gms | German Medical Science

Introduction: The aim of the study was to study of the role of Covid-19 infection in the structure of comorbid infections (CI) in the inpatient contingent of patients with spondyloarthritis (SpA) in the course of a one-moment retrospective study.

Methods: The study included 237 patients with SpA (137 men, 100 women, mean age 38.9±12 years) who were hospitalized at the V.A. Nasonova Research Institute of Rheumatology. Ankylosing spondylitis was diagnosed in 149 patients, psoriatic arthritis - in 67, spondyloarthritis associated with Crohn’s disease - in 1, undifferentiated spondyloarthritis - in 20. The majority of respondents had higher education (62%). None of the patients consumed alcohol on a daily basis, 147 patients never smoked (including those who have suffered from Covid-19 – 29). The Charlson comorbidity index, equal to 0, had 115 respondents (including those who have suffered from Covid-19 – 23), 1 – 56 (including those who have suffered from Covid-19 – 7), 2 - 29 (including those who have suffered from Covid-19 – 4), 3 – 18 (including those who have suffered from Covid-19 – 2), 4 – 12 (including those who have suffered from covid-19 – 4), 5 or more – 7 (none of the Covid-19 patients). Most patients (n=155) received immunosuppressive therapy: glucocorticoids-GC (n=74), methotrexate-MT (n=128), leflunomide-LEF (n=17), biological drugs - TNF-ɑ inhibitors, inhibitors of interleukin (iIL)-12/23, iIL-17 (n=74). 82 patients received nonsteroidal anti-inflammatory drugs (NSAIDs) and/or sulfasalazine (SULF). Patients were interviewed by a research doctor with the completion of a unified questionnaire, additional data were obtained from medical documentation.

Results: Leading in the structure of CI in patients with SpA were respiratory tract infections: acute nasopharyngitis (n=185), tonsillitis (82), sinusitis (39), acute bronchitis (38), pneumonia (35), influenza (36), tuberculosis (6). Infectious diseases of other localization include herpes-viral infections (n=116), mycoses (56), urinary tract infections (47), conjunctivitis and blepharitis (41), otitis (29), genital infections (19), skin infections (15), intestinal infections (13), nervous system infections (2), bone infections (2), chronic hepatitis B (1), chronic hepatitis C (1), HIV infection (1), rubella in adulthood (1), measles in adulthood (1). 40 SpA patients have had Covid-19. At the time of diagnosis of Covid-19, 14 patients received NSAIDs, 11 – SULF, 5 – MT, 1 – GC, 3 – SULF and GC, 23 – MT and GC, 1 – SULF, MT, GC, 1 – MT, GC and golimumab, 1 – LEF and secukinumab (SEC). 13 patients were diagnosed with pneumonia: 8 - 1 degree of lesion on computed tomography, 4 - 2 degree of lesion on computed tomography, 1 – mixed pneumonia (viral pneumonia, complicated by bacterial-fungal). 4 patients with pneumonia received immunosuppressive therapy (2 – MT, 1 – GC, 1 – LEF and SEC), 6 had arterial hypertension, 2 – chronic heart failure, 1 – chronic obstructive pulmonary disease, 1 – endometrial cancer without metastases (in the anamnesis), 2 patients were smoking, 1 patient was 65 years old. In 27 patients with SpA Covid-19 showed symptoms of acute nasopharyngitis or was asymptomatic. Temporary discontinuation of therapy due to the development of Covid-19 occurred in 7 cases. Exacerbation of SpA after Covid-19 was diagnosed in 22 patients.

Conclusion: The data obtained indicate the important of the problem of CI (including Covid-19) in SpA. Further studies are needed on large samples of patients in order to find significant risk factors for CI, study their relationship with clinical characteristics and influence on the course of SpA.

Disclosures: No