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  • Correspondence on ‘Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 global rheumatology alliance physician-reported registry’ by Gianfrancesco M et al. The impact of cardiovascular como…

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Correspondence
Correspondence on ‘Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 global rheumatology alliance physician-reported registry’ by Gianfrancesco M et al. The impact of cardiovascular comorbidity on COVID-19 infection in a large cohort of rheumatoid arthritis patients
  1. Fabio Cacciapaglia1,
  2. Andreina Manfredi2,
  3. Gianluca Erre3,
  4. Matteo Piga4,
  5. Garifallia Sakellariou5,
  6. ombretta viapiana6,
  7. Elisa Gremese7,8,
  8. Francesca Romana Spinelli9,
  9. Fabiola Atzeni10,
  10. Elena Bartoloni11
  1. 1 Rheumatology Unit – Department of Emergence Medicine and Transplantation (DETO), Università degli Studi di Bari Facoltà di Medicina e Chirurgia, Bari, Puglia, Italy
  2. 2 Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy
  3. 3 Specialità Mediche – Azienda Ospedaliero Universitaria di Sassari, UOC Reumatologia, Sassari, Italy
  4. 4 Chair and Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA, Italy
  5. 5 Division of Rheumatology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
  6. 6 Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
  7. 7 Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  8. 8 Institute of Rheumatology, Università Cattolica del Sacro Cuore
  9. 9 Dipartimento di Medicina Interna e Specialità Mediche - Reumatologia, Universita degli Studi di Roma La Sapienza, Roma, Italy
  10. 10 Rheumatology Unit, University of Messina Faculty of Medicine and Surgery, Messina, Sicilia, Italy
  11. 11 Department of Medicine, University of Perugia, Rheumatology Unit, Perugia, Italy
  1. Correspondence to Dr Fabio Cacciapaglia, Rheumatology Unit - Department of Emergence Medicine and Transplantation (DETO), Università degli Studi di Bari Facoltà di Medicina e Chirurgia, Bari, Puglia, Italy; fabio.cacciapaglia79{at}gmail.com

https://doi.org/10.1136/annrheumdis-2020-218813

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    We read with interest the paper published by Gianfrancesco et al 1 describing the epidemiological findings associated with hospitalisation for COVID-19 in 600 patients with rheumatic diseases. Multivariate adjusted models proved a significant increased risk of hospitalisation for older age (>65 years), prednisone doses of ≥10 mg/day and presence of comorbidities, such as cardiovascular (CV) and lung diseases or diabetes. The use of biological or targeted synthetic disease-modifying antirheumatic drug (DMARD) appeared to decrease hospitalisation risk.

    Underlying CV comorbidities seem to increase the susceptibility to SARS-CoV-2 infection and to contribute to myocardial injury, arrhythmia, acute coronary syndrome and venous thromboembolism also in non-rheumatic patients.2 3 Pathophysiological mechanisms underlying cardiac injury in patients with SARS-CoV-2 infection are poorly understood. However, biological features of SARS-CoV-2 and its interaction with the immune system seem to have a pivotal role in organ damage and, in particular, in CV manifestations.3

    Clinical and demographic characteristics of patients with rheumatic disease suffering from COVID-19 have been explored by several Italian groups, with the highest number of COVID-19 cases observed in the North, particularly in Lombardy. In this setting, Fredi et al, on behalf of the Brescia Rheumatology COVID-19 Study Group,4 confirmed that patients with COVID-19 were older and more likely to have arterial hypertension and obesity, while no association with …

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    Footnotes

    • Collaborators Cardiovascular Obesity and Rheumatic DISeases (CORDIS) Study Group of the Italian Society of Rheumatology.

    • Contributors FC designed the study and was responsible for the literature search, data collection, statistical analysis and interpretation, and wrote the manuscript. AM was responsible for the literature search, data collection and interpretation. GE, MP, GS, OV and EG were responsible for data collection and interpretation. FA and FRS were responsible for the literature search, data collection and writing of the final draft. EB was responsible for literature search, data collection, data analysis, data interpretation and writing of the manuscript.

    • 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 involved in the design, or conduct, or reporting or dissemination plans of this research. Refer to the Methods section for further details.

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