Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry

ObjectivesCOVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease.MethodsCase series of individuals with rheumatic disease and COVID-19 from...

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Published inAnnals of the rheumatic diseases Vol. 79; no. 7; pp. 859 - 866
Main Authors Gianfrancesco, Milena, Hyrich, Kimme L, Al-Adely, Sarah, Carmona, Loreto, Danila, Maria I, Gossec, Laure, Izadi, Zara, Jacobsohn, Lindsay, Katz, Patricia, Lawson-Tovey, Saskia, Mateus, Elsa F, Rush, Stephanie, Schmajuk, Gabriela, Simard, Julia, Strangfeld, Anja, Trupin, Laura, Wysham, Katherine D, Bhana, Suleman, Costello, Wendy, Grainger, Rebecca, Hausmann, Jonathan S, Liew, Jean W, Sirotich, Emily, Sufka, Paul, Wallace, Zachary S, Yazdany, Jinoos, Machado, Pedro M, Robinson, Philip C
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.07.2020
BMJ Publishing Group
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Abstract ObjectivesCOVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease.MethodsCase series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed.ResultsA total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥10 mg/day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95% CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57) was observed.ConclusionsWe found that glucocorticoid exposure of ≥10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.
AbstractList ObjectivesCOVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease.MethodsCase series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed.ResultsA total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥10 mg/day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95% CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57) was observed.ConclusionsWe found that glucocorticoid exposure of ≥10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.
Objectives COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease. Methods Case series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed. Results A total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥q10\,mg/day was associated with higher odds of hospitalisation (OR 2.05, 95%\,CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95%\,CI 0.70 to 2.17 and OR 0.74, 95%\,CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95%\,CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95%\,CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95%\,CI 0.57 to 1.57) was observed. Conclusions We found that glucocorticoid exposure of ≥q10\,mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.
COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease. Case series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed. A total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥10 mg/day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95% CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57) was observed. We found that glucocorticoid exposure of ≥10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.
Objectives COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease. Methods Case series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed. Results A total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥10 mg/day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95% CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57) was observed. Conclusions We found that glucocorticoid exposure of ≥10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.
Author Trupin, Laura
Jacobsohn, Lindsay
Wallace, Zachary S
Sufka, Paul
Grainger, Rebecca
Gossec, Laure
Schmajuk, Gabriela
Robinson, Philip C
Hyrich, Kimme L
Liew, Jean W
Izadi, Zara
Sirotich, Emily
Wysham, Katherine D
Carmona, Loreto
Yazdany, Jinoos
Rush, Stephanie
Hausmann, Jonathan S
Lawson-Tovey, Saskia
Danila, Maria I
Mateus, Elsa F
Gianfrancesco, Milena
Simard, Julia
Al-Adely, Sarah
Strangfeld, Anja
Machado, Pedro M
Bhana, Suleman
Costello, Wendy
Katz, Patricia
AuthorAffiliation 15 Department of Medicine , University of Otago , Wellington , New Zealand
11 Forschungsbereich Epidemiologie , Deutsches Rheuma-Forschungszentrum Berlin , Berlin , Germany
18 Department of Health Research Methods, Evidence, and Impact , McMaster University , Hamilton , Ontario , Canada
23 University College London Hospitals (UCLH) National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) , London , UK
19 Canadian Arthritis Patient Alliance , Toronto , Ontario , Canada
8 Centre for Genetics and Genomics Versus Arthritis , The University of Manchester , Manchester , UK
17 Harvard Medical School , Boston , Massachusetts , USA
25 Faculty of Medicine , The University of Queensland , Herston , Queensland , Australia
5 Division of Clinical Immunology and Rheumatology, Department of Medicine , The University of Alabama at Birmingham , Birmingham , Alabama , USA
1 Department of Medicine, Division of Rheumatology , University of California San Francisco , San Francisco , California
