Background In patients with ANCA associated vasculitis (AAV) a higher mortality rate due to COVID-19 has been observed compared to general population1.
Objectives We aimed to evaluate the frequency and severity of COVID-19 in a well-defined AAV cohort.
Methods Medical records of AAV cases diagnosed at our secondary/tertiary rheumatology center between January 2010 and February 2020 and followed during the COVID-19 pandemic between March 2020 and November 2021 were analyzed.
Results During the 122-month period, AAV was newly diagnosed in 117 patients. Fifteen patients died before the beginning of COVID-19 pandemic. Of the remaining 102 patients (68.8% females, 42 (41.2%) GPA; 32 (31.4%) MPA; 19 (18.6%) EGPA and 8 (7.8%) not further clinically subclassified AAV), SARS-CoV-2 infection was documented by PCR test in 11 (10.8%) patients (9 (81.8%) females; mean (SD) patient age at COVID-19 65.3 (±20.4) years; 7 GPA and 4 MPA). Five patients had mild COVID-19 symptomatically treated at home, and 6 patients had severe infection. Clinical features of COVID-19 are presented in Table 1. Three patients (27.3%) died due to COVID-19. There were 5 additional deaths of AAV patients during pandemic period, all these related to cancer progression.
At the time of diagnosed COVID-19, AAV was in remission in 10 patients and relapsed 2 months prior in one patient. All patients except one were receiving immunomodulatory treatment (steroids only 2; DMARDs only 4; steroids + DMARDs 4).
Of the 97 patients eligible for vaccination against COVID-19 (5 AAV patients died before vaccines against SARS-CoV-2 were available), 79 (81.4%) received by the end of November 2021 at least one dose, including 2 patients that later developed COVID-19 (both fully vaccinated; 2.5% breakthrough rate).
Conclusion Our study shows that COVID-19 heralds a poor prognosis in AAV, with over 50% patients having severe disease and 25% deaths.
References Kronbichler A, et al. Autoimmun Rev 2021 doi: 10.1016/j.autrev.2021.102986
Disclosure of Interests None declared
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