Complicações da infecção pelo SARS-CoV-2 na atividade da doença de pacientes portadores de artrite reumatoide atendidos em um serviço de reumatologia no Estado do Amazonas

Abstract

Introduction: The ReumaCOV-Brazil project was a multicenter study provided by the Brazilian Society of Rheumatology with the objective of identifying the behavior of immunemediated rheumatic diseases (IMRD) in the face of COVID-19 infection. It had a prospective, longitudinal design with 1,300 patients, 641 of whom had rheumatoid arthritis (RA). Demographic, epidemiological, clinical, morbid outcomes, and lethality variables were observed. The present work is a post-hoc evaluation of the ReumaCoV-Brazil project database, focusing on the 51 patients with rheumatoid arthritis (RA) enrolled in the study in the State of Amazonas. Objectives: The primary objective was to assess the complications of COVID-19 infection on the activity of RA patients being cared for in the rheumatology service in the state of Amazonas. Secondary objectives: Describe the sociodemographic aspects of patients with RA; to compare disease activity in RA patients infected and not infected with the coronavirus - SARS-CoV-2; to verify complications of infection on the clinical outcomes of RA.Methods: A case-control design was used, comparing patients with RA and COVID-19 (case group) against patients with RA without COVID-19 (control group). Patients immunosuppressed by other causes (cancer, HIV, transplant recipients) were excluded. Results: Of the 51 patients with RA analyzed, there were 44 women and 7 men. Nineteen had COVID-19 (all women) and 32 did not. The mean age was 54 ± 13 years; comorbidities, smoking, alcohol consumption, medications in use, COVID-19 severity indicators, and RA severity indicators (DAS-28) did not show statistically significant differences between cases and controls. Conclusions: The study did not demonstrate an impact of SARS-CoV-2 infection on rheumatoid arthritis activity. The sociodemographic aspects of our sample were in agreement with those described in the literature, regarding gender, age group, and comorbidities. Disease activity parameters (DAS28, PGA) did not show significant differences between cases and controls. Patients infected with COVID-19 did not present unfavorable clinical outcomes, such as mechanical ventilation and death.