10) Legend: GCA giant cell arteritis; IgAV IgA vasculitis; AAV ANCA associated vasculitis; CryoV cryoglobulinemic vasculitis; # median and interquartile range (IQR); * determined as BVAS-3 (median, IQR) in IgAV and AAV, and as a percentage of patients with permanent vision defect or ischemic stroke in GCA.