Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases
Objectives Although patients with immune-mediated inflammatory diseases (IMID) are thought to be more susceptible to viral infections, it is unclear whether their presentation differs between patients with IMID and healthy controls. This study aimed to investigate the symptom pattern of common viral...
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BMJ Publishing Group
2025-01-01
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| author | Carola Berking Georg Schett Andreas Ramming Raja Atreya Markus F Neurath Bernhard Manger Filippo Fagni Arnd Kleyer Milena L Pachowsky Axel J Hueber Stefan Kleinert Karin Manger Florian Schuch Monika Ronneberger David Simon Michael Sticherling Koray Tascilar Christine Meder Moritz Leppkes Peter Dietrich Verena Schoenau Daniela Bohr Fabian Hartmann Selahattin Alp Temiz Ioanna Minopoulou Louis Schuster Melek Yalcin Mutlu Gerhard Kroenke Till Orlemann Johanna Mößner |
| author_facet | Carola Berking Georg Schett Andreas Ramming Raja Atreya Markus F Neurath Bernhard Manger Filippo Fagni Arnd Kleyer Milena L Pachowsky Axel J Hueber Stefan Kleinert Karin Manger Florian Schuch Monika Ronneberger David Simon Michael Sticherling Koray Tascilar Christine Meder Moritz Leppkes Peter Dietrich Verena Schoenau Daniela Bohr Fabian Hartmann Selahattin Alp Temiz Ioanna Minopoulou Louis Schuster Melek Yalcin Mutlu Gerhard Kroenke Till Orlemann Johanna Mößner |
| author_sort | Carola Berking |
| collection | DOAJ |
| description | Objectives Although patients with immune-mediated inflammatory diseases (IMID) are thought to be more susceptible to viral infections, it is unclear whether their presentation differs between patients with IMID and healthy controls. This study aimed to investigate the symptom pattern of common viral infections in patients with IMID and compare it with controls without IMIDs.Design A cross-sectional study conducted between 1 February and 30 April 2020, using a questionnaire.Setting Seven tertiary regional care centers in Germany, which specialised in the care of patients with IMID (namely, in gastroenterology, dermatology, rheumatology and immunology clinical care).Participants One thousand nine hundred nine participants completed the survey (757 patients with IMID; 1152 non-IMID controls).Primary outcome measure The occurrence of 11 common viral illness symptoms within the preceding 3 months in patients with IMID and non-IMID controls.Results Symptom data were clustered, based on number and co-occurrance, into 3 major clusters and 2 subclusters ranked by the average number of symptoms. Patients with inflammatory bowel disease and psoriasis were significantly overrepresented in the lower-frequency subcluster of the polysymptomatic cluster. Patients with rheumatoid arthritis were overrepresented in the lower-frequency subclusters of the intermediate and oligo-/asymptomatic clusters. Controls were over-represented only in the higher-frequency subclusters of each major cluster where none of the IMIDs were over-represented. Spondyloarthritis and other IMIDs were also overrepresented in the low-frequency subcluster, but the results were not significant. Overall, patients with rheumatoid arthritis patients reported fewer symptoms (rate ratio=0.68, 95% CI, 0.59 to 0.80) than non-IMID controls.Conclusion Patients with IMID are over-represented in low-frequency subclusters, even among individuals who have reported a broad range of viral infection symptoms. This pattern suggests that the manifestations of viral infections are different between patients with IMID and controls, thus challenging the accurate and early diagnosis of infections. |
| format | Article |
| id | doaj-art-2e62c7b0f85c47a8b059ba341487064d |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj-art-2e62c7b0f85c47a8b059ba341487064d2025-01-14T22:30:09ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-088486Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseasesCarola Berking0Georg Schett1Andreas Ramming2Raja Atreya3Markus F Neurath4Bernhard Manger5Filippo Fagni6Arnd Kleyer7Milena L Pachowsky8Axel J Hueber9Stefan Kleinert10Karin Manger11Florian Schuch12Monika Ronneberger13David Simon14Michael Sticherling15Koray Tascilar16Christine Meder17Moritz Leppkes18Peter Dietrich19Verena Schoenau20Daniela Bohr21Fabian Hartmann22Selahattin Alp Temiz23Ioanna Minopoulou24Louis Schuster25Melek Yalcin Mutlu26Gerhard Kroenke27Till Orlemann28Johanna Mößner294 Universitätsklinikum Erlangen Department of Dermatology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany2 Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany2 Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany2 Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany3 Department of Rheumatology and Clinical Immunology, Charite - Universitatsmedizin Berlin, Berlin, Berlin, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany7 Rheumatology Practice Erlangen, Erlangen, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany7 Rheumatology Practice Erlangen, Erlangen, Germany7 Rheumatology Practice Erlangen, Erlangen, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany2 Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany2 Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany2 Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany5 Universitätsklinikum Erlangen Department of Medicine 1, Kussmaul Research Campus & Ludwig Demling Endoscopy Center of Excellence, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany1 Universitätsklinikum Erlangen Department of Medicine-3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany2 Universitätsklinikum Erlangen, Deutsches Zentrum fuer Immunotherapie, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, Germany6 Universitätsklinikum Erlangen Department of Medicine-2, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bayern, GermanyObjectives Although patients with immune-mediated inflammatory diseases (IMID) are thought to be more susceptible to viral infections, it is unclear whether their presentation differs between patients with IMID and healthy controls. This study aimed to investigate the symptom pattern of common viral infections in patients with IMID and compare it with controls without IMIDs.Design A cross-sectional study conducted between 1 February and 30 April 2020, using a questionnaire.Setting Seven tertiary regional care centers in Germany, which specialised in the care of patients with IMID (namely, in gastroenterology, dermatology, rheumatology and immunology clinical care).Participants One thousand nine hundred nine participants completed the survey (757 patients with IMID; 1152 non-IMID controls).Primary outcome measure The occurrence of 11 common viral illness symptoms within the preceding 3 months in patients with IMID and non-IMID controls.Results Symptom data were clustered, based on number and co-occurrance, into 3 major clusters and 2 subclusters ranked by the average number of symptoms. Patients with inflammatory bowel disease and psoriasis were significantly overrepresented in the lower-frequency subcluster of the polysymptomatic cluster. Patients with rheumatoid arthritis were overrepresented in the lower-frequency subclusters of the intermediate and oligo-/asymptomatic clusters. Controls were over-represented only in the higher-frequency subclusters of each major cluster where none of the IMIDs were over-represented. Spondyloarthritis and other IMIDs were also overrepresented in the low-frequency subcluster, but the results were not significant. Overall, patients with rheumatoid arthritis patients reported fewer symptoms (rate ratio=0.68, 95% CI, 0.59 to 0.80) than non-IMID controls.Conclusion Patients with IMID are over-represented in low-frequency subclusters, even among individuals who have reported a broad range of viral infection symptoms. This pattern suggests that the manifestations of viral infections are different between patients with IMID and controls, thus challenging the accurate and early diagnosis of infections.https://bmjopen.bmj.com/content/15/1/e088486.full |
| spellingShingle | Carola Berking Georg Schett Andreas Ramming Raja Atreya Markus F Neurath Bernhard Manger Filippo Fagni Arnd Kleyer Milena L Pachowsky Axel J Hueber Stefan Kleinert Karin Manger Florian Schuch Monika Ronneberger David Simon Michael Sticherling Koray Tascilar Christine Meder Moritz Leppkes Peter Dietrich Verena Schoenau Daniela Bohr Fabian Hartmann Selahattin Alp Temiz Ioanna Minopoulou Louis Schuster Melek Yalcin Mutlu Gerhard Kroenke Till Orlemann Johanna Mößner Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases BMJ Open |
| title | Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases |
| title_full | Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases |
| title_fullStr | Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases |
| title_full_unstemmed | Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases |
| title_short | Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases |
| title_sort | paucity of viral infection symptoms in patients with immune mediated inflammatory diseases |
| url | https://bmjopen.bmj.com/content/15/1/e088486.full |
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