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Clinical characteristics of 17 patients with COVID-19 and systemic autoimmune diseases: a retrospective study
  1. Yao Huang1,
  2. Zhe Chen2,
  3. Yu Wang2,
  4. Liang Han1,
  5. Kai Qin2,
  6. Wenya Huang2,
  7. Ying Huang2,
  8. Hui Wang1,
  9. Pan Shen1,
  10. Xin Ba1,
  11. Weiji Lin1,
  12. Hui Dong2,
  13. Mingmin Zhang2,
  14. Shenghao Tu2
  1. 1 Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
  2. 2 Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
  1. Correspondence to Professor Shenghao Tu, Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China; shtu{at}tjh.tjmu.edu.cn

Abstract

Objectives Increasing data about COVID-19 have been acquired from the general population. We aim to further evaluate the clinical characteristics of COVID-19 in patients with systemic autoimmune diseases (AIDs).

Methods We included all confirmed inpatients with COVID-19 and systemic AIDs in Wuhan Tongji Hospital from 29 January to 8 March 2020. We retrospectively collected and analysed information on epidemiology of 1255 inpatients and additional clinical characteristics of patients with systemic AIDs. Outcomes were followed up until 16 April 2020.

Results Of the 1255 patients with COVID-19, the median age was 64.0 years and 53.1% were male. More than half (63.0%) had chronic comorbidities. The proportions of elderly, male and patients with comorbidities were significantly higher in intensive care unit (ICU) than in the general ward (p<0.001). 17 (0.61%) patients with systemic AIDs were further screened and analysed from 2804 inpatients. The median age was 64.0 years and 82.4% were female. All patients were living in Wuhan and two family clusters were found. 1 (5.9%) patient was admitted to ICU and one died. 10 (62.5%) of 16 patients changed or stopped their anti-AIDs treatments during hospitalisation, and 5 of them felt that the disease had worsened after the quarantine.

Conclusions Older males with chronic comorbidities are more vulnerable to severe COVID-19. The lower proportion of COVID-19 in patients with systemic AIDs needs more high-quality human clinical trials and in-depth mechanism researches. Of note, the withdrawal of anti-AIDs treatments during hospitalisation can lead to flares of diseases.

  • autoimmune diseases
  • epidemiology
  • hydroxychloroquine
  • glucocorticoids

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Footnotes

  • Handling editor Josef S Smolen

  • YH and ZC contributed equally.

  • Contributors YH and ZC collected the data and performed the analysis, and YH wrote the article. YW, LH, KQ, WH and YH gave advice on the study. HW, PS, XB and WL helped to analyse data. HD and MZ helped to revise the paper. ST solved the discrepancies and gave advice on the study.

  • Funding This article was supported by the National Natural Science Foundation of China (No. 81573802, 81503426, 81874383).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Ethics Commission of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (TJ-IRB20200365). Written informed consent was waived by Tongji Hospital for emerging infectious diseases and the urgent need to collect data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request by email to shtu@tjh.tjmu.edu.cn.