OBJECTIVE: The outcome of patients with COVID-19 improved over the pandemic, including patients with systemic rheumatic diseases. However, data on patients with systemic sclerosis (SSc) are lacking. This study aimed to assess the outcome of patients with both SSc and COVID-19 over several waves. METHODS: Patients with both SSc and COVID-19 who were registered in the European Scleroderma Trials and Research group (EUSTAR) were collected between April 2020 and April 2021. Patients were assigned to waves 1, 2, or 3 depending on the date of their COVID-19 diagnosis. Primary endpoints were death, intensive care unit stay, or ventilatory support (severe outcome). Subgroup analyses of patients who were hospitalized or died were conducted. General and SSc-specific characteristics and treatment were compared over the waves. Descriptive statistics and multivariate logistic regression were applied. RESULTS: A total of 333 patients were included; 57 patients (17%) had a severe outcome, and 30 patients (9%) died. Compared to wave 1, significantly fewer patients with SSc suffered from severe COVID-19 in waves 2 and 3 (28.2% vs 9.8% and 12.7%; P < 0.001), fewer patients required hospitalization (46.7% vs 19.6% and 25.5%; P < 0.001) or ventilatory support (24.0% vs 8.7% and 10.9%; P = 0.001), and fewer patients died (15.7% vs 5.0% and 7.5%; P = 0.011). Patients were significantly younger, more often men, had less frequent arterial hypertension, and less SSc cardiac involvement over waves 1 to 3. Patients received significantly less medium to high doses of corticosteroids as they did SSc treatment. CONCLUSION: The outcome of patients with both SSc and COVID-19 improved significantly over time because of intrinsic and extrinsic factors.

• MeSH
• COVID-19 * MeSH
• Hypertension * MeSH
• Humans MeSH
• Scleroderma, Localized * MeSH
• Scleroderma, Systemic * complications   diagnosis   epidemiology   MeSH
• COVID-19 Testing MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Diagnosis, Differential MeSH
• Fibrosis diagnosis   therapy   MeSH
• Calcinosis diagnosis   pathology   therapy   MeSH
• Skin Manifestations * MeSH
• Humans MeSH
• Fingers blood supply   pathology   MeSH
• Raynaud Disease MeSH
• Scleroderma, Systemic * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

• MeSH
• Lung Diseases, Interstitial * diagnosis   therapy   MeSH
• Humans MeSH
• Disease Progression MeSH
• Scleroderma, Systemic * complications   therapy   MeSH
• Lung Transplantation MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Familial Primary Pulmonary Hypertension * diagnosis   classification   therapy   MeSH
• Humans MeSH
• Scleroderma, Systemic * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Gastrointestinal Tract * diagnostic imaging   physiopathology   MeSH
• Humans MeSH
• Scleroderma, Systemic * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Humans MeSH
• Malnutrition * diagnosis   pathology   therapy   MeSH
• Scleroderma, Systemic * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Acute Kidney Injury * diagnosis   pathology   therapy   MeSH
• Diagnosis, Differential MeSH
• Humans MeSH
• Risk Factors MeSH
• Scleroderma, Systemic * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Humans MeSH
• Musculoskeletal Diseases * diagnostic imaging   pathology   therapy   MeSH
• Scleroderma, Systemic * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Pregnancy Complications MeSH
• Humans MeSH
• Scleroderma, Systemic * complications   MeSH
• Pregnancy * drug effects   MeSH
• Check Tag
• Humans MeSH
• Pregnancy * drug effects   MeSH
• Female MeSH
• Publication type
• Review MeSH

• MeSH
• Acute Disease * MeSH
• Humans MeSH
• Scleroderma, Systemic * complications   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH