Systematic analysis for clinical characteristics and outcomes of IgG4-related disease patients during the COVID-19 pandemic

期刊论文
发表日期：

2024年6月22日

查看全文

Tong Zhang,
Huilan Liu,
Mengxin Tian,
Mingzhu Zhou,
Hang Zhou,
Xia Zhang,
Tianqi Wang,
Mingxin Bai,
Yuetong Xu,
Fan Yang,
Yunzhi Zhufeng,
Qiyuan Hao,
Difei Lian,
Wenhuan Zeng,
Shuju Song,
Haiyu Qi,
Yanying Liu

摘要

Background

To systematically describe clinical characteristics and investigate factors associated with COVID-19-related infection, hospital admission, and IgG4-related disease relapse in IgG4-RD patients.

Methods

Physician-reported IgG4-RD patients were included in this retrospective study. Using multivariable logistic regression analysis to determine factors for primary outcome (COVID-19-related IgG4-RD relapse) and secondary outcome (COVID-19-related infection and hospital admission). Covariates included age, sex, body mass index, smoking status, comorbidities, IgG4-RD clinical features, and treatment strategies.

Results

Among 649 patients, 530 had a diagnosis of COVID-19, 25 had COVID-19-related hospital admission, and 69 had COVID-19-related IgG4-RD relapse. Independent factors associated with COVID-19 infection were age (OR, 0.98; 95% CI, 0.96–1.00), body mass index (1.10, 1.03–1.18), and tofacitinib (0.34, 0.14–0.79). Further analysis indicated that age (1.10, 1.03–1.16), coronary heart disease (24.38, 3.33–178.33), COVID-19-related dyspnea (7.11, 1.85–27.34), pulmonary infection (73.63, 16.22–4615.34), and methotrexate (17.15, 1.93–157.79) were associated with a higher risk of COVID-19-related hospital admission. Importantly, age (0.93, 0.89–0.98), male sex (0.16, 0.03–0.80), ever/current smoking (19.23, 3.78–97.80), COVID-19-related headache (2.98, 1.09–8.17) and psychiatric symptoms (3.12, 1.07–9.10), disease activity before COVID-19 (1.89, 1.02–3.51), number of involved organs (1.38, 1.08–1.76), glucocorticoid dosage (1.08, 1.03–1.13), and methotrexate (5.56, 1.40–22.08) were strong factors for COVID-19-related IgG4-RD relapse.

Conclusions

Our data add to evidence that smoking and disease-specific factors (disease activity, number of involved organs, and specific medications) were risk factors of COVID-19-related IgG4-RD relapse. The results highlight the importance of adequate disease control with b/tsDMARDs, preferably without using methotrexate and increasing glucocorticoid dosages in the COVID-19 era.

Key Points

• COVID-19-related infection or hospital admission were associated with known general factors (age, body mass index, specific comorbidities and methotrexate) among IgG4-RD patients.

• Smoking and disease-specific factors (disease activity, number of involved organs and specific medications) were associated with higher odds of COVID-19-related IgG4-RD relapse.

• The results highlight the importance of adequate disease control with b/tsDMARDs, preferably without using methotrexate or increasing glucocorticoid dosages.