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Gout and Excess Risk of Severe SARS-CoV-2 Infection Among Vaccinated Individuals: A General Population Study.

Arthritis & Rheumatology 2022 September 10
OBJECTIVES: Gout patients often have multiple comorbidities, making them susceptible to SARS-CoV-2 infection and its severe outcomes; however, few studies have examined the association between gout and the risk of SARS-CoV-2 infection and its severe sequelae, especially after COVID-19 vaccination.

METHODS: We conducted two cohort studies using The Health Improvement Network. Individuals with gout and those without gout from the general population were followed from December 8th , 2020, to October 31st , 2021. We estimated the rate difference (RD) and hazard ratio (HR) of SARS-CoV-2 infection and its severe outcomes (i.e., hospitalization and death over 30 days after SARS-CoV-2 infection) for individuals with gout versus those without gout using Cox proportional hazard model according to COVID-19 vaccination status. We adjusted potential confounders using overlap weighting of exposure score.

RESULTS: Among the vaccinated cohort, 1,955 cases of breakthrough infection occurred in 54,576 individuals with gout (4.68/1000 person-months) and 52,468 cases in 1,336,377 individuals without gout (3.76/1000 person-months). The adjusted RD of breakthrough infection was 0.91 (95%CI: 0.62-1.20)/1000 person-months, and the adjusted HR was 1.24 (95%CI: 1.19-1.30). Gout was also associated with an increased risk of hospitalization (adjusted HR=1.30, 95%CI: 1.10-1.53) and death (adjusted HR=1.36, 95%CI: 0.87-2.13). Women with gout showed an increased risk of hospitalization (adjusted HR 1.55, 95%CI: 1.15-2.10) and death (adjusted HR=2.46, 95%CI: 1.12-5.41). Similar associations with gout were observed in the unvaccinated cohort.

CONCLUSIONS: These general population data suggest that individuals with gout, especially women, have higher risks of both SARS-CoV-2 infection and severe sequelae, even with vaccinations. This article is protected by copyright. All rights reserved.

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