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

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.

The impact of the COVID-19 Pandemic on Patients with Chronic Rheumatic Diseases: A Study in 15 Arab Countries

“…The young age of participants (40 years) re ected the pro le of social media users, rather than the usual older age reported in studies on patients with CRD (10,25). In fact, according to the Arab Social Media Report (26), 64.3% of social media users were aged less than 30 years.…”

“…In fact, according to the Arab Social Media Report (26), 64.3% of social media users were aged less than 30 years. On the other hand, the gender of participants (72% females) rather re ected the pro le of patients with CRD (10,25). The same report indicated that 32% of social media users were females, whereas the published cohorts of patients with CRD reported a female prevalence of 72% (10,27).…”

“…Whether they have a higher risk of infection with SARS-CoV-2 is uncertain (7)(8)(9)(10)(11)(12), and, although several recommendations were developed worldwide (13)(14)(15)(16)(17), strong evidence is lacking to guide treatment decisions. Moreover, di culty to access the rheumatology clinic drove some patients to self-modify their treatment (18), which put them, along with the signi cant stress factor, at high risk of CRD are.…”

Impact of Corticosteroids and Immunosuppressive Therapies on Symptomatic SARS-CoV-2 Infection in a Large Cohort of Patients with Chronic Inflammatory Arthritis

“…Preliminary observational studies appear overall reassuring on the incidence and clinical course of COVID-19 in immunosuppressed patients [32][33][34][35][36][37]. However, different classes of immunomodulating agents, often used in combination in patients with IMIDs, may have a different and even opposite impact on SARS-CoV-2 infection [38][39][40][41], which is at present undetermined. Furthermore, previous comparisons of small patient cohorts with the general population hamper de nitive conclusions on the speci c effects, if any, of disease-and treatment-related risk factors.…”

The impact of COVID-19 pandemic on rheumatology practice and rheumatologists: a cross-sectional multinational study

“…Many rheumatology patients are immunocompromised and vulnerable to infection. Whether these patients had higher risk of infection with the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) was uncertain [10][11][12][13][14][15][16]. Several recommendations were developed worldwide to guide the rheumatologists in their therapeutic choices [17][18][19][20][21][22].…”