Comparación entre la primera y la sexta ola de la pandemia por el coronavirus SARS-COV-2 en pacientes con enfermedad inmunomediada / Comparison of the first and sixth waves of the SARS-COV-2 coronavirus pandemic in patients with immune-mediated disease

Introducción: Las últimas evidencias revelan que la infección por COVID-19 no tienen peor pronóstico en los pacientes con enfermedades inflamatorias inmunomediadas (EIMI), aunque desarrollan menor respuesta a la vacunación. Objetivo: Comparar la incidencia de COVID-19 y características clínicas en pacientes con EIMI entre la primera y sexta olas. Método: Estudio observacional prospectivo de 2 cohortes de pacientes con EIMI diagnosticados de COVID-19. Primera cohorte: marzo-mayo de 2020; segunda cohorte: diciembre/2021 a febrero/2022. Se recogieron variables sociodemográficas y clínicas, y en la segunda cohorte el estado de vacunación contra la COVID-19. El análisis estadístico estableció las diferencias de las características y la evolución clínica entre ambas cohortes. Resultados: De un total de 1.627 pacientes en seguimiento, contrajeron COVID-19 durante la primera ola 77 (4,60%) y 184 en la sexta (11,3%). En la sexta hubo menos hospitalizaciones, ingresos en cuidados intensivos y fallecimientos que en la primera (p=0,000) y 180 pacientes (97,8%) tenían al menos una dosis de vacuna. Conclusión: La detección precoz y la vacunación han evitado la aparición de complicaciones graves.(AU)

Introduction: Recent evidence shows that COVID-19 infection does not have a worse prognosis in patients with immune-mediated inflammatory diseases (IMID), although they develop a worse response to vaccination. Objective:To compare the incidence of COVID-19 and clinical features in patients with IMID between the first and sixth waves. Method: Prospective observational study of two cohorts of IMID patients diagnosed with COVID-19. First cohort March to May 2020, and second cohort December/2021 to February/2022. Sociodemographic and clinical variables were collected and, in the second cohort, COVID-19 vaccination status. Statistical analysis established differences in characteristics and clinical course between the two cohorts. Results: In total, 1627 patients were followed up, of whom 77 (4.60%) contracted COVID-19 during the first wave and 184 in the sixth wave (11.3%). In the sixth wave, there were fewer hospitalisations, intensive care unit admissions, and deaths than in the first wave (P=.000) and 180 patients (97.8%) had at least one dose of vaccine. Conclusion: Early detection and vaccination have prevented the occurrence of serious complications.(AU)

Comparison of the first and sixth waves of the SARS-COV-2 coronavirus pandemic in patients with immune-mediated disease.

INTRODUCTION: Recent evidence shows that COVID-19 infection does not have a worse prognosis in patients with immune-mediated inflammatory diseases (IMID), although they develop a worse response to vaccination. OBJECTIVE: To compare the incidence of COVID-19 and clinical features in patients with IMID between the first and sixth waves. METHOD: Prospective observational study of two cohorts of IMID patients diagnosed with COVID-19. First cohort March to May 2020, and second cohort December/2021 to February/2022. Sociodemographic and clinical variables were collected and, in the second cohort, COVID-19 vaccination status. Statistical analysis established differences in characteristics and clinical course between the two cohorts. RESULTS: In total, 1627 patients were followed up, of whom 77 (4.60%) contracted COVID-19 during the first wave and 184 in the sixth wave (11.3%). In the sixth wave, there were fewer hospitalisations, intensive care unit admissions, and deaths than in the first wave (p=.000) and 180 patients (97.8%) had at least one dose of vaccine. CONCLUSION: Early detection and vaccination have prevented the occurrence of serious complications.

Development and feasibility of 4 checklists for the evaluation of comorbidity in patients with rheumatoid arthritis, axial spondyloarthritis and psoriatic arthritis: GECOAI Project.

OBJECTIVE: To develop and assess the feasibility in daily practice of four comorbidity checklists, for common use in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). METHODS: A multidisciplinary panel of experts on comorbidity was established. Data from the GECOAR, GECOAX and GECOAP projects were analysed and a narrative literature review in Medline on RA, axSpA and PsA comorbidity was performed in order to select the most relevant and common comorbidities across the three diseases. With these results and those obtained from a focus group of patients, in a nominal group meeting, the experts generated preliminary checklists. These were afterwards modified by an external evaluation by two associations, a patients' association and an association of health professionals related to rheumatology. As a result, the final checklists were generated. A cross-sectional study was conducted to test the feasibility of three of the checklists in daily practice, in which eight health professionals evaluated the checklists in five patients with RA, five with axSpA and five with SpA. RESULTS: Four comorbidity checklists were designed, three for health professionals (one to assess current comorbidity, one on prevention/health promotion and one with the referral criteria to other health professionals), and another for patients. The feasibility study showed them to be simple, clear, and useful for use in routine clinical practice. CONCLUSIONS: The use of specific and common checklists for patients with RA, axSpA and PsA is feasible and might contribute favorably to their prognosis as well as in daily practice.

