Evidence map›Paper›PMID 40514058›Full record

ArticleRMD open2025

Rising incidence of systemic autoimmune inflammatory rheumatic diseases during the COVID-19 pandemic: a geographical cohort study.

Enrico De Lorenzis, Paolo Parente, Salvatore Soldati, Andrea Barbara, Gerlando Natalello, Marina Davoli, Silvia Laura Bosello, Maria Antonietta D'Agostino, Mirko Di Martino

Abstract read
In one paragraph

Article in RMD open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Enrico De LorenzisRheumatology and Clinical Immunology, Catholic University of the Sacred Heart, Roma, Italy.ORCID 0000-0001-9819-105X
Paolo ParenteLocal Health Authority Rome 1, Roma, Italy.
Salvatore SoldatiDepartment of Epidemiology, Lazio Health Regional Health System, Roma, Italy.
Andrea BarbaraLocal Health Authority Rome 1, Roma, Italy.
Gerlando NatalelloRheumatology and Clinical Immunology, Catholic University of the Sacred Heart, Roma, Italy.ORCID 0000-0001-7333-371X
Marina DavoliDepartment of Epidemiology, Lazio Health Regional Health System, Roma, Italy.
Silvia Laura BoselloRheumatology and Clinical Immunology, Catholic University of the Sacred Heart, Roma, Italy.
Maria Antonietta D'Agostino *Rheumatology and Clinical Immunology, Catholic University of the Sacred Heart, Roma, Italy mariaantoniettadagostino@unicatt.it.
Mirko Di Martino *Department of Epidemiology, Lazio Health Regional Health System, Roma, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe natural infection with SARS-CoV-2, or vaccination against it, has been postulated to directly contribute to an increase in the incidence of autoimmune inflammatory rheumatic diseases (AIIRDs). Conversely, preventive measures limiting access to healthcare services could have resulted in missed or delayed AIIRD diagnoses or have reduced the infection rate of any triggering infections. We aimed to define real-life trends in AIIRD diagnoses from the prepandemic period through 2023 in a large and geographically circumscribed population of 6.5 million inhabitants.

methodsAIIRDs' annual diagnosis rates from 2017 to 2023 were derived from the registration of disease-specific exemption codes of the resident population of Lazio, a highly populated region in central Italy. Incidence rate ratios (IRRs) were calculated to compare pandemic and average prepandemic rates (2017-2019). Poisson regression was used to define statistically significant changes.

resultsA total of 16 254 AIIRD diagnoses were registered over the 7-year period. The average prepandemic incidence of AIIRDs was 4.81 per 10 000 inhabitants (95% CI 4.69 to 4.92). Compared with the prepandemic period, the diagnosis rate decreased in 2020 (IRR 0.68, 95% CI 0.64 to 0.72) but remained above prepandemic levels in 2021, 2022 and 2023. In 2023, there was a 22% increase in AIIRD incidence compared with prepandemic levels (IRR 1.22, 95% CI 1.17 to 1.28, p<0.001). This excess incidence was primarily driven by increases in both primary arthritides and systemic rheumatic diseases.

conclusionsWe observed a temporary decline in diagnosis in 2020, followed by a substantial increase from 2021 to 2023. This trend (decline and increase) may be linked to COVID-19 infection or to the reduction and subsequently potential increase of other infectious triggers following the use of preventive measures, such as facial masks and social distancing.

Indexed as

Autoimmune DiseasesCOVID-19Rheumatic DiseasesAdultAgedCohort StudiesFemaleHumansIncidenceItalyMaleMiddle AgedPandemicsSARS-CoV-2Arthritis, PsoriaticArthritis, RheumatoidCOVID-19EpidemiologySjogren's Syndrome

Identifiers

PMID40514058
PMCPMC12164633

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.