• Turk J Med Sci · Jan 2024

    Multicenter Study

    Clinical characteristics and disease course before and after SARS-CoV-2 infection in a large cohort of systemic sclerosis patients.

    • Aslıhan Avanoglu Güler, Büşra Özçimen, Mesude Seda Aydoğdu, Alper Sari, Aliyeva Numune, Nazife Tüzün Ersan, Seda Çolak, Hazan Karadeniz, İbrahim Vasi, Hamit Küçük, Yasemin Yalçinkaya, Abdülsamet Erden, Mehmet Kayaalp, Mehmet Akif Öztürk, Berna Göker, Ahmet Omma, Sedat Yilmaz, Süleyman Serdar Koca, Murat Inanç, Ali Akdoğan, and Abdurrahman Tufan.
    • Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkiye.
    • Turk J Med Sci. 2024 Jan 1; 54 (1): 768576-85.

    Background/AimThe objective of this study is to evaluate the clinical presentations and adverse outcomes of Coronavirus Disease 2019 (COVID-19) in patients with systemic sclerosis (SSc) and assess the impact of SSc features on the clinical course of COVID-19.Materials And MethodsIn this multicenter, retrospective study, SSc patients with COVID-19 were included. Clinical features of SSc, along with detailed COVID-19 data, were extracted from medical records and patient interviews.ResultsThe study included 112 patients (mean age 51.4 ± 12.8 years; 90.2% female). SSc-associated interstitial lung disease (ILD) was evident in 57.1% of the patients. The findings revealed hospitalization in 25.5%, respiratory support in 16.3%, intensive care unit admission in 3.6%, and a mortality rate of 2.7% among SSc patients with COVID-19. Risk factors for respiratory failure, identified through univariate analysis, included ILD (OR: 7.49, 95% CI: 1.63-34.46), ≥1 comorbidity (OR: 4.55, 95% CI: 1.39-14.88), a higher physician global assessment score at the last outpatient visit (OR 2.73, 95% CI: 1.22-6.10), and the use of mycophenolate at the time of infection (OR: 5.16, 95 %CI: 1.79-14.99). Notably, ≥1 comorbidity emerged as the sole significant predictor of the need for respiratory support in COVID-19 (OR: 5.78, 95% CI: 1.14-29.23). In the early post-COVID-19 period, 17% of patients reported the progression of the Raynaud phenomenon, and 10.6% developed new digital ulcers. Furthermore, progression or new onset of dyspnea and cough were detected in 28.3% and 11.4% of patients, respectively.ConclusionThis study suggests a potential association between adverse outcomes of COVID-19 and SSc-related ILD, severe disease activity, and the use of mycophenolate. Additionally, it highlights that having comorbidities is an independent risk factor for the need for respiratory support in COVID-19 cases.© TÜBİTAK.

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