.: ORİJİNAL ARAŞTIRMA
Evaluation of Systemic Autoimmune Rheumatic Autoantibodies in post-COVID-19 Patients and Their Impact on Clinical Outcomes: A Retrospective-Cohort Study
COVID-19 Geçiren Hastalarda Sistemik Otoimmün Romatizmal Otoantikorların Değerlendirilmesi ve Bunların Klinik Sonuçlar Üzerindeki Etkisi: Retrospektif Kohort Bir Çalışma
Turkiye Klinikleri J Med Sci. 2025;45(2):66-76
doi: 10.5336/medsci.2024-105195
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: The role of systemic autoimmunity in post-coronavirus disease-2019 (COVID-19) patients from real-world data is still unknown. The aim of our study was to evaluate the presence of rheumatic and antiphospholipid antibodies in post-COVID-19 patients and examine their frequencies and the clinical outcomes. Material and Methods: The data of 393 people who had COVID-19 and were followed up in our outpatient clinic were retrospectively analyzed. In our descriptive study, clinical and biochemical parameters as well as the presence of antinuclear antibodies, antiphospholipid antibodies, romatoid factor and immunoglobulin G cyclic citrullinated peptide 3rd generation were evaluated in all patients. Results: One hundred fifty nine of 393 (40.5%) patients had at least one autoimmune reactivity. 31 patients with 1 or more autoantibodies positivity and/or accompanying musculoskeletal symptoms after COVID-19 were referred to the rheumatology outpatient clinic. Autoimmune disease was diagnosed in 9 of these patients. The distribution of autoimmune disease diagnoses is as follows; systemic lupus erythematosus (SLE) or SLE-like syndrome was diagnosed in 3 patients, mixed connective tissue disease in 3 patients, Sjögren's syndrome in 2 patients and scleroderma in 1 patient. Conclusion: Although it is not possible to establish a cause-and-effect relationship due to the lack of a control group in the design of our study and the lack of serologic laboratory test results before COVID-19 in patients diagnosed with autoimmune diseases, we think it may be important that autoantibodies and acute phase reactants other than ANA and CCP were found to be higher in hospitalized patients and that various systemic autoimmune reactivities were detected in 40% of post-COVID-19 patients.
Keywords: Coronavirus disease-2019; post-acute-coronavirus disease-2019 syndrome; autoantibodies; autoimmune diseases; musculoskeletal abnormality
Objective: The role of systemic autoimmunity in post-coronavirus disease-2019 (COVID-19) patients from real-world data is still unknown. The aim of our study was to evaluate the presence of rheumatic and antiphospholipid antibodies in post-COVID-19 patients and examine their frequencies and the clinical outcomes. Material and Methods: The data of 393 people who had COVID-19 and were followed up in our outpatient clinic were retrospectively analyzed. In our descriptive study, clinical and biochemical parameters as well as the presence of antinuclear antibodies, antiphospholipid antibodies, romatoid factor and immunoglobulin G cyclic citrullinated peptide 3rd generation were evaluated in all patients. Results: One hundred fifty nine of 393 (40.5%) patients had at least one autoimmune reactivity. 31 patients with 1 or more autoantibodies positivity and/or accompanying musculoskeletal symptoms after COVID-19 were referred to the rheumatology outpatient clinic. Autoimmune disease was diagnosed in 9 of these patients. The distribution of autoimmune disease diagnoses is as follows; systemic lupus erythematosus (SLE) or SLE-like syndrome was diagnosed in 3 patients, mixed connective tissue disease in 3 patients, Sjögren's syndrome in 2 patients and scleroderma in 1 patient. Conclusion: Although it is not possible to establish a cause-and-effect relationship due to the lack of a control group in the design of our study and the lack of serologic laboratory test results before COVID-19 in patients diagnosed with autoimmune diseases, we think it may be important that autoantibodies and acute phase reactants other than ANA and CCP were found to be higher in hospitalized patients and that various systemic autoimmune reactivities were detected in 40% of post-COVID-19 patients.
