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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Computed tomography of the chest organs as a method for the diagnosis of covid-19 in patients with immunoinflammatory rheumatic diseases

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  • Eugenia Aronova - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Galina Gridneva - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Leonid Blank - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Boris Belov - V.A. Nasonova Research Institute of Rheumatology, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocCO.13

doi: 10.3205/21dgrh013, urn:nbn:de:0183-21dgrh0136

Published: September 14, 2021

© 2021 Aronova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: Computed tomography (CT) of the chest is highly sensitive in detecting changes in the lungs characteristic of COVID-19, and allows them to be detected even before positive laboratory tests for infection appear. The aim of our study was еo characterize CT of the lungs as a method for diagnosing COVID-19 in patients with immunoinflammatory rheumatic diseases (IIRD) in real clinical practice.

Methods: The retrospective study included data on 37 patients with IIRD (27 women and 10 men) hospitalized at the V.A. Nasonova Research Institute of Rheumatology from April to November 2020 with diagnoses: rheumatoid arthritis - 15 patients (40%), systemic lupus erythematosus - 7 (19%), progressive systemic sclerosis - 4 (10%), systemic vasculitis - 2 (5, 4%), osteoarthritis - 2 (5.4%), other - 20.2%. The average age of patients is 55 ± 11.9 years (from 26 to 72 years). All patients had a CT scan that was suspicious of COVID-19-associated pneumonia. The survey plan also included an assessment of clinical parameters, complete blood count, biochemical and immunological blood tests (including ferritin and CRP), SarS-CoV-2 RNA PCR and rapid blood test for IgG/IgM antibodies to SarS-CoV-2.

Results: The new coronavirus infection COVID-19 was verified in 31 patients. In 6 patients (16%), clinical and laboratory data for COVID-19 were not obtained, changes in the lungs in this case were regarded as manifestations of rheumatic disease, two patients from this group suffered from rheumatoid arthritis, and the rest - systemic lupus erythematosus.

Conclusion: The CT picture of pulmonary changes in patients with IIRD is not specific. Upon detection of changes suspicious of viral pneumonia, a differential diagnosis is required between COVID-19 and exacerbation of rheumatic disease, taking into account the data of immunological and virological examination. It is advisable to isolate and observe patients in observation until the results of a complete examination are obtained.

Disclosures: None declared