COVID-19 among Rheumatoid Arthritis Patients on Immunosuppressive Therapy During the First Wave of the COVID-19 Pandemic: a Prospective Comparative Study

Background and aim of the work: COVID-19 has multiple challenges among risky cases like rheumatoid arthritis patients. So, this ‎study was done to look for COVID-19 in patients with rheumatoid arthritis and compare the severity ‎and outcome of COVID-19 in rheumatoid arthritis patients to those in other groups‎‎‎. Patients and Methods: the prospective comparative study included 146 randomly selected patients attending Zagazig ‎University Hospital in Egypt ,who were treated by the Egyptian Ministry of Health and Population ‎protocol for COVID-19, and the disease-modifying antirheumatic drugs (DMARDs)who fulfilled the ‎selection criteria to be recruited into three groups: rheumatoid arthritis (RA) patients; rheumatoid ‎arthritis with COVID-19 patients (RA-COVID); and a COVID-19 (COVID-19) group‎.‎ Results: the mean age of the studied group was 50 years old. The three studied groups showed no statistically ‎significant difference (p > 0.05) as regards age, sex, level of education, and marital status. But there ‎was a statistically significant difference between groups regarding occupation and special habits in ‎the form of hashish smoking. There was no marked difference in COVID-19 symptoms between group II and group III. The mean of the Modified Health Assessment Questionnaire (MHAQ) was 5.5 in RA group versus 8 in RA-COVID-19 group ,with ‎statistically significant difference between group I and II as regard DAS28. The duration from being diagnosed with ‎COVID-19 till recovery was significantly higher in RA-COVID-19 cases compared to COVID-19. ‎RA-COVI-19 group did tend toward higher hospital admission rates (OR 0.81; 95% CI 0.35-0.88; p = 0.03)‎‎‎‎‎‎‎‎. Conclusion: COVID-19 is accompanied by non-significant worsening of symptoms in RA patients on DMARDs, ‎except the admission rates. More research into expanding cases is required‎ ‎‎‎‎‎‎‎.