POS1244 PRELIMINARY RESULTS OF LONG-TERM FOLLOW-UP OF THE HEALTH STATUS OF PATIENTS USING csDMARDs AND b/tsDMARDS FOR RHEUMATIC DISEASES DURING THE COVID-19 PANDEMIC
Authors: F. Unlu Ozkan, K. Sari, I. Aktas
Journal: Annals of the Rheumatic Diseases (2021)

Background: Since its inception, the COVID-19 outbreak has been carefully monitored both by the patients using DMARDs and their physicians. There is no data that patients with rheumatic and musculoskeletal diseases (RMD) are at a higher risk of contracting COVID-19 disease than those without RMD (1). COVID-19-related death in people with RMD has been associated with older age, male gender, concomitant cardiovascular and pulmonary diseases, moderate/high disease activity, and certain treatments (rituximab (RTX), sulfasalazine (SSZ) and some immunosuppressants) (2). Objectives: To determine the conditions of getting and being affected poorly by COVID-19 and related factors of RMD patients followed in our outpatient clinic. Methods: 160 patients over 18 years of age who applied to our outpatient clinic between July 2020-January 2021; who used DMARDs for rheumatic diseases and agreed to participate were included in the study. The patients’s demographic data, RMDs, csDMARDs and b/tsDMARDs usage, comorbid diseases and smoking status were recorded. The data of the patients on COVID-19 disease between March 2020 and January 2021 were questioned at each visit. Results: Patient characteristics are presented in Table 1. 57 (36%) of all patients had COVID-19 PCR test, 23 (14%) were positive, and 1 patient was diagnosed with COVID-19 because the CT findings were positive, although the PCR test was negative. Table 1. Patient characteristics All Patients n=160 COVID-19 Patients n=24 Male 61 (38%) 6 (25%) Female 99 (62%) 18 (75%) Mean age 49.5 49.5 Ever smoker 88 (55%) 8 (33,3%) Obesity 51 (32%) 9 (37,5%) Hypertension (HT) 46 (29%) 7 (29%) Diabetes (DM) 22 (14%) 2 (8%) Cardiovascular disease (CVD) 26 (16%) 5 (20%) Chronic lung disease (CLD) 12 (7,5%) 4 (16%) SpA 71 (44,3%) 9 (37,5%) RA 71 (44,3%) 14 (58,3%) PsA 14 (8,8%) 1 (4,2%) SLE 2 (1,25%) - PMR 2 (1,25%) - cDMARD only 82 (51,2%) 14 (58,3%) b/tsDMARD only 55 (34,4%) 8 (33.3%) Combined DMARD 23 (14,4%) 2 (8.4%) The rate of getting COVID-19 infection was 15% in all patients. This rate was 18% in all obese patients, 19% in those with at least one comorbid disease (HT, DM, CVD, CLD), and 22% in those who were obese and had at least one comorbid disease. 16% of non-smokers and 9% of those who ever smoked got COVID-19. Among patients over the age of 65 (n=17), 2 patients (%12) had COVID-19. Treatments of RMDs of patients with COVID-19 were as follows: bDMARD=8 [(Etanercept(ETN) n=2, adalimumab (ADA) n=2, certolizumab pegol (CTZ) n=1, infliximab (IFX) n=1, golimumab (GOL) n=1, RTX n=1)], csDMARD=14 [(methotrexate (MTX) n=4, leflunomid (LEF) n=4, SSZ n=3, HCQ n=2, MTX+SSZ+HCQ n=1)], combined=2 [tofacitinib (TOF)+MTX n=1, TCZ+LEF n=1)], none of them was using glucocorticoids. Overall 17% of patients using csDMARD, 14,5% of patients using b/tsDMARD as monotherapy and 9% of patients using combination treatment had COVID-19. Of the patients using HCQ (n=14), 3 (21%) were diagnosed with COVID-19 disease. 18 of the patients received COVID-19 treatment at home, 6 were hospitalized and 1 of them (RA patient, LEF user) needed intensive care unit. None of them died. Conclusion: Preliminary results regarding the health status associated with COVID-19 of our patients with RMD are presented. Biologic drugs seems not to increase COVID-19 but final results will be presented after the completion of statistical analysis of all data. References: [1]Landewé RB, Machado PM, Kroon F, et al. EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2. Ann Rheum Dis. 2020;79(7):851-858. doi:10.1136/annrheumdis-2020-217877 [2]Strangfeld A, Schäfer M, Gianfrancesco MA, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry [published online ahead of print, 2021 Jan 27]. Ann Rheum Dis. 2021;annrheumdis-2020-219498. doi:10.1136/annrheumdis-2020-219498 Disclosure of Interests: None declared