AuthorAffiliation_xml – name: 4 Instituto de Salud Musculoesquelética , Madrid , Spain
– name: 22 Centre for Rheumatology & Department of Neuromuscular Diseases , University College London (UCL) , London , UK
– name: 3 National Institute of Health Research Manchester Biomedical Research Centre , Manchester University NHS Foundation Trust , Manchester , Greater Manchester , UK
– name: 6 Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM , Sorbonne Universite , Paris , France
– name: 8 Centre for Genetics and Genomics Versus Arthritis , The University of Manchester , Manchester , UK
– name: 11 Forschungsbereich Epidemiologie , Deutsches Rheuma-Forschungszentrum Berlin , Berlin , Germany
– name: 17 Harvard Medical School , Boston , Massachusetts , USA
– name: 1 Department of Medicine, Division of Rheumatology , University of California San Francisco , San Francisco , California , USA
– name: 23 University College London Hospitals (UCLH) National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) , London , UK
– name: 25 Faculty of Medicine , The University of Queensland , Herston , Queensland , Australia
– name: 15 Department of Medicine , University of Otago , Wellington , New Zealand
– name: 5 Division of Clinical Immunology and Rheumatology, Department of Medicine , The University of Alabama at Birmingham , Birmingham , Alabama , USA
– name: 18 Department of Health Research Methods, Evidence, and Impact , McMaster University , Hamilton , Ontario , Canada
– name: 26 Metro North Hospital & Health Service , Royal Brisbane and Women's Hospital , Herston , Queensland , Australia
– name: 24 Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS trust , London , UK
– name: 20 Healthpartners , St Paul , Minnesota , USA
– name: 10 Health Research & Policy, Division of Epidemiology and Department of Medicine, Division of Immunology & Rheumatology , Stanford School of Medicine , Stanford , California , USA
– name: 16 Boston Children’s Hospital , Boston , Massachusetts , USA
– name: 12 University of Washington , Seattle , Washington , USA
– name: 7 APHP, Rheumatology Department , Hopital Universitaire Pitie Salpetriere , Paris , France
– name: 19 Canadian Arthritis Patient Alliance , Toronto , Ontario , Canada
– name: 13 Crystal Run Healthcare , Middletown , New York , USA
– name: 14 Irish Children's Arthritis Network (iCAN) , Tipperary , Ireland
– name: 9 Portuguese League Against Rheumatic Diseases (LPCDR) , Lisbon , Portugal
– name: 2 Centre for Epidemiology Versus Arthritis , The University of Manchester , Manchester , UK
– name: 21 Massachusetts General Hospital , Boston , Massachusetts , USA
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  givenname: Milena
  surname: Gianfrancesco
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  email: philip.robinson@uq.edu.au
  organization: Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA
– sequence: 2
  givenname: Kimme L
  surname: Hyrich
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  organization: National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
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  email: philip.robinson@uq.edu.au
  organization: Instituto de Salud Musculoesquelética, Madrid, Spain
– sequence: 5
  givenname: Maria I
  surname: Danila
  fullname: Danila, Maria I
  email: philip.robinson@uq.edu.au
  organization: Division of Clinical Immunology and Rheumatology, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
– sequence: 6
  givenname: Laure
  orcidid: 0000-0002-4528-310X
  surname: Gossec
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  email: philip.robinson@uq.edu.au
  organization: APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
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  givenname: Zara
  surname: Izadi
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  organization: Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA
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  organization: Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA
– sequence: 9
  givenname: Patricia
  surname: Katz
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  organization: Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK
– sequence: 11
  givenname: Elsa F
  surname: Mateus
  fullname: Mateus, Elsa F
  email: philip.robinson@uq.edu.au
  organization: Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal
– sequence: 12
  givenname: Stephanie
  surname: Rush
  fullname: Rush, Stephanie
  email: philip.robinson@uq.edu.au
  organization: Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA
– sequence: 13
  givenname: Gabriela
  surname: Schmajuk
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– sequence: 15
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– sequence: 17
  givenname: Katherine D
  surname: Wysham
  fullname: Wysham, Katherine D
  email: philip.robinson@uq.edu.au
