Features of the clinical course of rheumatic diseases in patients who have had a new coronavirus infection


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Material and methods. The clinical course of IRD was analyzed in 324 patients who underwent new coronavirus infection (NCI) from March 2020 to February 2021 and were treated at Clinical Rheumatology Hospital No.25 (Saint Petersburg) for exacerbation of the underlying disease. Results. The risk factors of severe COVID-19 course in IRD were: age older than 60 years, presence of comorbid conditions (CHD, CHF, COPD), use of glucocorticoids in dose more than 12,5 mg/ day and erythrocyte sedimentation rate values s40 mm/h before development of NCI. The use of immunosuppressive therapy and biological therapy had no effect on the worsening of the course of the viral infection in patients with IRD. The development of postcovid syndrome (asthenia, dyspnea, weight loss, memory loss) was noted in 1/4 of the patients. Postcovid articular syndrome was characterized by the formation of arthritis associated with viral infection in 3,6% of patients, transformation of undifferentiated arthritis (UDA) into specific nosological forms in 49% (more often into early rheumatoid arthritis), and exacerbation of joint syndrome in 83,4% of patients with advanced stage rheumatoid arthritis. In patients with diffuse connective tissue disease, a significant increase in immunological activity due to antinuclear antibodies (maximum 1:163840) was noted. Along with the results of the study, the article presents clinical cases of the development of arthritis associated with a viral infection and death in systemic scleroderma and interstitial lung damage after COVID-19. Conclusion. In the cohort of patients with IRD observed at Clinical Rheumatology Hospital No. 25 (Saint Petersburg), COVID-19 had moderate and severe course in half of patients, initiated the development of pneumonic complications in 68,6% of patients, arthritis associated with viral infection in 3,6%, UDA transformation into IRD in 49% and exacerbation of the main disease in the overwhelming number of patients. Patients with diffuse connective tissue disease with interstitial lung damage have a high risk of adverse outcome of NCI and require dynamic monitoring by primary care physicians.

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作者简介

Vadim Mazurov

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

Email: maz.nwgmu@yandex.ru
MD, professor, academician of RAS, Honored worker of science of Russian Federation, Director of the Research Institute of Rheumatology; head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Irina Belyaeva

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

MD, professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Lyubov Sarantseva

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

senior laboratory assistant of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald; rheumatologist

Anton Chudinov

Clinical Rheumatology Hospital No. 25, Saint Petersburg

PhD, head of the Center of biologic therapies

Roman Bashkinov

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

Email: evgeniy.trofimov@szgmu.ru
postgraduate student at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Evgeny Trofimov

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia

PhD, Deputy Director of the Research Institute of Rheumatology; associate professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Inna Gaydukova

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

MD, Deputy Director of the Research Institute of Rheumatology; professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Olga Smulskaya

Clinical Rheumatology Hospital No. 25, Saint Petersburg

PhD, rheumatologist

Oksana Inamova

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

PhD, Chief physician of Clinical Rheumatology Hospital No. 25 (Saint Petersburg), Deputy Director of the Research Institute of Rheumatology; assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Marianna Petrova

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

PhD, Deputy Chief physician of Clinical Rheumatology Hospital No. 25 (Saint Petersburg), Head of the «City Clinical Center for Gout» of Saint Petersburg, associate professor of at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald

Yulia Khokhlova

Clinical Rheumatology Hospital No. 25, Saint Petersburg

rheumatologist

Elizaveta Vasilenko

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

PhD, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald; rheumatologist

Evgeny Melnikov

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25, Saint Petersburg

Email: melnikovzhenya@mail.ru
postgraduate student at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald; rheumatologist

参考

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