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分析 SARS-CoV-2 感染后 RA 发作的相关因素:一项来自患者调查的回顾性研究。

Analysis of related factors for RA flares after SARS-CoV-2 infection: a retrospective study from patient survey.

机构信息

Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China.

Department of Clinical Epidemiology and Evidence-Based Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China.

出版信息

Sci Rep. 2024 Feb 20;14(1):4243. doi: 10.1038/s41598-024-52748-3.

Abstract

SARS-CoV-2 and its variants are widely prevalent worldwide. With frequent secondary and breakthrough infections, immune dysfunction in RA patients, and long-term use of immune preparations, SARS-CoV-2 infection poses a significant challenge to patients and rheumatologists. Whether SARS-CoV-2 infection causes RA flares and what factors aggravate RA flares are poorly studied. A questionnaire survey was conducted on RA patients infected with SARS-CoV-2 after December 7, 2022, in China through a multicenter and inter-network platform regarding general personal condition, primary disease, comorbidity, SARS-CoV-2 vaccination, viral infection, and impact on the primary disease. A total of 306 RA patients were included in this study, and the patient data were analyzed, in which the general condition of RA patients, medication use before SARS-CoV-2 infection and post-infection typing and manifestations, and medication adjustment did not affect the Flare of RA patients after SARS-CoV-2 infection. The control of disease before SARS-CoV-2 infection (OR = 2.10), RA involving pulmonary lesions (OR = 2.28), and the recovery time of COVID-19 (OR = 2.50) were risk factors for RA flare. RA involving pulmonary lesions, control status of disease before infection, and recovery time of COVID-19 disease are risk factors for RA flare after SARS-CoV-2 infection.

摘要

SARS-CoV-2 及其变体在全球广泛流行。由于 RA 患者存在免疫功能障碍,且经常发生二次感染和突破性感染,再加上长期使用免疫制剂,SARS-CoV-2 感染对患者和风湿病医生构成了重大挑战。SARS-CoV-2 感染是否会引发 RA 发作,以及哪些因素会加重 RA 发作,这些问题的研究还不够充分。本研究通过多中心、跨网络平台,对 2022 年 12 月 7 日后中国感染 SARS-CoV-2 的 RA 患者进行了一般个人情况、原发性疾病、合并症、SARS-CoV-2 疫苗接种、病毒感染以及对原发性疾病影响的问卷调查。共纳入 306 例 RA 患者,对患者数据进行分析,发现 RA 患者的一般情况、感染 SARS-CoV-2 前的用药情况以及感染后的分型和表现、药物调整均不会影响 SARS-CoV-2 感染后 RA 患者的发作。感染 SARS-CoV-2 前疾病的控制情况(OR=2.10)、累及肺部病变的 RA(OR=2.28)和 COVID-19 康复时间(OR=2.50)是 RA 发作的危险因素。累及肺部病变、感染前疾病控制状况和 COVID-19 疾病康复时间是 SARS-CoV-2 感染后 RA 发作的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9575/10879520/362c781eee85/41598_2024_52748_Fig1_HTML.jpg

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