FACTORS ASSOCIATED WITH THE RISK OF INFECTION AND HOSPITALIZATION BY SARS-COV-2 IN RHEUMATIC PATIENT
SARS-CoV-2 infection in rheumatic patients
DOI:
https://doi.org/10.13037/2359-4330.8335Keywords:
Covid-19. Doenças Reumáticas. Imunossupressão., Covid-19. Rheumatic Diseases. Immunosuppression.Abstract
INTRODUCTION: The severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) presents clinical heterogeneity, depending on the singularities of the individuals. Rheumatic diseases, which course with immunological alterations, in addition to requiring immunomodulatory therapy for their control, end up influencing the responsiveness to SARS-CoV-2 infection. However, this association, as well as the risk and severity factors, have not been clearly elucidated. PURPOSE: to analyze the factors associated with infection and hospitalization of rheumatologic patients by SARS-Cov-2. MATERIALS AND METHODS: This is a narrative literature review, which used the PUBMED, Science Direct and the Regional Portal of the Virtual Health Library (VHL) databases, with the descriptors “Covid-19”, “Rheumatic Disease”and "Immunosuppression". 11 scientific productions were selected to compose this review. RESULTS: Rheumatic disease was not associated with increased susceptibility to infection/hospitalization by SARS-Cov-2. Regarding demographic factors, the association with increased risk of illness/hospitalization due to Covid-19 was not convergent. Comorbidities were identified as a factor of greater propensity for viral infection, as for anti-rheumatic drugs, there were divergences. CONCLUSIONS: Rheumatology patients had similar susceptibility to infection/hospitalization than the general population. Advanced age and the presence of comorbidities are factors associated with an increased risk of serious infection and hospitalization for Covid-19. As for immunosuppressive therapy, patients using Rituximab or glucocorticosteroids chronically have a higher rate of hospitalization and severe Covid-19 infection, with the former also increasing the risk of death. The use of anti-TNF alpha, on the other hand, has a protective effect.
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