Characterization of Covid-19 infection in rheumatoid arthritis patients- the CoViD-in-RA project
Rheumatoid arthritis is an incredibly diverse disease. The variability observed in clinical presentation, response to treatment and clinical outcomes suggest that the mechanisms activated during the initiation of the disease, are not uniform. Thus, RA offers a unique model to understand how different underlying immune abnormality lead to different outcome when infected with COVID-19. We aim to correlate clinical manifestations, response to treatment and laboratory parameters in order to inform clinical decisions in RA, especially during COVID‑19 infection. Patients with recent arthritis will have blood tests (to analyze immune cells and proteins characteristic for RA subtypes) at baseline and at 6 months. Many patients followed in our service have already had these tests (EUPA cohort Dr Boire), and will also be included in our study, distinguishing between subjects who had COVID infection and those who did not develop it. All patients will have COVID‑19 serologies and an analysis of their immune cells. This simple approach is original because we will study the different kinds of immune blood cells (not all cells mixed in whole blood) of patients before they have received any medication, as well as after initiating specific RA treatments. We will follow the patients when receiving DMARDs and advanced therapies prescribed to control their disease. We believe that RA heterogeneity could translate into a different susceptibility to the risk of having COVID‑19 infection and to the severity of the infection, with a potentially protective effect from certain treatments in some patients. If we can determine which biological profiles or which treatments are associated with a good or bad response to SARS-CoV2, this could facilitate the management of individuals using these drugs for RA or other diseases, and perhaps also help target therapeutic interventions for COVID‑19 in any person, affected with RA or not.