0440: COVID-19 in Patients with ANCA Associated Vasculitis – Single Center Experience

Alojzija Hocevar¹, Matija Tomšič² and Ziga Rotar¹, ¹University Medical Centre Ljubljana, Ljubljana, Slovenia, ²UMC Ljubljana, LJUBLJANA, Slovenia

Background/Purpose: In patients with ANCA associated vasculitis (AAV) a higher mortality rate due to COVID-19 has been observed compared to general population. We aimed to evaluate the frequency and severity of COVID-19 in a well-defined AAV cohort.

Methods: We analysed characteristics of cases with PCR or rapid antigen test proven SARS CoV-2 infection during the 2-year period between March/2020 and February/2022 in a cohort of AAV patients (AAV diagnosed at our center between January/2010 and February/2020 and followed during COIVD-19 pandemic). Severity of COVID-19 was determined (severe disease defined as the need of hospitalization or development of COVID-19 associated complications or death) and risk factors for severe disease analyzed. COVID-19 cases were additionally stratified into three groups based to the period of pandemic: "pre-vaccination" period (March/2020 – February/2021); "vaccination" period (March/2021 – December/2021), and "Omicron" period (January/2022 – February/2022).

Results: In a cohort of 102 AAV patients (68.8% females, 42 (41.2%) GPA; 32 (31.4%) MPA; 19 (18.6%) EGPA and 8 (7.8%) clinically not further subclassified AAV), 29 SARS-CoV-2 infection episodes were documented in 26 (25.4%) patients (20 (69.0%) females; median (IQR) age at COVID-19 72.8 (52.9;82.2) years; 17 (58.6%), 9 (31.0%) and 3 (10.3%) episodes in GPA, MPA, and EGPA, respectively). There were 21 (72.4%) mild and 8 (27.6%) severe COVID-19 episodes. Three patients (10.3%) died due to COVID-19. Differences in demographic, AAV characteristics and comorbidities between mild vs. severe COVID-19 are presented in table 1. Table 2 shows differences in COVID-19 manifestations based on the period of infection.

Conclusion: Our study reveals differences in the presentation of COVID-19 during different time frames of pandemic, severe disease episodes being recorded predominantly in the pre-vaccination period.

Table 1. Characteristics of demographic, medications for AAV and comorbidities by COVID-19 severity
Legend: Data are median (IQR) or n (%). *includes coronary artery disease, cerebrovascular disease, peripheral artery disease and aortic atherosclerosis. †includes interstitial lung disease, chronic obstructive pulmonary disease, asthma or other lung diseases

Table 2. Symptoms of SARS-CoV-2 infection, stratified based on the time of infection
Legend: * average
Disclosures: A. Hocevar, None; M. Tomšič, None; Z. Rotar, Pfizer, AbbVie/Abbott, Eli Lilly.