Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases

Abstract

BackgroundThe susceptibility of patients with rheumatic diseases and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown.MethodsWe performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with severe acute respiratory syndrome coronavirus 2-positive PCR tests performed in the hospital to the same reference populations. Rates of PCR+ confirmed COVID-19 were compared among groups.ResultsPatients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Patients with systemic autoimmune or immune-mediated disease (AI/IMID) showed a significant increase, whereas patients with inflammatory arthritis (IA) or systemic lupus erythematosus did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. Patients with IA on targeted-synthetic or biological disease-modifying antirheumatic drugs (DMARDs), but not those on conventional-synthetic DMARDs, had a greater prevalence despite a similar age distribution.ConclusionPatients with AI/IMID show a variable risk of hospital-diagnosed COVID-19. Interplay of ageing, therapies and disease-specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyse the specific factors involved in COVID-19 susceptibility.

Rheumatic Musculoskeletal Diseases and COVID-19 A Review of the First 6 Months of the Pandemic

“…Currently available data do not imply a strikingly increased risk of infection for RMD with or without DMARD therapy in general ( 51 , 52 ), although differences in the individual diseases have been reported ( 53 ). Pablos et al investigated the prevalence of COVID-19 in seven Spanish hospitals providing medical care for a population of 2.9 million patients, and found a comparable prevalence of the infection in RA and PsoA with the general population (0.58%); in contrast, patients with spondylarthritis (SpA) had a higher prevalence ( 53 ). As this was also the case for patients on bDMARDs or JAKi, one might speculate that the higher infection rate of SpA patients was due to a higher percentage of these drugs in SpA patients compared to the other groups.…”

Recommendations for the Management of Patients With Systemic Rheumatic Diseases During the Coronavirus Disease Pandemic

“…A large-scale study from the UK showed that common autoimmune diseases such as RA and SLE were risk factors for COVID-19 related death [150]. Moreover, compared with the reference population, COVID-19 has occurred more frequently in patients with rheumatic diseases (odds ratio 1.32, 95% CIs 1.15∼1.52), especially in patients receiving bDMARDs or tsDMARDs as reported in a Spanish retrospective study conducted in seven hospitals [151]. COVID-19 is a highly infectious disease, especially during the early stage, and is associated with significant morbidity and fatality rates.…”

COVID-19 Pandemic in Women–Rheumatologist’s Perspective

“…The risk was similar to general population in patients with SLE and was higher in other systemic autoimmune diseases. 12 The severity of COVID-19 in RD seems to be similar to the general population. 10 A global rheumatology alliance that included 600 patients (70% female) of RD from multiple centers found a mortality of 9% in a patients with RD and COVID-19.…”