Clinical impact of COVID-19 on a French population of spondyloarthritis patients
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LETTER TO THE EDITOR
Clinical impact of COVID-19 on a French population of spondyloarthritis patients Christian Hubert Roux 1,2
&
O. Brocq 3 & F. Gerald 1 & C. Pradier 4 & L. Bailly 4
Received: 30 June 2020 / Revised: 4 September 2020 / Accepted: 16 September 2020 # International League of Associations for Rheumatology (ILAR) 2020
Dear Editor, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-mediated coronavirus disease 2019 (COVID-19) has raised many questions regarding chronic inflammatory arthritides such as risks of using biological disease-modifying antirheumatic drugs (bDMARDs) or nonsteroidal anti-inflammatory drugs (NSAIDs) [1], which are widely used in spondyloarthritis (SpA). Possible deleterious effects have been suggested [2], and recent observations from the rheumatologic community have required us to evaluate this evolving medical situation [3, 4]. Since the impact of COVID-19 on inflammatory rheumatic diseases is not well elucidated [5], a survey in a population with SpA was conducted herein. A questionnaire was administered using a private social network of the “Association contre les spondylarthrites” (ACS) in 1656 members on Thursday, April 30, 2020. The questionnaire was created using Microsoft Forms software (Microsoft Corp., Redmond, WA, USA). It included questions on age, body mass index (BMI), diseases, NSAIDs and bDMARDs, clinical manifestations of COVID-19 (detailed in Table 1), confirmed or suspected COVID-19 and possible hospitalisation. A written explanation of the aim of this study was given with the questionnaire. The study protocol was approved by the national ethics commission (CNIL) * Christian Hubert Roux [email protected] 1
Rheumatology Department, University hospital Nice, University Cote D’azur, Nice, France
2
Laboratory LAMHESS, Université Cote d’Azur, Nice, France
3
Rheumatology Department, CHPG Monaco, Monaco City, Monaco
4
Department of Public Health, University Hospital Centre Nice, Université Cote d’Azur, Nice, France
and registered by “L’institut national des données de santé” (MR 4316150420; Clinical trial number: NCT04355923). Out of 1656 members, 611 (37%) responded to the questionnaire. The mean age of the participants was 47 years (± 11.8). The mean BMI was 25.9 (± 5.2). Overall, 406 (66%) and 380 (62%) patients were treated with bDMARDS and NSAIDs, respectively. Co-prescription was frequent in 37% of the participants (225/611). Overall, 460 (75%) declared one or more symptoms possibly linked to COVID-19. Analysis of the association between NSAIDs use and declared cases suspected of COVID-19 showed a significant trend (p = 0.05). Similar result was not obtained regarding bDMARD use. As a possible consequence of media warnings, the onset of symptoms and suspicion of the disease were associated with decline in or discontinuation of NSAID (p = 0.01) and bDMARD treatment (p = 0.04). Present data on the impact of COVID-19 on SpA can assist rheumatologists in their patients counselling and management. Although our findings cannot indicate the inc
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