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Serological tests confirm the low incidence of COVID-19 in chronic rheumatic inflammatory diseases treated with biological DMARD
  1. Maurizio Benucci1,
  2. Arianna Damiani2,
  3. Gianfranco Giannasi3,
  4. Francesca Li Gobbi1,
  5. Luca Quartuccio4,
  6. Valentina Grossi5,
  7. Maria Infantino5,
  8. Mariangela Manfredi5
  1. 1 Rheumatology Unit, S Giovanni di Dio Hospital, Azienda USL-Toscana Centro, Florence, Italy
  2. 2 Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
  3. 3 Emergency Department and Covid Unit, S Giovanni di DioHospital, Azienda USL-Toscana Centro, Florence, Italy
  4. 4 Clinic of Rheumatology, Department of Medicine (DAME), ASUFC, Udine, Italy
  5. 5 Immunology and Allergology Laboratory, S.Giovanni di DioHospital, Azienda USL-Toscana Centro, Florence, Italy
  1. Correspondence to Dr Maurizio Benucci, Rheumatology Unit, Ospedale San Giovanni di Dio, Firenze 50143, Toscana, Italy; maubenucci{at}

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We read the interesting epidemiological study on 600 patients with rheumatic diseases hospitalised for COVID-19 infection (COVID-19 Global Rheumatology Alliance Registry) published by Gianfrancesco et al.1 Data analysis showed a slightly increased risk of hospitalisation for prednisone doses of ≥10 mg, while biological disease-modifying anti-rheumatic drug (b-DMARD)/targeted synthetic disease-modifying anti-rheumatic drug (ts-DMARD) monotherapy just prior to COVID-19 diagnosis appeared protective, in particular, the tumour necrosis factor targeting agents, as result of a subsequent subanalysis. The epidemiological impact of COVID-19 in patients with rheumatic diseases being treated with b-DMARD has been the subject of several reports by Italian groups. In the first report, only 4 cases were confirmed through rhinopharyngeal swabs out of 320 observed cases.2 In another study assessed in the emergency period in Lombardy through visit or phone contact, only 3 cases through rhinopharyngeal swabs out of 520 cases were confirmed.3 Another study of 859 patients in another rheumatology centre in Tuscany, which applied a phone contact methodology, identified only 2 patients suffering from COVID-19 pneumonia.4 As part of the Tuscany population serological screening, the Incidence COVID-19-Rheumatic Disease–Biologics study has been planned. …

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