La etnia caucásica y la fibromialgia se asocian con el desarrollo de Long-COVID en pacientes con enfermedades reumáticas e infección por SARS-CoV-2. Datos del registro SAR-COVID
Palabras clave:
COVID-19, Long-COVID, infecciones, enfermedades reumáticas
Resumen
Introducción: la persistencia de síntomas luego de la infección por SARS-CoV-2 es una complicación relevante. Objetivos: describir la evolución de la infección por SARS-CoV-2 en pacientes con enfermedades reumáticas (ER), y evaluar la frecuencia y las características del síndrome Long-COVID (SLC). Materiales y métodos: estudio observacional, prospectivo, realizado con pacientes con ER e infección confirmada por SARS-CoV-2, entre agosto de 2020 y junio de 2023. El SLC se definió como síntomas persistentes >28 días. Resultados: se incluyeron 2707 pacientes; el 94% presentó COVID-19 sintomática aguda. Fallecieron 109 (4,0%) pacientes durante la fase aguda y 512 (18,9%) desarrollaron SLC. Los síntomas más frecuentes en este grupo fueron fatiga y disnea. En el análisis multivariado, la fibromialgia (OR 2.48, IC 95% 1,62-3,78), recibir tratamiento para la COVID-19 aguda (OR 1.55, IC 1,19-2,00) e ingreso a unidad cerrada (OR 1.55, IC 1,04-2,30) se asociaron con mayor riesgo de SLC, mientras que la etnia mestiza mostró un efecto protector (OR 0.74, IC 95% 0,59-0,92). Conclusiones: en pacientes con ER, 2 de cada 10 tuvieron SLC. El diagnóstico previo de fibromialgia y la mayor severidad de la COVID aguda se asociaron con mayores probabilidades de desarrollar esta condición, mientras que la etnia mestiza presentó un efecto contrario.Citas
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V. Ayoubkhani D, Bosworth ML, King S, Pouwels KB, Glickman M, Nafilyan V, Zaccardi F, Khunti K, Alwan NA, Walker AS. Risk of Long COVID in people infected with severe acute respiratory syndrome coronavirus 2 after 2 doses of a coronavirus disease 2019 vaccine. Community-based, matched cohort study. Open Forum Infect Dis. 2022;9(9):ofac464. doi: 10.1093/ofid/ofac464.
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VII. Fedorchenko Y, Zimba O. Long COVID in autoimmune rheumatic diseases. Rheumatol Int. 2023;43(7):1197-1207. doi: 10.1007/s00296-023-05319-0.
VIII. Di Iorio M, Cook CE, Vanni KMM, Patel NJ, D'Silva KM, Fu X, et al. DMARD disruption, rheumatic disease flare, and prolonged COVID-19 symptom duration after acute COVID-19 among patients with rheumatic disease: a prospective study. Semin Arthritis Rheum. 2022;55:152025. doi: 10.1016/j.semarthrit.2022.152025.
IX. Sapkota HR, Nune A. Long COVID from rheumatology perspective - a narrative review. Clin Rheumatol. 2022 Feb;41(2):337-348. doi: 10.1007/s10067-021-06001-1.
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XI. Isnardi CA, Gómez G, Quintana R, Roberts K, Berbotto G, Baez RM, et al. Características epidemiológicas y desenlaces de la infección por SARS-CoV-2 en pacientes con patologías reumáticas: Primer reporte del registro argentino SAR-COVID. Rev Arg Reumatol. 2021;32(1);7-15.
XII. Isnardi CA, Soriano ER, Graf C, de la Vega MC, Pons-Estel BA, Roberts K, et al. Does the use of immunosuppressive drugs impact on SARS-CoV-2 infection outcome? Data from a national cohort of patients with immune-mediated inflammatory diseases (SAR-COVID Registry). J Clin Rheumatol. 2023;29(2):68-77.
XIII. Méndez H. Sociedad y estratificación. Método Graffar-Méndez Castellano. Caracas: Fundacredesa; 1994.
XIV. World Health Organization 2022. Post COVID-19 condition (Long COVID). Acceso: 21 de mayo de 2024. Disponible en: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition#:~:text=Post%20COVID%2D19%20condition%2C%20also,explained%20by%20an%20%alternative%20 diagnosis.
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XVIII. Chen DY, Huang PI, Tang KT. Characteristics of long COVID in patients with autoimmune rheumatic diseases: a systematic review and meta-analysis. Rheumatol Adv Pract. 2024;8(2):rkae027. doi: 10.1093/rap/rkae027.
XIX. Boekel L, Atiqi S, Leeuw M, Hooijberg F, Besten Y, Lemset W, et al. Patients with inflammatory rheumatic diseases are not at increased risk of long-covid: data from a large prospective controlled cohort study. Ann Rheum Dis. 2023;82:53-54.
