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Aim: Coronavirus disease 2019 (COVID‐19) has been proposed as triggering autoimmunity. The aim of this study was to evaluate the presence and clinical significance of autoantibodies in patients with COVID‐19. Methods: We retrospectively collected data from 245 patients who were hospitalized for COVID‐19. All patients were tested for the presence of antinuclear antibody (ANA), rheumatoid factor (RF), anti‐citrullinated peptide antibody (ACPA), and anti‐cytoplasmic neutrophil antibody (ANCA). Risk factors for death and critical COVID‐19, defined as the need for invasive mechanical ventilation or extracorporeal membrane oxygenation, were analyzed. Results: Ninety (36.7%) patients tested positive for ANA, and 51 (20.8%) patients tested positive for RF. Three patients each (1.2%) tested positive for ACPA and ANCA. RF‐positive patients had higher rates of invasive mechanical ventilation and death than RF‐negative patients (70.6% vs 28.4%, P < 0.001 and 45.1% vs 18.6%, P < 0.001, respectively). Underlying lung disease, kidney disease, heart disease, quick COVID severity index (qCSI), and lactate dehydrogenase (LDH) were associated with in‐hospital death. RF (odds ratio [OR] 7.31, 95% CI 2.50–21.37, P < 0.001), qCSI (OR 1.42, 95% CI 1.19–1.69, P < 0.001), and LDH (OR 1.004, 95% CI 1.002–1.005, P < 0.001) were associated with critical COVID‐19. Combination of RF, qCSI, and LDH showed good prognostic value (area under the curve = 0.903, P < 0.001) for critical COVID‐19. Conclusions: ANA and RF were frequently detected in COVID‐19 patients. RF could be a risk factor for critical COVID‐19. The results of this study suggest immune dysfunction contributes to the complications of COVID‐19. [ABSTRACT FROM AUTHOR]

Aim: To evaluate clinical characteristics and natural history of non‐radiographic axial spondyloarthritis (nr‐axSpA) using KOrean Nonradiographic Axial SPondyloArthritis (KONASPA) data. Methods: Data were collected from 11 centers in South Korea. A total of 278 patients with nr‐axSpA from January 2018 to July 2020 were included. Demographic data, clinical features, comorbidities, disease activity, medications, and laboratory results were collected. Results: Mean age at symptom onset was 28.2 ± 14.2 years. Of 278 patients, 152 (54.7%) were male. Mean Bath Ankylosing Spondylitis Disease Activity Index at diagnosis was 3.5 ± 2.1. Dyslipidemia was the most common comorbidity (8.4%), followed by hypertension (6.1%). Mean age at diagnosis of nr‐axSpA was older in female patients than in male patients (31.8 ± 15.8 years vs 24.9 ± 12.0 years, P < 0.001). Enthesitis and uveitis were more frequently found in female patients than in male patients. Thirty‐one (11.1%) participants with nr‐axSpA progressed to ankylosing spondylitis. The median follow‐up duration was 48 months. In multivariable Cox regression analysis, age at symptom onset (hazard ratio [HR] 0.93, 95% confidence interval (CI) 0.88‐0.97, P = 0.006), body mass index (BMI) (HR 1.24, 95% CI 1.06‐1.44, P = 0.005) and sacroiliitis grade (HR 1.86, 95% CI 1.19‐2.92, P = 0.006) were associated with progression to ankylosing spondylitis. Conclusions: Results of nationwide data revealed that women with nr‐axSpA showed a late disease onset and more extra‐articular manifestations than men. Young age at symptom onset, high BMI, and presence of radiographic sacroiliitis at diagnosis were risk factors for progression to AS. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of tumor necrosis factor a inhibitors (TNFi) on spinal radiographic progression in patients with ankylosing spondylitis (AS). Methods: Subjects were selected from patients at a single tertiary hospital between 1995 and 2014. Patients who used TNFi with baseline and paired follow-up radiographic data with a minimum interval of 2 years were included. Time to start TNFi was defined as the time from symptom onset to the start of TNFi use. TNFi index was defined as the ratio of the period of TNFi use to the entire period of disease. Radiographic damage was assessed by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Univariable and multivariable linear regression analyses were used to identify factors associated with radiographic progression. Results: A total of 151 patients were included in the analysis. Seventeen (11.3%) patients were female and mean DmSASSS/year was 1.01 units/year. Mean X-ray follow-up duration was 102.9 ± 54.9 months. Mean time from symptom onset to start of TNFi use was 104.8 ± 83.6 months (median 84 months) and mean TNFi index was 42.9 ± 23.8% (median 40.9%). In multivariable analysis, initial mSASSS, initial C-reactive protein, body mass index, current smoker, and delayed start of TNFi use were associated with radiographic progression. Presence of peripheral arthritis and the TNFi index were negatively associated with radiographic progression. Conclusions: A delay in starting TNFi use and low TNFi index were associated with radiographic progression. Early and long-term use of TNFi appear to reduce spinal radiographic progression in patients with AS. [ABSTRACT FROM AUTHOR]