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What is the true incidence of COVID-19 in patients with rheumatic diseases?
  1. Ennio Giulio Favalli1,
  2. Francesca Ingegnoli1,2,
  3. Rolando Cimaz2,3,
  4. Roberto Caporali1,2
  1. 1 Division of Clinical Rheumatology, Gaetano Pini-CTO, Milano, Lombardia, Italy
  2. 2 Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milano, Lombardia, Italy
  3. 3 Division of Pediatric Rheumatology, Gaetano Pini-CTO, Milano, Lombardia, Italy
  1. Correspondence to Dr Ennio Giulio Favalli, Division of Clinical Rheumatology, Gaetano Pini-CTO, Milano 20122, Italy; ennio.favalli{at}

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After its emergence in December 2019 in Wuhan, China, the COVID-19 outbreak has now one of its main epicentres in Lombardy (Italy), with more than 50 000 confirmed cases and 9000 deaths. As rheumatologists operating in the same pandemic area (Milan), we read with great interest the letter published by Monti and colleagues1 about the description of COVID-19 among patients with rheumatic diseases treated with biologic disease-modifying drugs (bDMARDs). Certainly, the quantification of the risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and its evolution towards severe interstitial pneumonia leading to acute respiratory distress syndrome (ARDS) is crucial in such a population of fragile patients. To fill this gap, in the same period of health emergency between 25 February and 2 April 2020, we collected data from patients treated with bDMARDs afferent to the Research Center for Adult and Pediatric Rheumatic Diseases of the ASST Gaetano Pini-CTO in Milan, by using a survey investigating the impact of COVID-19. …

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  • Contributors EGF was responsible for data collection and analysis, and drafted and revised the paper. FI collected the data, and drafted and revised the paper. RCi and RCo drafted and revised the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • 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.

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