XX. Azzolini E, Levi R, Sarti R, Pozzi C, Mollura M, Mantovani A, et al. Association between BNT162b2 vaccination and Long COVID after infections not requiring hospitalization in health care workers. JAMA. 2022;328(7):676-678. doi: 10.1001/jama.2022.11691.
XXI. Zisis SN, Durieux JC, Mouchati C, Pérez JA, McComsey GA. The protective effect of Coronavirus disease 2019 (COVID-19) vaccination on postacute sequelae of COVID-19: a multicenter study from a large national health research network. Open Forum Infect Dis. 2022;9(7):ofac228. doi: 10.1093/ofid/ofac228.
XXII. Antonelli M, Pujol JC, Spector TD, Ourselin S, Steves CJ. Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2. Lancet. 2022;399(10343):2263–2264. doi: 10.1016/S0140-6736(22)00941-2.
XXIII. Chen DY, Huang PI, Tang KT. Characteristics of long COVID in patients with autoimmune rheumatic diseases: a systematic review and meta-analysis. Rheumatol Adv Pract. 2024;8(2):rkae027. doi: 10.1093/rap/rkae027.
XXIV. Haider S, Janowski AJ, Lesnak JB, Hayashi K, Dailey DL, Chimenti R, et al. A comparison of pain, fatigue, and function between post-COVID-19 condition, fibromyalgia, and chronic fatigue syndrome: a survey study. Pain. 2023 Feb 1;164(2):385-401. doi: 10.1097/j.pain.0000000000002711.
XXV. Plaut S. "Long COVID-19" and viral "fibromyalgia-ness". Suggesting a mechanistic role for fascial myofibroblasts (Nineveh, the shadow is in the fascia). Front Med (Lausanne). 2023;10:952278. doi: 10.3389/fmed.2023.952278.
XXVI. Rivera J, Rodríguez T, Pallarés M, Castrejón I, González T, Vallejo-Slocker L, et al. Prevalence of post-COVID-19 in patients with fibromyalgia: a comparative study with other inflammatory and autoimmune rheumatic diseases. BMC Musculoskelet Disord. 2022;23(1):471. doi: 10.1186/s12891-022-05436-0.
XXVII. Cankurtaran D, Tezel N, Ercan B, Yildiz SY, Akyuz EU. The effects of COVID-19 fear and anxiety on symptom severity, sleep quality, and mood in patients with fibromyalgia: a pilot study. Adv Rheumatol. 2021;61(1):41. doi: 10.1186/s42358-021-00200-9.
XXVIII. Mosch B, Hagena V, Herpertz S, Diers M. Adverse effects of the COVID-19 pandemic on fibromyalgia patients in Germany: a longitudinal investigation including pre-pandemic data of pain and health-related outcomes. Clin Exp Rheumatol. 2023;41(6):1301-1309. doi: 10.55563/clinexprheumatol/i7kod6.
XXIX. Lazaridou A, Paschali M, Vilsmark ES, Wilkins T, Napadow V, Edwards R. The impact of COVID-19 pandemic on mental and physical wellbeing in women with fibromyalgia: a longitudinal mixed-methods study. BMC Womens Health. 2022;22(1):267. doi: 10.1186/s12905-022-01840-9.
XXX. Jiang DH, Roy DJ, Gu BJ, Hassett LC, McCoy RG Postacute sequelae of severe acute respiratory syndrome Coronavirus 2 infection: a state-of-the-art review. JACC Basic Transl Sci. 2021;6(9):796–811. doi: 10.1016/j.jacbts.2021.07.002.
XXXI. Thompson EJ, Williams DM, Walker AJ, Mitchell RE, Niedzwiedz CL, Yang TC, et al. Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records. Nat Commun. 2022;13(1):3528. doi: 10.1038/s41467-022-30836-0.
Publicado
2024-12-30
Cómo citar
1.
Isnardi CA, Cosatti M, González Gómez C, Alfaro MA, Virasoro BM, Gómez G, D’ Angelo ME, Saurit V, Petkovic I, Quintana R, Tissera Y, Berbotto G, Haye Salinas MJ, Ornella S, Pera M, Reyes Torres Álvaro A, Báez RM, Pereira D, Alle G, Castro Coello V, Alba P, Cogo K, Alonso CG, Gobbi C, Gallino Yanzi J, Gamba MJ, Nieto R, Velozo E, Tanten R, Correa M de los Ángeles, Pons-Estel G, Pisoni C. La etnia caucásica y la fibromialgia se asocian con el desarrollo de Long-COVID en pacientes con enfermedades reumáticas e infección por SARS-CoV-2. Datos del registro SAR-COVID. Rev. Argent. Reumatol. [Internet]. 30 de diciembre de 2024 [citado 21 de febrero de 2025];35(4):81 -92. Disponible en: https://ojs.reumatologia.org.ar/index.php/revistaSAR/article/view/895
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Derechos de autor 2025 a nombre de los autores. Derechos de reproducción: Sociedad Argentina de Reumatología
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.
