• Olga Vera-Lastra, Erik Cimé-Aké, Ordinola NavarroAlbertoADepartment of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.Department of High Specialty Medical Unit, Antonio Fraga Mouret National Medical Center, La Raza, , Joel Eduardo Morales-Gutiérrez, Orestes de Jesús Cobos-Quevedo, Jorge Hurtado-Díaz, María Lucero Espinoza-Sánchez, Ana Lilia Peralta-Amaro, María Pilar Cruz-Domínguez, Gabriela Medina, Antonio Fraga-Mouret, Jesus Sepulveda-Delgado, and Luis J Jara.
• Department of Internal Medicine and Pathological Anatomy, Antonio Fraga Mouret National Medical Center, La Raza, México City, Mexico.
• Isr Med Assoc J. 2022 May 1; 24 (5): 299-305.

BackgroundPatients with autoimmune disease (AID) and coronavirus disease 2019 (COVID-19) could have higher mortality due to the co-morbidity and the use of immunosuppressive therapy.ObjectivesTo analyze the risk factors and outcomes of patients with AID and COVID-19 versus a control group.MethodsA prospective cohort study included patients with and without AID and COVID-19. Patients were paired by age and sex. Clinical, biochemical, immunological treatments, and outcomes (days of hospital stay, invasive mechanical ventilation [IMV], oxygen at discharge, and death) were collected.ResultsWe included 226 COVID-19 patients: 113 with AID (51.15 ± 14.3 years) and 113 controls (53.45 ± 13.3 years). The most frequent AIDs were Rheumatoid arthritis (26.5%), systemic lupus erythematosus (21%), and systemic sclerosis (14%). AID patients had lower lactate dehydrogenas, C-reactive protein, fibrinogen, IMV (P = 0.027), and oxygen levels at discharge (P ≤ 0.0001) and lower death rates (P ≤ 0.0001). Oxygen saturation (SaO2) ≤ 88% at hospitalization provided risk for IMV (RR [relative risk] 3.83, 95% confidence interval [95%CI] 1.1-13.6, P = 0.038). Higher creatinine and LDH levels were associated with death in the AID group. SaO2 ≤ 88% and CO-RADS ≥ 4 were risk factors for in-hospital mortality (RR 4.90, 95%CI 1.8-13.0, P = 0.001 and RR 7.60, 95%CI 1.4-39.7, P = 0.016, respectively). Anticoagulant therapy was protective (RR 0.36, 95%CI 0.1-0.9, P = 0.041).ConclusionsPatients with AID had better outcomes with COVID-19 than controls. Anticoagulation was associated with a lower death in patients with AID.

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