  organization: University of Washington, Seattle, Washington, USA
– sequence: 18
  givenname: Suleman
  surname: Bhana
  fullname: Bhana, Suleman
  email: philip.robinson@uq.edu.au
  organization: Crystal Run Healthcare, Middletown, New York, USA
– sequence: 19
  givenname: Wendy
  surname: Costello
  fullname: Costello, Wendy
  email: philip.robinson@uq.edu.au
  organization: Irish Children's Arthritis Network (iCAN), Tipperary, Ireland
– sequence: 20
  givenname: Rebecca
  surname: Grainger
  fullname: Grainger, Rebecca
  email: philip.robinson@uq.edu.au
  organization: Department of Medicine, University of Otago, Wellington, New Zealand
– sequence: 21
  givenname: Jonathan S
  surname: Hausmann
  fullname: Hausmann, Jonathan S
  email: philip.robinson@uq.edu.au
  organization: Harvard Medical School, Boston, Massachusetts, USA
– sequence: 22
  givenname: Jean W
  surname: Liew
  fullname: Liew, Jean W
  email: philip.robinson@uq.edu.au
  organization: University of Washington, Seattle, Washington, USA
– sequence: 23
  givenname: Emily
  surname: Sirotich
  fullname: Sirotich, Emily
  email: philip.robinson@uq.edu.au
  organization: Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
– sequence: 24
  givenname: Paul
  surname: Sufka
  fullname: Sufka, Paul
  email: philip.robinson@uq.edu.au
  organization: Healthpartners, St Paul, Minnesota, USA
– sequence: 25
  givenname: Zachary S
  surname: Wallace
  fullname: Wallace, Zachary S
  email: philip.robinson@uq.edu.au
  organization: Massachusetts General Hospital, Boston, Massachusetts, USA
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  givenname: Jinoos
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  fullname: Yazdany, Jinoos
  email: philip.robinson@uq.edu.au
  organization: Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA
– sequence: 27
  givenname: Pedro M
  orcidid: 0000-0002-8411-7972
  surname: Machado
  fullname: Machado, Pedro M
  email: philip.robinson@uq.edu.au
  organization: Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS trust, London, UK
– sequence: 28
  givenname: Philip C
  orcidid: 0000-0002-3156-3418
  surname: Robinson
  fullname: Robinson, Philip C
  email: philip.robinson@uq.edu.au
  organization: Metro North Hospital & Health Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32471903$$D View this record in MEDLINE/PubMed
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Keywords lupus erythematosus, systemic
methotrexate
arthritis, rheumatoid
hydroxychloroquine
tumor necrosis factor inhibitors
systemic
arthritis
lupus erythematosus
rheumatoid
Language English
License This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
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Snippet ObjectivesCOVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with...
COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19...
Objectives COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated...
SourceID pubmedcentral
hal
proquest
crossref
pubmed
bmj
SourceType Open Access Repository
Aggregation Database
Index Database
Publisher
StartPage 859
SubjectTerms Adolescent
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Antimalarials - therapeutic use
Antirheumatic Agents - therapeutic use
Arthritis
Arthritis, Psoriatic - complications
Arthritis, Psoriatic - drug therapy
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - drug therapy
Betacoronavirus
Biological Products - therapeutic use
Cardiovascular disease
Coronavirus Infections - complications
Coronavirus Infections - mortality
Coronavirus Infections - therapy
Coronaviruses
COVID-19
Diabetes
Epidemiology
Female
Glucocorticoids
Glucocorticoids - therapeutic use
Hospitalization - statistics & numerical data
Humans
Hypertension
Inflammation
Janus kinase
Janus Kinase Inhibitors - therapeutic use
Kidney diseases
Laboratories
Life Sciences
Lung diseases
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - drug therapy
Male
Medical imaging
Middle Aged
Multivariate Analysis
Nonsteroidal anti-inflammatory drugs
Pandemics
Patients
Physicians
Pneumonia, Viral - complications
Pneumonia, Viral - mortality
Pneumonia, Viral - therapy
Prednisone
Prednisone - therapeutic use
Protective Factors
Registries
Rheumatic diseases
Rheumatic Diseases - complications
Rheumatic Diseases - drug therapy
Rheumatology
Risk Factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
Spondylarthropathies - complications
Spondylarthropathies - drug therapy
Tumor necrosis factor
Tumor Necrosis Factor Inhibitors - therapeutic use
Tumor necrosis factor-TNF
Tumors
Variables
Vasculitis - complications
Vasculitis - drug therapy
Young Adult
Title Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry
URI http://dx.doi.org/10.1136/annrheumdis-2020-217871
https://www.ncbi.nlm.nih.gov/pubmed/32471903
https://www.proquest.com/docview/2430650452
https://hal.sorbonne-universite.fr/hal-03849959
https://pubmed.ncbi.nlm.nih.gov/PMC7299648
Volume 79
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