Journal Article

A deep look into the storm: Israeli multi-center experience of coronavirus disease 2019 (COVID-19) in patients with autoimmune inflammatory rheumatic diseases before and after vaccinations

Agmon-Levin, Nancy, Beshara-Garzuzi, Rima, Tavor, Yonit, Feld, Joy, Peleg, Hagit, Brodavka, Michal, Paran, Daphna, Elkayam, Ori, Elias, Muna, Molad, Yair, Kharouf, Fadi, Dagan, Amir, Giryes, Sami, Braun, Maya, Reitblatt, Tatiana, Zloof, Yair, Breuer, Gabriel S., Oren, Shirly, Markovits, Doron, Mevorach, Dror, Haddad, Amir, Pokroy-Shapira, Elisheva, Braun-Moscovici, Yolanda, Amit-Vazina, Mirit, Lidar, Merav, Sabbah, Firas, Toledano, Kochava, Rubin, Limor, Eviatar, Tali, Zisman, Devy, Gazitt, Tal, Tayer-Shifman, Oshrat, Balbir-Gurman, Alexandra

2023

Overview

We aimed to characterize the course of COVID-19 in autoimmune inflammatory rheumatic disease (AIIRD) patients in Israel, taking into consideration several remarkable aspects, including the outcomes of the different outbreaks, the effect of vaccination campaigns, and AIIRD activity post-recovery. We established a national registry of AIIRD patients diagnosed with COVID-19, including demographic data, AIIRD diagnosis, duration and systemic involvement, comorbidities, date of COVID-19 diagnosis, clinical course, and dates of vaccinations. COVID-19 was diagnosed by a positive SARS-CoV-2 polymerase chain reaction. Israel experienced 4 outbreaks of COVID-19 until 30.11.2021. The first three outbreaks (1.3.2020 - 30.4.2021) comprised 298 AIIRD patients. 64.9% had a mild disease and 24.2% had a severe course; 161 (53.3%) patients were hospitalized, 27 (8.9%) died. The 4 outbreak (delta variant), starting 6 months after the beginning of the vaccination campaign comprised 110 patients. Despite similar demographic and clinical characteristics, a smaller proportion of AIIRD patients had negative outcomes as compared to the first 3 outbreaks, with regards to severity (16 patients,14.5%), hospitalization (29 patients, 26.4%) and death (7 patients, 6.4%). COVID-19 did not seem to influence the AIIRD activity 1-3 months post-recovery. COVID-19 is more severe and has an increased mortality in active AIIRD patients with systemic involvement, older age and comorbidities. Vaccination with 3 doses of the mRNA vaccine against SARS-CoV-2 protected from severe COVID-19, hospitalization and death during the 4 outbreak. The pattern of spread of COVID-19 in AIIRD patients was similar to the general population.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: AIIRD / autoimmune inflammatory rheumatic disease / Chi-square test / Comorbidity / Coronaviruses / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / COVID-19 Testing / COVID-19 Vaccines / COVID-19, coronavirus disease 2019 / Data collection / Demography / Diabetes / Diagnosis / Epidemics / Fatalities / Hospitalization / Humans / Hypertension / Illnesses / Immunology / Independent sample / Israel - epidemiology / Lung diseases / Mortality / mRNA / mRNA vaccines / Outbreaks / Pandemics / Population / Regression analysis / Rheumatic diseases / Rheumatic Diseases - epidemiology / Rheumatology / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Software / Statistical analysis / Steroids / Vaccination / Variables