Keywords: Coronavirus disease-2019; post-acute-coronavirus disease-2019 syndrome; autoantibodies; autoimmune diseases; musculoskeletal abnormality
ÖZET
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID 19)] geçiren hastalarda sistemik otoimmünitenin rolü gerçek dünya verilerinde hala bilinmemektedir. Çalışmamızın amacı, COVID-19 sonrası hastalarda romatizmal ve antifosfolipid antikorların varlığını değerlendirmek ve sıklıklarını ve klinik sonuçlarını incelemekti. Gereç ve Yöntemler: COVID-19 geçiren ve polikliniğimizde takibe alınan 393 kişinin verileri retrospektif olarak incelendi. Tanımlayıcı çalışmamızda, tüm hastaların klinik ve biyokimyasal parametrelerinin yanı sıra antinükleer antikorlar, antifosfolipid antikorlar, romatoid faktör ve immünoglobulin G siklik sitrüline peptid [cyclic citrullinated peptide üçüncü nesil varlığı değerlendirildi. Bulgular: 393 hastanın 159'unda (%40,5) en az bir otoimmün reaktivite vardı. COVID-19 sonrası 1 veya daha fazla otoantikor pozitifliği ve/veya eşlik eden kas-iskelet sistemi semptomları olan 31 hasta romatoloji polikliniğine konsülte edildi. Bu hastaların 9'unda otoimmün hastalık teşhisi kondu. Otoimmün hastalık tanılarının dağılımı 3 hastada sistemik lupus eritematozus (SLE) veya SLE benzeri sendrom, 3 has tada karışık bağ dokusu hastalığı, 2 hastada Sjögren sendromu ve 1 hastada skleroderma şeklindeydi. Sonuç: Çalışmamızın tasarımında kontrol grubunun olmaması ve otoimmün hastalık tanısı almış hastalarda COVID-19 öncesi serolojik laboratuvar test sonuçlarının bulunmaması nedeniyle bir nedensonuç ilişkisi kurmak mümkün değildir. Ancak hastanede yatan hastalarda ANA ve CCP dışındaki otoantikorların ve akut faz reaktanlarının daha yüksek bulunması ve COVID-19 sonrası hastaların %40'ında çeşitli sistemik otoimmün reaktivitelerin tespit edilmiş olmasının önemli olabileceğini düşünüyoruz.
Anahtar Kelimeler: Koronavirüs hastalığı-2019; post-akut koronavirüs hastalığı-2019 sendromu; otoantikorlar; otoimmün hastalıklar; kas iskelet anomalileri
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID 19)] geçiren hastalarda sistemik otoimmünitenin rolü gerçek dünya verilerinde hala bilinmemektedir. Çalışmamızın amacı, COVID-19 sonrası hastalarda romatizmal ve antifosfolipid antikorların varlığını değerlendirmek ve sıklıklarını ve klinik sonuçlarını incelemekti. Gereç ve Yöntemler: COVID-19 geçiren ve polikliniğimizde takibe alınan 393 kişinin verileri retrospektif olarak incelendi. Tanımlayıcı çalışmamızda, tüm hastaların klinik ve biyokimyasal parametrelerinin yanı sıra antinükleer antikorlar, antifosfolipid antikorlar, romatoid faktör ve immünoglobulin G siklik sitrüline peptid [cyclic citrullinated peptide üçüncü nesil varlığı değerlendirildi. Bulgular: 393 hastanın 159'unda (%40,5) en az bir otoimmün reaktivite vardı. COVID-19 sonrası 1 veya daha fazla otoantikor pozitifliği ve/veya eşlik eden kas-iskelet sistemi semptomları olan 31 hasta romatoloji polikliniğine konsülte edildi. Bu hastaların 9'unda otoimmün hastalık teşhisi kondu. Otoimmün hastalık tanılarının dağılımı 3 hastada sistemik lupus eritematozus (SLE) veya SLE benzeri sendrom, 3 has tada karışık bağ dokusu hastalığı, 2 hastada Sjögren sendromu ve 1 hastada skleroderma şeklindeydi. Sonuç: Çalışmamızın tasarımında kontrol grubunun olmaması ve otoimmün hastalık tanısı almış hastalarda COVID-19 öncesi serolojik laboratuvar test sonuçlarının bulunmaması nedeniyle bir nedensonuç ilişkisi kurmak mümkün değildir. Ancak hastanede yatan hastalarda ANA ve CCP dışındaki otoantikorların ve akut faz reaktanlarının daha yüksek bulunması ve COVID-19 sonrası hastaların %40'ında çeşitli sistemik otoimmün reaktivitelerin tespit edilmiş olmasının önemli olabileceğini düşünüyoruz.
Anahtar Kelimeler: Koronavirüs hastalığı-2019; post-akut koronavirüs hastalığı-2019 sendromu; otoantikorlar; otoimmün hastalıklar; kas iskelet anomalileri
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