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Objectives To investigate the outcomes of COVID‐19‐related hospitalizations among patients with autoimmune rheumatic diseases (ARDs) in the United States in 2020. The primary outcome was in‐hospital mortality, and secondary outcomes included intubation rate, length of hospital stay (LOS), and total hospital charges (THCs). Methods Data for the study were obtained from the National Inpatient Sample database and included patients who were hospitalized with a principal diagnosis of COVID‐19. Univariable and multivariable logistic regression analyses were conducted to calculate odds ratios for the outcomes, adjusting for age, sex, and comorbidities. Results Out of the 1,050,720 COVID‐19 admissions, 30,775 had an ARD diagnosis. The unadjusted analysis showed higher mortality (12.21%) and intubation (9.2%) rates in the ARD group compared with the non‐ARD group (mortality rate: 11.14%, P = 0.013; intubation rate: 8.5%, P = 0.048). However, this difference was not significant after adjusting for confounding factors. The mean LOS and THCs did not differ significantly between the two groups. Among all ARD subgroups, the vasculitis group had significantly higher intubation rate, LOS, and THC. Conclusion The study suggests that ARD is not associated with an increased risk of mortality or worse outcomes among patients hospitalized with COVID‐19 after adjusting for confounding factors. However, the vasculitis group had poorer outcomes during COVID‐19 hospitalizations. Further studies are needed to evaluate the effect of ARD activity and immunosuppressants on outcomes. Additionally, more research is required to investigate the relationship between COVID‐19 and vasculitis.

In December 2021, we searched for publicly available posts using the terms "hepatitis b" and "hep b". We removed duplicates from the top 55 posts for each term and coded N5103 posts using a validated misinformation codebook with 72 variables including: engagement (e.g., number of likes), user characteristics (e.g., # of followers, # following), profitability (e.g., for profit, selling product or service), and claims with misinformation (determined by medical experts). We applied two-tailed z-tests, chi-square tests, and linear regressions to examine associations between profitability and misinformation (outcome). Results: Nearly a quarter of posts (n524, 23%) contained misinformation about hepatitis B and/or hepatitis B treatment. Misinformation posts had more engagement on average (1,599 likes vs. 970 likes, p, 0.01), were following more accounts (1,127 vs. 889, p5, 0.01), but had fewer followers (mean: 22,920n vs. 70,442, p, 0.001) than accurate posts. Nearly one-third of posts about hepatitis B referenced a conspiracy theory (30%), were for-profit (29%), and were selling a product or service (34%) through Instagram. Significantly more misinformation posts were for profit (47% vs. 14%, p, 0.01) and were selling a product or service (43% vs. 13% p, 0.01) compared to accurate posts. For-profit accounts (b5713, 95% CI 25-1401, p50.04) and those selling a product or service (b5843, 95% CI 196-1490, p50.01) were following significantly more accounts than their counterparts. Conclusion: Online health misinformation poses direct threat to patients and has broader reach and engagement than accurate information. Hepatitis B misinformation may exacerbate health disparities, given that financial incentives are difficult to distinguish, however our findings suggest that a high number of "following" accounts may be a marker for accounts seeking profitability off of Hepatitis B misinformation on Instagram. More research is needed to understand how exposure to health information can influence patient/caregiver behavior and downstream clinical and financial outcomes.

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