{"doi":"10.1101/2022.02.08.22270696","title":"DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study","abstract":"OBJECTIVE: To describe disease-modifying antirheumatic drug (DMARD) disruption, rheumatic disease flare/activity, and prolonged COVID-19 symptom duration among COVID-19 survivors with systemic autoimmune rheumatic diseases (SARDs). METHODS: We surveyed patients with SARDs after confirmed COVID-19 at Mass General Brigham to investigate post-acute sequelae of COVID-19. We obtained data on demographics, clinical characteristics, COVID-19 symptoms/course, and patient-reported measures. We examined baseline predictors of prolonged COVID-19 symptom duration (defined as lasting ≥28 days) using logistic regression. RESULTS: We analyzed surveys from 174 COVID-19 survivors (mean age 52 years, 81% female, 80% White, 50% rheumatoid arthritis) between March 2021 and January 2022. Fifty-one percent of 127 respondents on any DMARD reported a disruption to their regimen after COVID-19 onset. For individual DMARDs, 56-77% had any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41%. Global patient-reported disease activity was worse at the time of survey than before COVID-19 (mean 6.6±2.9 vs. 7.6±2.3, p<0.001). Median time to COVID-19 symptom resolution was 14 days (IQR 9,29). Prolonged symptom duration of ≥28 days occurred in 45%. Hospitalization for COVID-19 (OR 3.54, 95%CI 1.27-9.87) and initial COVID-19 symptom count (OR 1.38 per symptom, 95%CI 1.17-1.63) were associated with prolonged symptom duration. Respondents experiencing prolonged symptom duration had higher RAPID3 scores (p=0.007) and more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms. CONCLUSION: DMARD disruption, SARD flare, and prolonged symptom duration were common in this prospective study of COVID-19 survivors, suggesting substantial impact on SARDs after acute COVID-19.","journal":"medRxiv","year":2022,"id":298155,"datarank":0.29188652235829704,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"self_citation_contribution":0.29188652235829704,"citation_network_contribution":0.0,"self_endowment_contribution":0.29188652235829704,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9625,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":687300,"name":"Claire Cook","orcid":null,"position":1,"is_corresponding":false},{"id":490015,"name":"Kathleen M.M. Vanni","orcid":"0000-0003-0839-9661","position":2,"is_corresponding":false},{"id":686599,"name":"Naomi J. Patel","orcid":"0000-0002-6038-0346","position":3,"is_corresponding":false},{"id":236759,"name":"Kristin M. D’Silva","orcid":"0000-0001-8370-4166","position":4,"is_corresponding":false},{"id":236762,"name":"Xiaoqing Fu","orcid":"0009-0007-8267-8761","position":5,"is_corresponding":false},{"id":986778,"name":"Jiaqi Wang","orcid":"0000-0003-2061-8687","position":6,"is_corresponding":false},{"id":687299,"name":"Lauren Prisco","orcid":null,"position":7,"is_corresponding":false},{"id":858284,"name":"Emily Kowalski","orcid":null,"position":8,"is_corresponding":false},{"id":477450,"name":"Alessandra Zaccardelli","orcid":"0009-0007-6109-170X","position":9,"is_corresponding":false},{"id":687343,"name":"Lily W. Martin","orcid":null,"position":10,"is_corresponding":false},{"id":857537,"name":"Grace Qian","orcid":"0009-0000-7477-8657","position":11,"is_corresponding":false},{"id":236761,"name":"Tiffany Hsu","orcid":"0000-0003-1041-8040","position":12,"is_corresponding":false},{"id":236765,"name":"Zachary S. Wallace","orcid":"0000-0003-4708-7038","position":13,"is_corresponding":false},{"id":236764,"name":"Jeffrey A. Sparks","orcid":"0000-0002-5556-4618","position":14,"is_corresponding":false},{"id":858283,"name":"Michael Di Iorio","orcid":null,"position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:31:31.270564Z","pmid":"35169813","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}