Prevalência de infecções em pacientes com doenças reumatológicas em tratamento com imunossupressores

Abstract

Introduction: Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) are chronic, systemic and autoimmune diseases that are very frequent in rheumatology outpatient clinics. Because of the involvement of the immune system by the disease itself and the state of immunosuppression that can be caused by the treatment of such diseases, it can have a great influence on the course of infectious diseases. Objective: Analyze the prevalence and outcome of infectious diseases in patients with rheumatic diseases using immunosuppressive treatments. Methods: It was performed an observational, cross-sectional, descriptive and analytical study. The study sample consisted of patients treated at the CEMEC rheumatology clinic on the days referring to patients with more severe manifestations of the diseases, during the period from September 2022 to January 2023. All tests were performed with the aid of the Bioestat software 5.5. Quantitative variables were described by minimum, maximum, mean, median and standard deviation and qualitative variables by frequency and percentage, with a significance level of 0.05 being defined. Results: The urinary tract infection (UTI) was the most recurrent infection in both analyzed pathologies, followed by lower airway infections. In patients with SLE, candidiasis had an epidemiological significance. The most frequent etiological agents were bacteria, fungus and viruses, respectively. There was no association between the use of immunobiologicals and the incidence of infectious episodes. There was a correlation between RA and osteoporosis. Conclusion: There was an important prevalence of rheumatological diseases and infectious conditions, mainly UTIs, and candidiasis was largely related to SLE. There was no relevant association between the most potent immunosuppressants and hospitalizations. In the study, the main difficulty was inconstancy in filling out information in the medical records, useful for understanding the clinical and pathological characteristics of patients, which could be applied to improve prevention and conduct in the face of infections. It is therefore understood the relevance of filling in the patient's vaccination status, as well as the DAS-28 classification for future studies comparing disease activity with the incidence of infection.