Does the Impact of COVID-19 on Patients With Systemic Sclerosis Change Over Time?

Elisabeth Deibel, Patricia E. Carreira, Madelon Vonk, Nicoletta del Papa, Radim Bečvář, Alfredo Guillén-Del-Castillo, Corrado Campochiaro, Hadi Poormoghim, Sophie Liem, Maria Grazia Lazzaroni, Alessandro Giollo, Arsène Mekinian, Jeska de Vries-Bouwstra, Maria De Santis, Alexandra Balbir-Gurman, Carina Mihai, Giacomo De Luca, Sergey Moiseev, Elisabetta Zanatta, Rosario FotiSimona Rednic, Christopher Denton, Maurizio Cutolo, Laura Belloli, Paolo Airo, Liudmila Garzanova, Gianluca Moroncini, Murat İnanç, Stylianos Panopoulos, Jose Luis Tandaipan, Emmanuel Chatelus, Edoardo Rosato, Masataka Kuwana, Sule Yavuz, Juan J. Alegre-Sancho, Vanessa Smith, Gabriella Szűcs, Joerg Henes, Ignasi Rodríguez-Pintó, Fabiola Atzeni, Julia Spierings, Marie Elise Truchetet, Marcin Milchert, Daniel Brito de Araujo, Gabriela Riemekasten, Vera Bernardino, Thierry Martin, Francesco del Galdo, Alessandra Vacca, Fabian Mendoza, Øyvind Midtvedt, Giuseppe Murdaca, Tânia Santiago, Veronica Codullo, Fabio Cacciapaglia, Ulrich Walker, Cathrine Brunborg, Francesca Tirelli, Yannick Allanore, Daniel E. Furst, Marco Matucci, Armando Gabrielli, Oliver Distler*, Anna Maria Hoffmann-Vold

*Corresponding author for this work
1 Citation (Scopus)


Objective: The outcome of patients with COVID-19 improved over the pandemic, including patients with systemic rheumatic diseases. However, data on patients with systemic sclerosis (SSc) are lacking. This study aimed to assess the outcome of patients with both SSc and COVID-19 over several waves. Methods: Patients with both SSc and COVID-19 who were registered in the European Scleroderma Trials and Research group (EUSTAR) were collected between April 2020 and April 2021. Patients were assigned to waves 1, 2, or 3 depending on the date of their COVID-19 diagnosis. Primary endpoints were death, intensive care unit stay, or ventilatory support (severe outcome). Subgroup analyses of patients who were hospitalized or died were conducted. General and SSc-specific characteristics and treatment were compared over the waves. Descriptive statistics and multivariate logistic regression were applied. Results: A total of 333 patients were included; 57 patients (17%) had a severe outcome, and 30 patients (9%) died. Compared to wave 1, significantly fewer patients with SSc suffered from severe COVID-19 in waves 2 and 3 (28.2% vs 9.8% and 12.7%; P < 0.001), fewer patients required hospitalization (46.7% vs 19.6% and 25.5%; P < 0.001) or ventilatory support (24.0% vs 8.7% and 10.9%; P = 0.001), and fewer patients died (15.7% vs 5.0% and 7.5%; P = 0.011). Patients were significantly younger, more often men, had less frequent arterial hypertension, and less SSc cardiac involvement over waves 1 to 3. Patients received significantly less medium to high doses of corticosteroids as they did SSc treatment. Conclusion: The outcome of patients with both SSc and COVID-19 improved significantly over time because of intrinsic and extrinsic factors.

Original languageEnglish
JournalArthritis Care and Research
Issue number1
Pages (from-to)88-97
Number of pages10
Publication statusPublished - 01.2024

Research Areas and Centers

  • Academic Focus: Center for Infection and Inflammation Research (ZIEL)

DFG Research Classification Scheme

  • 204-05 Immunology
  • 205-18 Rheumatology

Coronavirus related work

  • Research on SARS-CoV-2 / COVID-19

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