{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:28:41Z","timestamp":1754144921214,"version":"3.41.2"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The coronavirus disease (COVID-19) pandemic has potentially impacted the care of patients with rheumatic diseases, including Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) syndrome. We investigates the effects on clinical characteristics, potential factors, and outcomes in SAPHO patients during the COVID-19 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>SAPHO patients were recruited for this cross-sectional study from Fangshan Hospital of Beijing University of Chinese Medicine. In total, 375 patients (mean age, 47.5 years, 72.53% females) were asked about demographic data, disease status, current treatments, and clinical manifestations during the epidemic, and potential relationships were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 375 included patients, 329 were infected with coronavirus 2019. Compared with non-infected patients, infected ones were more likely to have higher disease activity (<jats:italic>p<\/jats:italic> = 0.006). However, Janus kinase (JAK) inhibitor use was lower in detected COVID-19 cases than in non-infected cases in our cohort. Disease symptoms during COVID-19 were more commonly present in the non-JAK group than JAK groups, including rhinorrhea (<jats:italic>p<\/jats:italic> = 0.030), nasal congestion (<jats:italic>p<\/jats:italic> = 0.023), sore throat (<jats:italic>p<\/jats:italic> = 0.042), pneumonia (<jats:italic>p<\/jats:italic> = 0.044), headache (<jats:italic>p<\/jats:italic> = 0.023), and prevalence of palpitation (<jats:italic>p<\/jats:italic> = 0.015). In this study, 29 participants underwent tonsillectomy. Tonsillectomized patients showed a significantly higher prevalence of pneumonia than patients who did not undergo tonsillectomy (<jats:italic>p<\/jats:italic> = 0.009). The associated effect factors were displayed in the case of previous tonsillectomy using multivariate analysis and Firth\u2019s penalized likelihood. JAK inhibitor use (<jats:italic>p<\/jats:italic> = 0.025) and pneumonia (<jats:italic>p<\/jats:italic> = 0.011) were more likely to develop in patients with a history of tonsillectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Disease activity was inversely correlated with JAK inhibitor use in SAPHO patients with COVID-19 during the pandemic. Thus, JAK antagonists have protective effects on SAPHO patients with infections and can significantly mitigate new clinical crown symptoms. However, there was a significant negative correlation between tonsillectomy and the prevalence of SAPHO with COVID-19, which demonstrates that tonsillectomy may be associated with an increased risk of COVID-19 adverse outcomes, especially in cases of taste disorders and pneumonia.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1580989","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T05:34:43Z","timestamp":1752644083000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effects on clinical characteristics, potential factors and outcomes in SAPHO patients during the COVID-19 epidemic"],"prefix":"10.3389","volume":"12","author":[{"given":"Minhui","family":"Su","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haixu","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengyan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengfei","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinghua","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keqiang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zixi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meiling","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1097\/BOR.0000000000000786","article-title":"COVID-19 and rheumatoid arthritis.","volume":"33","author":"D\u2019Silva","year":"2021","journal-title":"Curr Opin Rheumatol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1080\/22221751.2021.1898291","article-title":"Lessons learned 1 year after SARS-CoV-2 emergence leading to COVID-19 pandemic.","volume":"10","author":"To","year":"2021","journal-title":"Emerg Microbes Infect."},{"key":"B3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1007\/s11684-020-0767-8","article-title":"Coronavirus disease 2019 (COVID-19): A clinical update.","volume":"14","author":"Zhou","year":"2020","journal-title":"Front Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e18821","DOI":"10.2196\/18821","article-title":"Preparation for quarantine on the cruise ship diamond princess in Japan due to COVID-19.","volume":"6","author":"Yamahata","year":"2020","journal-title":"JMIR Public Health Surveill."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e2010182","DOI":"10.1001\/jamanetworkopen.2020.10182","article-title":"Comparison of clinical characteristics of patients with asymptomatic vs symptomatic coronavirus disease 2019 in Wuhan, China.","volume":"3","author":"Yang","year":"2020","journal-title":"JAMA Netw."},{"key":"B6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1007\/s11420-020-09798-w","article-title":"Rheumatic disease-related symptoms during the height of the COVID-19 pandemic.","volume":"16","author":"Mancuso","year":"2019","journal-title":"HSS J."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e583","DOI":"10.1016\/S2665-9913(20)30286-1","article-title":"Patients with rheumatic diseases adhere to COVID-19 isolation measures more strictly than the general population.","volume":"2","author":"Hooijberg","year":"2020","journal-title":"Lancet Rheumatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1759720X20912865","DOI":"10.1177\/1759720X20912865","article-title":"Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: Review and update.","volume":"12","author":"Liu","year":"2020","journal-title":"Ther Adv Musculoskelet. 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