Características clínicas de los pacientes con enfermedades inmunomediadas inflamatorias afectados por Covid-19 / Clinical characteristics of patients with affected inflammatory immunemediated diseases by Covid-19

Objetivo principal: Describir la incidencia de Covid-19 por sexo y especialidad en pacientes con Enfermedad Inmunomediada Inflamatoria (EIMI). Metodología: Estudio observacional prospectivo de pacientes en seguimiento/tratamiento en un Centro de Enfermedades Inmuno-mediadas Inflamatorias, de marzo a junio de 2020. Resultados: El total de pacientes en seguimiento era de 1672, se realizaron 3480 consultas, siendo telemáticas 2382(68.4 %). Se confirmaron 77(4.60 %) casos de Covid-19, siendo mujeres 40 (51.98 %). Los síntomas prevalentes fueron: tos seca (81.8 %), mialgias/artralgias (77.9 %), cefalea (68.8 %), fiebre (55.8 %) y neumonía (22.4 %). Se encontraron diferencias en los síntomas por especialidad: mialgias/artralgias (p=0.001), cefalea (p=0.011), fiebre (p=0.012). Necesitaron hospitalización 17 pacientes (22.10 %) y 3 (17.65 %) en Cuidados Intensivos. Conclusión: La terapia con fármacos biológicos no se asoció con peores resultados de Covid-19. Las consultas telemáticas realizada por Enfermeras de Práctica Avanzada garantizaron el seguimiento óptimo, la detección precoz y la continuidad del tratamiento.(AU)

Objective: Describe the incidence of Covid-19 by sex and specialty in patients with Immune-Mediated Inflammatory Disease (IMID). Methods: Prospective observational study of patients in treatment at a Centre for Immune-Mediated Inflammatory Diseases, march to june 2020. Results: The patients in follow-up were 1672, 3480 consultations were carried out, 2382 were telematic (68.4 %). The cases of covid-19 were 77 (4.60 %), were women 40 (51.98 %). The prevalent symptoms were: seca (81.8 %), myalgia/arthralgia (77.9 %), headache (68.8 %), fever (55.8 %) and pneumonia (22.4 %). Statistical differences were found in symptoms by specialty: myalgia / arthralgia (p=0.001), headache (p=0.011), fever (p=0.012). Hospital admission was required in 17 (22.10 %) patients and 3 (17.65 %) in the Intensive Care Unit. Conclusions: Biological drug therapy was not associated with worse Covid-19 outcomes. Telematic consultations carried out by Advanced Nurse Practitioner ensured optimal follow-up, early detection and continuity of treatment.(AU)

Development and feasibility of 4 checklists for the evaluation of comorbidity in patients with rheumatoid arthritis, axial spondyloarthritis and psoriatic arthritis: GECOAI Project. / Desarrollo y viabilidad de cuatro checklists para la evaluación de la comorbilidad en pacientes con artritis reumatoide, espondiloartritis axial y artritis psoriásica: Proyecto GECOAI.

OBJECTIVE: To develop and assess the feasibility in daily practice of four comorbidity checklists, for common use in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). METHODS: A multidisciplinary panel of experts on comorbidity was established. Data from the GECOAR, GECOAX and GECOAP projects were analysed and a narrative literature review in Medline on RA, axSpA and PsA comorbidity was performed in order to select the most relevant and common comorbidities across the three diseases. With these results and those obtained from a focus group of patients, in a nominal group meeting, the experts generated preliminary checklists. These were afterwards modified by an external evaluation by two associations, a patients' association and an association of health professionals related to rheumatology. As a result, the final checklists were generated. A cross-sectional study was conducted to test the feasibility of three of the checklists in daily practice, in which eight health professionals evaluated the checklists in five patients with RA, five with axSpA and five with SpA. RESULTS: Four comorbidity checklists were designed, three for health professionals (one to assess current comorbidity, one on prevention/health promotion and one with the referral criteria to other health professionals), and another for patients. The feasibility study showed them to be simple, clear, and useful for use in routine clinical practice. CONCLUSIONS: The use of specific and common checklists for patients with RA, axSpA and PsA is feasible and might contribute favorably to their prognosis as well as in daily practice.