Post-Covid-19 syndrome in patients with autoimmune rheumatological diseases

• Grant number: 22/09565-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): August 01, 2022
• Effective date (End): February 28, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Eloisa Silva Dutra de Oliveira Bonfá
• Grantee: Artur Fonseca Sartori
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated research grant: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy, AP.TEM

Abstract

Acute COVID-19 infection typically takes about 2 weeks to resolve. Severe cases of acute infection can last for 3 or 6 weeks depending on the severity1,2. However, some patients have symptoms that can last for weeks or even months. The World Health Organization classifies as post-covid-19 syndrome, any persistent manifestation of at least 28 days after the first symptom of acute infection1. On the other hand, long covid is a term used to describe persistent manifestations after 12 weeks of symptoms, excluding other alternative diagnoses1,2. These symptoms are usually less severe than acute infection, including fatigue, cough, dyspnea, headache, chest pain, anxiety, and in most cases, do not require hospital care, however, a decline in the patient's quality of life has been reported2. There are still no definitive data on the prevalence of this syndrome, since the literature points to differences in different populations, due to differences in the demographic and clinical characteristics of the subpopulations3-5. As reported for the prevalence, the number of symptoms and the duration of persistence of each symptom can vary considerably in different populations6,7. Autoimmune rheumatic diseases form a heterogeneous group of chronic diseases characterized by a dysregulation of the immune system that results in inflammation and damage to different tissues and represent an important cause of morbidity in the world population8. It is estimated that 4 to 5% of the global population is affected by some autoimmune rheumatic disease, with a tendency of increase of this percentage in the coming years9-12. Infections, and particularly severe infections, represent a major concern in patients with autoimmune rheumatic diseases, as they are recognized as a major cause of morbidity and mortality in this population, and may contribute to a third of deaths recorded in this population13-16. Changes in the immune system, as a direct result of the rheumatic disease, or as an indirect result of the treatments to which patients are submitted, or the presence of other comorbidities, make these patients more susceptible to infections and to greater complications and worse prognosis 13-16. The recent coronavirus pandemic has highlighted this evidence, showing a greater propensity to infection, a worse course of the disease and a worse prognosis17,18. Therefore, the present project aims to describe the post-covid syndrome in patients with rheumatic diseases followed up at the Rheumatology outpatient clinic of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. The study will describe the prevalence, the type, and number of symptoms, in addition to associated factors, through a structured interview, and the demographic, clinical and laboratory data of the patients.