The incidence, clinical characteristics, and outcome of COVID-19 in a prospectively followed cohort of patients with Behcet's syndrome

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dc.authoridAYDIN, Tahacan/0000-0002-8125-4808
dc.authoridTabak, Fehmi/0000-0001-8632-2825
dc.authoridATLI, ZEYNEP/0000-0002-2959-0978
dc.authoridDuru, Guzin/0000-0002-4774-9284
dc.authoridHatemi, Gulen/0000-0002-1952-1135
dc.authoridbalkan, ilker/0000-0002-8977-5931
dc.contributor.authorOzcifci, Guzin
dc.contributor.authorAydin, Tahacan
dc.contributor.authorAtli, Zeynep
dc.contributor.authorBalkan, Ilker Inanc
dc.contributor.authorTabak, Fehmi
dc.contributor.authorOztas, Mert
dc.contributor.authorOzguler, Yesim
dc.date.accessioned2025-03-23T19:44:38Z
dc.date.available2025-03-23T19:44:38Z
dc.date.issued2022
dc.departmentSinop Üniversitesi
dc.description.abstractInitial case series of small number of patients at the beginning of the pandemic reported a rather guarded prognosis for Behcet's syndrome (BS) patients infected with SARS-CoV-2. In this prospective study, we describe the incidence, clinical characteristics, disease course, management, and outcome in a large cohort of BS patients with laboratory-confirmed infection of SARS-CoV-2. We defined a cohort of 1047 registered BS patients who were aged between 16 and 60 years and seen routinely before the pandemic at the multidisciplinary outpatient clinic. We followed prospectively this cohort from beginning of April 2020 until the end of April 2021. During 13 months of follow-up, of the 1047 (599 M/448 F) patients, 592 (56.5%) were tested for SARS-CoV-2 PCR at least once and 215 (20.5%; 95% CI 0.18-0.23) were tested positive. We observed 2 peaks which took place in December 2020 and April 2021. Of the 215 PCR positive patients, complete information was available in 214. Of these 214, 14 (6.5%) were asymptomatic for COVID-19. In the remaining, the most common symptoms were anosmia, fatigue, fever, arthralgia, and headache. A total of 40 (18.7%) had lung involvement, 25 (11.7%) were hospitalized, 1 was admitted to the intensive care unit while none died. Favipiravir was the most prescribed drug (74.3%), followed by colchicine (40.2%), and hydroxychloroquine (20.1%) in the treatment of COVID-19. After COVID-19, 5 patients (2.3%) were given supplemental O-2 and 31 (14.5%) antiaggregant or anticoagulants. During COVID-19, of the 214 PCR positive patients, 116 (54.2%) decreased the dose of their immunosuppressives or stopped taking completely; 36 (16.8%) experienced a BS flare which was mostly oral ulcers (10.3%). None of the patients reported a thrombotic event. A total of 93 (43.5%) patients reported BS flares after a median 45 days of COVID-19 infection and this was found to be significantly associated with immunosuppressive drug discontinuation. Multiple regression analysis adjusted for age and gender indicated that smoking and using interferon-alpha decreased the likelihood of getting COVID-19. The incidence and severity of COVID-19 did not differ between those who were using colchicine or not. The cumulative incidence of COVID-19 in this prospectively followed cohort of BS patients was almost two folds of that estimated for the general population living in Istanbul, Turkey, however, the clinical outcome of COVID-19 was not severe and there was no mortality. The protective effect of smoking and interferon deserves further investigation. On the other hand, colchicine did not have any positive or negative effect against COVID-19. Significant number of patients flared after COVID-19, however, this was significantly associated with immunosuppressive discontinuation during the infection. Contrary to our previous observations, COVID-19 did not seem to exacerbate thrombotic events during or after the infection.
dc.identifier.doi10.1007/s00296-021-05056-2
dc.identifier.endpage113
dc.identifier.issn0172-8172
dc.identifier.issn1437-160X
dc.identifier.issue1
dc.identifier.pmid34825278
dc.identifier.scopus2-s2.0-85119878823
dc.identifier.scopusqualityQ1
dc.identifier.startpage101
dc.identifier.urihttps://doi.org/10.1007/s00296-021-05056-2
dc.identifier.urihttps://hdl.handle.net/11486/6984
dc.identifier.volume42
dc.identifier.wosWOS:000722475000002
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer Heidelberg
dc.relation.ispartofRheumatology International
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250323
dc.subjectOutcome
dc.subjectCOVID-19
dc.subjectBehcet's disease
dc.subjectColchicine
dc.subjectSmoking
dc.subjectInterferon-alpha
dc.titleThe incidence, clinical characteristics, and outcome of COVID-19 in a prospectively followed cohort of patients with Behcet's syndrome
dc.typeArticle

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