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Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors
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  1. Vega Jovani1,
  2. Irene Calabuig1,
  3. Maria Luisa Peral-Garrido1,
  4. Ernesto Tovar-Sugrañes1,
  5. María-del-Carmen López-González1,
  6. Pilar Bernabeu1,
  7. Agustín Martínez1,
  8. Joaquim Esteve-Vives1,
  9. Jose-Manuel León-Ramírez2,
  10. Oscar Moreno-Perez3,4,
  11. Vicente Boix4,5,
  12. Joan Gil2,
  13. Esperanza Merino5,
  14. Paloma Vela1,4,
  15. Mariano Andrés1,4
  1. 1 Reumatología, Hospital General Universitario de Alicante, Alicante, Spain
  2. 2 Neumología, Hospital General Universitario de Alicante, Alicante, Spain
  3. 3 Endocrinologia y Nutricion, Hospital General Universitario de Alicante, Alicante, Spain
  4. 4 Medicina Clínica, Universidad Miguel Hernandez de Elche, Elche, Spain
  5. 5 Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, Spain
  1. Correspondence to Dr Vega Jovani, Reumatología, Hospital General Universitario de Alicante, Alicante, Spain; vegajovani{at}gmail.com

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The recent outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for COVID-19, has brought about a great concern for the management of patients with inflammatory rheumatic diseases. Rheumatologists and patients are worried about the risk of contagion and suffering a more severe disease, derived from immunosuppressive treatment. Also, for the risk of relapse in case of discontinuing medications. To date, most of these questions remain to be answered.

Accordingly, we read with interest the recent paper from D’Silva and coauthors.1 They analysed the outcomes of 52 patients with rheumatic diseases (18 under biologics or targeted synthetic disease-modifying antirheumatic drugs (DMARDs)) hospitalised for COVID-19, identifying an independent increased risk of intubation and similar to mortality. These results are welcome and of relevance, but some issues need to be commented. Controls were matched for age, gender and disease duration, but multivariate models repeated adjustment for age. For outcome assessment in COVID-19, some laboratory markers—lymphopenia, troponins2— should have been considered as covariates for the …

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