Continuous variables were compared by the use of the Student’s two-tailed = 111; 68

Continuous variables were compared by the use of the Student’s two-tailed = 111; 68.5%) and 18.5% (30/162) had moderate or high disease activity at the time of illness (Table 1 and Supplementary Table S1). 0.001) and tocilizumab (OR 0.147, 95% CI 0.053C0.408, < 0.001) had reduced odds of illness. Further, TNFi tended to become protecting of severe and essential disease. Older age, major comorbidities, and rituximab were associated with an increased risk of illness and worse prognosis. Most individuals with inflammatory RMDs (86.2%) developed a powerful antibody response. Seroconversion was associated with symptomatic disease (OR 13.46, 95% CI 2.21C81.85, = 0.005) and tended 18α-Glycyrrhetinic acid to be blunted by TNFi (OR 0.17, 95% CI 0.03C1.05; = 0.057). Conclusions TNFi and tocilizumab reduced the risk of illness by SARS-CoV-2. Treatment with TNFi also tended to reduce rates of severe disease and seroconversion. Older age, general comorbidities and rituximab were associated with improved risk for illness and worse prognosis, in line with earlier reports. Most individuals with RMDs developed a proper antibody response after COVID-19, particularly if they had symptomatic disease. Keywords: SARS-CoV-2, COVID-19, antibody response, seroconversion, inflammatory rheumatic diseases Introduction Illness by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) offers quickly become a global concern since the end of 2019 (1). Risk factors for illness and worse prognosis have been extensively recorded for the general human population, such as older age, cardiovascular and respiratory disease (2, 3). Less evidence is available for individuals with inflammatory rheumatic and musculoskeletal diseases (RMDs), whether treated or not with immunosuppressors, although observational data is definitely rapidly accruing (4C8). Individuals with RMDs under standard synthetic (cs), targeted synthetic (ts) or biological (b) disease-modifying anti-rheumatic medicines (DMARDs) have in the beginning been hypothesized to be at improved risk for development or severe forms of coronavirus disease 19 (COVID-19). However, most observational studies failed to demonstrate an increased vulnerability of individuals with RMDs, having a cumulative incidence of COVID-19 similar to the general human 18α-Glycyrrhetinic acid population and most individuals exhibiting mild-to-moderate disease program (9, 10). Indeed, it seems that anti-cytokine therapy does not increase the risk for illness or severe disease (10C12). These medicines possess actually been hypothesized to be protecting of essential disease, by counterbalancing the observed hyperinflammatory state with raised levels of IL-6, IL-1, and TNF (13C15). It remains unclear, though, whether individuals with inflammatory RMDs, due to the underlying immune dysregulation and/or to the immunosuppressive treatment, can generate a proper humoral immune response following SARS-CoV-2 illness. With this study we targeted to: determine risk factors for illness by SARS-CoV-2; assess the medical results of COVID-19; find predictors for severe and essential disease; 18α-Glycyrrhetinic acid and evaluate the development of IgG antibodies against SARS-CoV-2 in individuals with inflammatory RMDs. Materials and Methods SMOC2 We performed a multicenter observational nationwide study of adult individuals with inflammatory RMDs prospectively adopted in the Rheumatic Diseases Portuguese Register (Reuma.pt) in the 1st 6 months of the pandemic in Portugalfrom March 2 (1st reported case in the country) to September 30. Reuma.pt is a real-life-based nationwide observational registry that captures a large portion of individuals with inflammatory rheumatic diseases and the vast majority of individuals treated with biological therapies (16). Since March 2020, the Portuguese Society of Rheumatology developed a novel module to capture info on medical manifestations, treatment, and end result of rheumatic individuals infected with SARS-CoV-2. During this period, all centers guaranteed their individuals’ regular follow-up, either through physical sessions or teleconsultations. With this initial phase of the pandemic, the overall awareness of physicians to register any case of COVID-19 in Reuma.pt was large. In addition, all centers were specifically invited to participate in this study. Study Human population We included all adult individuals with inflammatory RMDs authorized at Reuma.pt, with confirmed or suspected illness by SARS-CoV-2 between March 2 and September 30 of 2020. A confirmed case of SARS-CoV-2 illness was defined as a positive RT-PCR on samples from the respiratory tract or positive seroconversion for SARS-CoV-2, no matter patient’s symptoms. A suspected case of COVID-19 was defined as presence of fever plus at least one other respiratory sign (dyspnoea, persistent cough, odynophagia, anosmia, and/or dysgeusia), or presence of one of the previous symptoms after a contact with a confirmed case, in the absence of a RT-PCR test (17). In order to evaluate risk factors for SARS-CoV-2 illness, we also included all adult.