Clinical signs, symptoms, and severity of COVID-19 in patients with rheumatic diseases during the COVID-19 epidemic

Introduction: Recent studies have shown that patients with rheumatic diseases are more likely to experience severe cases of COVID-19. Additionally, certain anti-inflammatory medications have been linked to a reduction in the severity of COVID-19 symptoms. Objectives: This cross-sectional study aimed to determine the frequency of clinical signs, symptoms, and severity of COVID-19 in outpatients with rheumatic diseases.Patients and Methods: A total of 77 patients with rheumatic disorders who were diagnosed with COVID-19 and referred to Isfahan rheumatology clinics in 2020 were selected for this study. The study investigated their clinical signs, symptoms, severity of COVID-19, type of rheumatic disease, and the medications they were using. Furthermore, the study examined the relationship between the severity of COVID-19 and the type of rheumatic disease.Results: Among the 77 patients, 79.2% had rheumatoid arthritis (RA), 9.1% had systemic lupus erythematosus (SLE), 9.1% had Sjogren's syndrome, and 2.6% had other rheumatic disorders. The severity of COVID-19 was classified as mild in 40.3% of cases, moderate in 44.2%, and severe in 15.6%. There was no statistically significant relationship between the type of rheumatic disease and the severity of COVID-19 (P= 0.093).Conclusion: The findings suggest that patients with rheumatic diseases are more likely to experience severe cases of COVID-19. Conversely, the combination of hydroxychloroquine, sulfasalazine, and prednisolone has been associated with a lower prevalence of severe cases of COVID-19. In contrast, the administration of methotrexate and prednisolone has been linked to a higher prevalence of severe cases of COVID-19.