Characteristics associated with hospitalization for COVID-19 in people with rheumatic disease: Data from the COVID-19 Global Rheumatology Alliance Physician-Reported Registry

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: March 24,2020 to April 20,2020. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (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 ≥10mg/day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06,3.96). Use of conventional DMARD alone or in combination with biologics/JAK inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70,2.17 and OR 0.74, 95% CI 0.37,1.46 respectively). Non-steroidal anti-inflammatory drug use (NSAIDs) was not associated with hospitalisation status (OR 0.64, 95% CI 0.39, 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19,0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57,1.57) 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.