• Juan C Sarmiento-Monroy, Gerard Espinosa, Maria-Carlota Londoño, Fernanda Meira, Berta Caballol, Sara Llufriu, Josep Lluis Carrasco, Aina Moll-Udina, Luis F Quintana, Priscila Giavedoni, Julio Ramírez, Jose Inciarte-Mundo, Elisabeth Solana, Yolanda Blanco, Eugenia Martinez-Hernandez, Maria Sepúlveda, Victor Llorenç, Sergio Prieto-González, Georgina Espígol-Frigolé, Jose C Milisenda, Maria C Cid, Jose M Mascaró, Isabel Blanco, Joan Albert Barberá, Oriol Sibila, Jordi Gratacos-Ginès, Alfredo Adán, Alvaro Agustí, Raimon Sanmartí, Julian Panés, Ricard Cervera, Jordi Vila, Alex Soriano, José A Gómez-Puerta, and Immunocovid Clinic.
• Rheumatology Department, Hospital Clínic, Barcelona, Catalonia, Spain.
• J. Autoimmun. 2021 Feb 1; 117: 102580.

Background And AimThere is increasing interest regarding SARS-CoV-2 infection in patients with autoimmune and immune-mediated inflammatory diseases (AI/IMID) with some discrepancies in different cohorts about their risk and outcomes. The aim was to describe a multidisciplinary cohort of patients with AI/IMID and symptomatic SARS-CoV-2 infection in a single tertiary center and analyze sociodemographic, clinical, and therapeutic factors associated with poor outcomes.MethodsA retrospective observational study was conducted from the 1st of March until May 29th, 2020 in a University tertiary hospital in Barcelona, Spain. Patients with an underlying AI/IMID and symptomatic SARS-CoV-2 infection were identified in our local SARS-CoV-2 infection database. Controls (2:1) were selected from the same database and matched by age and gender. The primary outcome was severe SARS-CoV-2 infection, which was a composite endpoint including admission to the intensive care unit (ICU), need for mechanical ventilation (MV), and/or death. Several covariates including age, sex, and comorbidities among others were combined into a multivariate model having severe SARS-CoV-2 as the dependent variable. Also, a sensitivity analysis was performed evaluating AID and IMID separately.ResultsThe prevalence of symptomatic SARS-CoV-2 infection in a cohort of AI/IMID patients was 1.3%. Eighty-five patients with AI/IMID and symptomatic SARS-CoV-2 were identified, requiring hospitalization in 58 (68%) cases. A total of 175 patients admitted for SARS-CoV-2 (58 with AI/IMID and 117 matched-controls) were analyzed. In logistic regression analysis, a significant inverse association between AI/IMID group and severe SARS-CoV-2 (OR 0.28; 95% CI 0.12-0.61; p = 0.001), need of MV (OR 0.20; IC 95% 0.05-0.71; p = 0.014), and ICU admission (OR 0.25; IC 95% 0.10-0.62; p = 0.003) was found.ConclusionsPatients with AI/IMID who require admission for SARS-CoV-2 infection have a lower risk of developing severe disease, including the need to stay in the ICU and MV.Copyright © 2020 Elsevier Ltd. All rights reserved.

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