For a study, researchers sought to assess the prevalence, prognoses, and illness-related variables linked to poor outcomes in individuals with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) who also had coronavirus disease (COVID-19).
In the outpatient setting, patients with AAV were questioned about their COVID-19 history. The patient’s medical records were consulted for the patient’s cumulative clinical findings and treatment history. Patients admitted with COVID-19 had their clinical, laboratory, and imaging results documented. For comparison, information from individuals who either acquired symptoms of COVID-19 or passed away from the condition was utilized.
There were 89 patients total (47.2% female; mean age, 56±12.5 years). In 56 cases (62.9%), the diagnosis was granulomatosis with polyangiitis, and in 33 (37.1%), the diagnosis was microscopic polyangiitis. There were 61 (68.2%) patients with renal involvement and 21 (23.6%) individuals with peripheral nerve involvement. A history of widespread alveolar bleeding was present in 10 cases. COVID-19 was present in 15 patients (16.9%), of whom 9 (60%) had severe pneumonia. About 6 (42.9%) patients were admitted to the intensive care unit, 6 (85.7%) patients were hospitalized, and 5 (35.7%) patients died. When they were admitted to the hospital, all of the deceased patients had hypogammaglobulinemia (IgG levels <700 mg/dL). Higher disease activity, the use of glucocorticoids and rituximab, and glomerular filtration rates under less than 30 mL/min were all linked to symptomatic COVID-19. Mortality was linked to a history of peripheral nerve involvement, greater organ damage scores, and hypogammaglobulinemia.
The patients with AAV and COVID-19 had terrible prognoses, particularly those with extensive multisystem involvement. The death rate was correlated with hypogammaglobulinemia. During the COVID-19 pandemic, serum IgG levels in AAV patients should be monitored.