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The spread of SARS-CoV-2 infection is much greater than that captured by the swab diagnosis




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The true prevalence of COVID-19 is still unknown due to the high rate of asymptomatic infections. Measuring seroprevalence may be important to improve knowledge about the effects of COVID-19 in patients with rheumatism. Data shared at the 2021 EULAR conference show that the spread of SARS-CoV-2 infection is much greater than that observed by capturing only COVID-19 cases diagnosed with a cotton swab, but healthy. Emphasizes that it is in line with the group.

As part of the MAINSTREAM project, Favalli et al. Conducted a cross-sectional study of serum prevalence between May 4 and June 16, 2020. COVID-19 treated with a biological or targeted synthetic disease-modifying antirheumatic drug (b / tsDMARD) in a prevalent area (Lombardy, Italy) (RA) or spondyloarthritis (SpA). During this time, 300 people were tested for IgG, IgM, and IgA antibodies against three viral antigens: nucleoprotein, peplomer, and receptor-binding domain. These data were compared to those observed in healthy populations of the same period and region. All participants also completed a questionnaire to collect information on symptoms consistent with COVID-19. , And comorbidity.

Overall, 65% of the participants had RA, 23% had psoriatic arthritis, and 21% had ankylosing spondylitis. Most people are treated with tumor necrosis factor inhibitors (TNFi; 57%), the rest are abatacept (20%), interleukin-6 inhibitors (IL-6i; 11%), or Janus kinase inhibitors ( JAKi; 5%) was received. Of the 300, 4 had a pre-diagnosis of COVID-19 as defined by a nasopharyngeal swab.

As a result of evaluating the immunoglobulin titer, IgG, IgM, and IgA patients were 9%, 13.6%, and 13.3%, respectively, and there was no significant difference in the healthy population. Of the seropositive patients, 55.3% were asymptomatic, 16% were mild, 19.6% were severely symptomatic, and 7.1% were hospitalized. There were no deaths or hospitalizations in the intensive care unit. The titers of IgM, IgG, and IgA for the viral receptor-binding domain were higher in patients with both mild and severe symptoms compared to asymptomatic patients. There were no differences between seronegative and seropositive patients regarding age, gender, rheumatism diagnosis, and treatment with cs- and b / ts DMARD or corticosteroids. The relative increase in risk was associated with obesity and the presence of at least two comorbidities.

This study confirms that even in a cohort of patients with rheumatism, the spread of SARS-CoV-2 infection is much greater than that observed by capturing only COVID-19 cases diagnosed with a cotton swab. Underlying rheumatic disease and ongoing treatment with b / ts DMARD do not appear to affect SARS-CoV-2 antibody positivity and are conversely associated with symptomatic COVID-19 and the presence of comorbidity Seems to be doing.

COVID-19 infection rates are low in people with rheumatic disease, most reporting mild illness

Provided by the European Alliance of the Rheumatology Society

Quote: Https: // the cotton swab diagnosis (June 18, 2021) obtained on June 18, 2021. Also much larger SARS-CoV-2 infection spread captured-swab.html

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