Journal Article

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

Trupin, Laura, Jacobsohn, Lindsay, Wallace, Zachary S, Sufka, Paul, Grainger, Rebecca, Gossec, Laure, Schmajuk, Gabriela, Robinson, Philip C, Hyrich, Kimme L, Liew, Jean W, Izadi, Zara, Sirotich, Emily, Wysham, Katherine D, Carmona, Loreto, Yazdany, Jinoos, Rush, Stephanie, Hausmann, Jonathan S, Lawson-Tovey, Saskia, Danila, Maria I, Mateus, Elsa F, Gianfrancesco, Milena, Simard, Julia, Al-Adely, Sarah, Strangfeld, Anja, Machado, Pedro M, Bhana, Suleman, Costello, Wendy, Katz, Patricia

2020

Overview

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.

• Publisher: Elsevier Limited,BMJ Publishing Group
• Subject: Adolescent / Adult / Aged / Anti-Inflammatory Agents, Non-Steroidal - therapeutic use / Antimalarials - therapeutic use / Antirheumatic Agents - therapeutic use / Arthritis / Arthritis, Psoriatic - complications / Arthritis, Psoriatic - drug therapy / Arthritis, Rheumatoid - complications / Arthritis, Rheumatoid - drug therapy / Betacoronavirus / Biological Products - therapeutic use / Cardiovascular disease / Coronavirus Infections - complications / Coronavirus Infections - mortality / Coronavirus Infections - therapy / Coronaviruses / COVID-19 / Diabetes / Epidemiology / Female / Glucocorticoids / Glucocorticoids - therapeutic use / Hospitalization - statistics & numerical data / Humans / Hypertension / Inflammation / Janus kinase / Janus Kinase Inhibitors - therapeutic use / Kidney diseases / Laboratories / Life Sciences / Lung diseases / Lupus Erythematosus, Systemic - complications / Lupus Erythematosus, Systemic - drug therapy / Male / Medical imaging / Middle Aged / Multivariate Analysis / Nonsteroidal anti-inflammatory drugs / Pandemics / Patients / Physicians / Pneumonia, Viral - complications / Pneumonia, Viral - mortality / Pneumonia, Viral - therapy / Prednisone / Prednisone - therapeutic use / Protective Factors / Registries / Rheumatic diseases / Rheumatic Diseases - complications / Rheumatic Diseases - drug therapy / Rheumatology / Risk Factors / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Severity of Illness Index / Spondylarthropathies - complications / Spondylarthropathies - drug therapy / Tumor necrosis factor / Tumor Necrosis Factor Inhibitors - therapeutic use / Tumor necrosis factor-TNF / Tumors / Variables / Vasculitis - complications / Vasculitis - drug therapy / Young Adult