新型冠状病毒感染与白塞综合征患者疾病活动相关性研究

The association between SARS-CoV-2 infection and disease flare in patients with Behçet’s syndrome

目的探讨新型冠状病毒(新冠)感染、新冠期间减停免疫抑制治疗和新冠疫苗接种对白塞综合征(Behçet’s syndrome,BS)患者疾病活动的影响。方法采用调查问卷,回顾性收集2022年12月1日至2023年1月31日期间BS患者的原发病特征和新冠感染相关信息。构建泊松广义估计方程模型,比较新冠感染组和非感染组BS疾病活动发生率比(incidence rate ratio,IRR)。运用Logistic回归和线性回归,基于比值比(odds ratio,OR)评估免疫抑制治疗减停和疫苗接种对BS疾病活动、新冠病程及发热时长的影响。结果研究纳入228例感染新冠的BS患者和31例未感染新冠的BS患者,结果显示感染组BS患者疾病活动风险显著增加(校正后IRR=2.208,95%CI:1.713~2.845,P<0.001)。治疗减停及新冠疫苗接种均不影响原发病活动和新冠感染病程,但治疗减停增加患者发热时长(校正后OR=2.736,95%CI:1.447~5.175,P=0.003),而疫苗接种缩短发热时长(校正后OR=0.743,95%CI:0.602~0.917,P=0.006)。结论新冠感染显著增加BS疾病活动风险,治疗调整和疫苗接种可影响新冠发热病程。

Objective This study investigated the impact of SARS-CoV-2 infection,post-infection immunosuppressant adjustment,and vaccination status on disease flare in patients with Behçet’s syndrome(BS).Methods A retrospective questionnaire-based survey was conducted on BS patients with and without SARS-CoV-2 infection between Dec 2022 and Jan 2023.A Poisson generalized estimating equation model was constructed to compare the incidence rate ratio(IRR)of BS disease flare between the SARS-CoV-2 infection status and the non-infection status.Logistic and linear regression analyses were employed to assess the effects of treatment adjustments and vaccination status on disease flare,the course of SARS-CoV-2 infection,and the duration of fever based on odds ratios(OR).Results 228 patients with SARS-CoV-2 infection and 31 patients without SARS-CoV-2 infection were recruited.A significantly increased risk of BS disease flare was observed after SARS-CoV-2 infection(adjusted IRR=2.208,95%CI:1.713-2.845,P<0.001).The incidence rate of disease flare and the course of SARS-CoV-2 infection were unrelated to treatment adjustments and SARS-CoV-2 vaccination.However,treatment adjustments prolonged the duration of fever in patients(adjusted OR=2.736,95%CI:1.447-5.175,P=0.003),while vaccination reduced the duration of fever(adjusted OR=0.743,95%CI:0.602-0.917,P=0.006).Conclusion SARS-CoV-2 infection increases the risk of disease flare in BS patients,and treatment adjustments and vaccination can impact the duration of SARS-CoV-2 infection fever.