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

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

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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: 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.
Original languageEnglish
Pages (from-to)859-866
Number of pages8
JournalAnnals Of Rheumatic Diseases
Volume79
Issue number7
DOIs
Publication statusPublished - 29 May 2020

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