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Serological tests confirm the low incidence of COVID-19 in chronic rheumatic inflammatory diseases treated with biological DMARD
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  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}tiscali.it

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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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