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

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
Annals of the Rheumatic Diseases 2020, 79 (7): 859-866
32471903

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.

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Christoph Haller

TN 2 Rheuma register, Pat. Die stationär wegen Covid-19 aufgenommen wurden (=Endpunkt) 46%. N=600. Mehr Frauen, VA RA, SLE, PsO. 9 verstorben.

Etwas ältere Pat.
SLE und Vaskulitis vermehrt.
54% csDMARDS hosp, biologic eher ambulant.

_> pat mit biologic tsdmards Or tief, also weniger hospitalisiert.

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