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

Abstract

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.

• Authors: Milena Gianfrancesco, Kimme L Hyrich, Sarah Al-Adely, Loreto Carmona, Maria I Danila, Laure Gossec, Zara Izadi, Lindsay Jacobsohn, Patricia Katz, Saskia Lawson-Tovey, Elsa F Mateus, Stephanie Rush, Gabriela Schmajuk, Julia Simard, Anja Strangfeld, Laura Trupin, Katherine D Wysham, Suleman Bhana, Wendy Costello, Rebecca Grainger, Jonathan S Hausmann, Jean W Liew, Emily Sirotich, Paul Sufka, Zachary S Wallace, Jinoos Yazdany, Pedro M Machado, Philip C Robinson, COVID-19 Global Rheumatology Alliance
• Journal: Annals of the rheumatic diseases (Ann Rheum Dis) Vol. 79 Issue 7 Pg. 859-866 (07 2020) ISSN: 1468-2060 [Electronic] England
• PMID: 32471903 (Publication Type: Journal Article)
• Copyright: © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antimalarials
• Antirheumatic Agents
• Biological Products
• Glucocorticoids
• Janus Kinase Inhibitors
• Tumor Necrosis Factor Inhibitors
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antimalarials (therapeutic use)
• Antirheumatic Agents (therapeutic use)
• Arthritis, Psoriatic (complications, drug therapy)
• Arthritis, Rheumatoid (complications, drug therapy)
• Betacoronavirus
• Biological Products (therapeutic use)
• COVID-19
• Coronavirus Infections (complications, mortality, therapy)
• Female
• Glucocorticoids (therapeutic use)
• Hospitalization (statistics & numerical data)
• Humans
• Janus Kinase Inhibitors (therapeutic use)
• Lupus Erythematosus, Systemic (complications, drug therapy)
• Male
• Middle Aged
• Multivariate Analysis
• Pandemics
• Pneumonia, Viral (complications, mortality, therapy)
• Prednisone (therapeutic use)
• Protective Factors
• Registries
• Rheumatic Diseases (complications, drug therapy)
• Risk Factors
• SARS-CoV-2
• Severity of Illness Index
• Spondylarthropathies (complications, drug therapy)
• Tumor Necrosis Factor Inhibitors (therapeutic use)
• Vasculitis (complications, drug therapy)
• Young Adult