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