COVID-19 in rheumatic diseases in Italy: first results from the Italian registry of the Italian Society for Rheumatology (CONTROL-19)

BackgroundItaly was one of the first countries significantly affected by the coronavirus disease 2019 (COVID-19) epidemic. The Italian Society for Rheumatology promptly launched a retrospective and anonymised data collection to monitor COVID-19 in patients with rheumatic and musculoskeletal diseases (RMDs), the CONTROL-19 surveillance database, which is part of the COVID-19 Global Rheumatology Alliance.MethodsCONTROL-19 includes patients with RMDs and proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) updated until May 3rd 2020. In this analysis, only molecular diagnoses were included. The data collection covered demographic data, medical history (general and RMD-related), treatments and COVID-19 related features, treatments, and outcome. In this paper,we report the first descriptive data from the CONTROL-19 registry.ResultsThe population of the first 232 patients (36% males) consisted mainly of elderly patients (mean age 62.2 years), who used corticosteroids (51.7%), and suffered from multi-morbidity (median comorbidities 2). Rheumatoid arthritis was the most frequent disease (34.1%), followed by spondyloarthritis (26.3%), connective tissue disease (21.1%) and vasculitis (11.2%). Most cases had an active disease (69.4%). Clinicalpresentationof COVID-19 was typical, with systemic symptoms (fever and asthenia)and respiratorysymptoms. The overall outcome was severe, with high frequencies of hospitalisation (69.8%), respiratorysupport oxygen (55.7%), non-invasive ventilation (20.9%) or mechanical ventilation (7.5%), and 19% of deaths. Male patients typically manifested a worse prognosis. Immunomodulatory treatments were not significantlyassociatedwith an increasedrisk of intensive care unit admission/mechanicalventilation! death.ConclusionAlthough the reportmainly includes the most severe cases, its temporal and spatial trend supports the validity of the nationalsurveillance system. More complete data are being acquired in order to both test the hypothesis thatRMD patients may have a different outcome from that of the generalpopulation and determine the safety of immunomodulatory treatments.