To analyze the clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with sarcoidosis from a large multicenter cohort from Southern Europe and to identify the risk factors associated with a more complicated infection. We searched for patients with sarcoidosis presenting with SARS-CoV-2 infection (defined according to the European Centre for Disease Prevention and Control guidelines) among those included in the SarcoGEAS Registry, a nationwide, multicenter registry of patients fulfilling the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders 1999 classification criteria for sarcoidosis. A 2:1 age-sex-matched subset of patients with sarcoidosis without SARS-CoV-2 infection was selected as control population. Forty-five patients with SARS-CoV-2 infection were identified (28 women, mean age 55 years). Thirty-six patients presented a symptomatic SARS-CoV-2 infection and 14 were hospitalized (12 required supplemental oxygen, 2 intensive care unit admission and 1 mechanical ventilation). Four patients died due to progressive respiratory failure. Patients who required hospital admission had an older mean age (64.9 vs. 51.0 years, p = 0.006), a higher frequency of baseline comorbidities including cardiovascular disease (64% vs. 23%, p = 0.016), diabetes mellitus (43% vs. 13%, p = 0.049) and chronic liver/kidney diseases (36% vs. 0%, p = 0.002) and presented more frequently fever (79% vs. 35%, p = 0.011) and dyspnea (50% vs. 3%, p = 0.001) in comparison with patients managed at home. Age- and sex-adjusted multivariate analysis identified the age at diagnosis of SARS-Cov-2 infection as the only independent variable associated with hospitalization (adjusted odds ratio 1.18, 95% conficence interval 1.04–1.35). A baseline moderate/severe pulmonary impairment in function tests was associated with a higher rate of hospitalization but the difference was not statistically significant (50% vs. 23%, p = 0.219). A close monitoring of SARS-CoV-2 infection in elderly patients with sarcoidosis, especially in those with baseline cardiopulmonary diseases and chronic liver or renal failure, is recommended. The low frequency of severe pulmonary involvement in patients with sarcoidosis from Southern Europe may explain the weak prognostic role of baseline lung impairment in our study, in contrast to studies from other geographical areas.

Background/Objectives: To determine the proportion of elderly-onset sarcoidosis (EOS) and to assess the influence of age at diagnosis on pulmonary and extrapulmonary manifestations. Methods: Retrospective multicentre study using the Spanish SARCOGEAS registry, including adults with sarcoidosis diagnosed across 36 hospitals. EOS was defined as diagnosis at ≥65 years. Associations between clinical features and age were assessed using multivariable logistic and linear regression models, including sex-stratified analyses. Results: Among 2187 patients (mean age 48.6 ± 15.2 years, 61.36% women), 358 (16.37%) had EOS. In multivariable analyses, female sex (OR 1.86; β +5.02 years), White ethnicity (OR 5.43; β +4.85 years), and renal involvement (OR 2.29; β +6.86 years) were independently associated with EOS and older age at diagnosis, whereas cutaneous (OR 0.49; β −3.50 years), articular or bone (OR 0.37; β −3.10 years), and neurological involvement (OR 0.49; β −2.47 years) were associated with non-EOS and younger age at diagnosis. Exploratory sex-stratified analyses suggested additional patterns: in women, calcium metabolism abnormalities were associated with EOS (OR 1.74) and older age at diagnosis (β +4.91 years), and ear–nose–throat involvement was associated with older age at diagnosis (β +5.74 years). Regarding pulmonary involvement, CT-based Scadding stage II was associated with younger age at diagnosis (β −3.75 years) in women and CT-based Scadding stage IV with older age at diagnosis (β +6.57 years) in men. Conclusions: EOS accounted for 16.37% of sarcoidosis cases. Older age at diagnosis was associated with specific patterns of organ involvement, which changed gradually across the age spectrum, some of them differing by sex in exploratory analyses. Further studies are needed to confirm these findings.