TY - JOUR
T1 - Factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy: results from the COVID-19 Global Rheumatology Alliance physician-reported registry
AU - COVID-19 Global Rheumatology Alliance
AU - Yeoh, Su Ann
AU - Gianfrancesco, Milena
AU - Lawson-Tovey, Saskia
AU - Hyrich, Kimme L.
AU - Strangfeld, Anja
AU - Gossec, Laure
AU - Carmona, Loreto
AU - Mateus, Elsa F.
AU - Schäfer, Martin
AU - Richez, Christophe
AU - Hachulla, Eric
AU - Holmqvist, Marie
AU - Scirè, Carlo Alberto
AU - Lorenz, Hanns Martin
AU - Voll, Reinhard E.
AU - Hasseli, Rebecca
AU - Jayatilleke, Arundathi
AU - Hsu, Tiffany Y.T.
AU - D'Silva, Kristin M.
AU - Pimentel-Quiroz, Victor R.
AU - Vasquez Del Mercado, Monica
AU - Shinjo, Samuel Katsuyuki
AU - Neto, Edgard Torres Dos Reis
AU - Junior, Laurindo Ferreira da Rocha
AU - de Oliveira E Silva Montandon, Ana Carolina
AU - Pons-Estel, Guillermo J.
AU - Ornella, Sofía
AU - D'Angelo Exeni, Maria Eugenia
AU - Velozo, Edson
AU - Jordan, Paula
AU - Sirotich, Emily
AU - Hausmann, Jonathan S.
AU - Liew, Jean W.
AU - Jacobsohn, Lindsay
AU - Gore-Massy, Monique
AU - Sufka, Paul
AU - Grainger, Rebecca
AU - Bhana, Suleman
AU - Wallace, Zachary
AU - Robinson, Philip C.
AU - Yazdany, Jinoos
AU - Machado, Pedro M.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/9/13
Y1 - 2022/9/13
N2 - OBJECTIVES: To investigate factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy (IIM). METHODS: Demographic data, clinical characteristics and COVID-19 outcome severity of adults with IIM were obtained from the COVID-19 Global Rheumatology Alliance physician-reported registry. A 3-point ordinal COVID-19 severity scale was defined: (1) no hospitalisation, (2) hospitalisation (and no death) and (3) death. ORs were estimated using multivariable ordinal logistic regression. Sensitivity analyses were performed using a 4-point ordinal scale: (1) no hospitalisation, (2) hospitalisation with no oxygen (and no death), (3) hospitalisation with oxygen/ventilation (and no death) and 4) death. RESULTS: Of 348 patients, 48% were not hospitalised, 39% were hospitalised (and did not die) and 13% died. Older age (OR=1.59/decade, 95% CI 1.31 to 1.91), high disease activity (OR=3.50, 95% CI 1.25 to 9.83; vs remission), ≥2 comorbidities (OR=2.63, 95% CI 1.39 to 4.98; vs none), prednisolone-equivalent dose >7.5 mg/day (OR=2.40, 95% CI 1.09 to 5.28; vs no intake) and exposure to rituximab (OR=2.71, 95% CI 1.28 to 5.72; vs conventional synthetic disease-modifying antirheumatic drugs only) were independently associated with severe COVID-19. In addition to these variables, in the sensitivity analyses, male sex (OR range: 1.65-1.83; vs female) was also significantly associated with severe outcomes, while COVID-19 diagnosis after 1 October 2020 (OR range: 0.51-0.59; vs on/before 15 June 2020) was significantly associated with less severe outcomes, but these associations were not significant in the main model (OR=1.57, 95% CI 0.95 to 2.59; and OR=0.61, 95% CI 0.37 to 1.00; respectively). CONCLUSIONS: This is the first large registry data on outcomes of COVID-19 in people with IIM. Older age, male sex, higher comorbidity burden, high disease activity, prednisolone-equivalent dose >7.5 mg/day and rituximab exposure were associated with severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with IIM.
AB - OBJECTIVES: To investigate factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy (IIM). METHODS: Demographic data, clinical characteristics and COVID-19 outcome severity of adults with IIM were obtained from the COVID-19 Global Rheumatology Alliance physician-reported registry. A 3-point ordinal COVID-19 severity scale was defined: (1) no hospitalisation, (2) hospitalisation (and no death) and (3) death. ORs were estimated using multivariable ordinal logistic regression. Sensitivity analyses were performed using a 4-point ordinal scale: (1) no hospitalisation, (2) hospitalisation with no oxygen (and no death), (3) hospitalisation with oxygen/ventilation (and no death) and 4) death. RESULTS: Of 348 patients, 48% were not hospitalised, 39% were hospitalised (and did not die) and 13% died. Older age (OR=1.59/decade, 95% CI 1.31 to 1.91), high disease activity (OR=3.50, 95% CI 1.25 to 9.83; vs remission), ≥2 comorbidities (OR=2.63, 95% CI 1.39 to 4.98; vs none), prednisolone-equivalent dose >7.5 mg/day (OR=2.40, 95% CI 1.09 to 5.28; vs no intake) and exposure to rituximab (OR=2.71, 95% CI 1.28 to 5.72; vs conventional synthetic disease-modifying antirheumatic drugs only) were independently associated with severe COVID-19. In addition to these variables, in the sensitivity analyses, male sex (OR range: 1.65-1.83; vs female) was also significantly associated with severe outcomes, while COVID-19 diagnosis after 1 October 2020 (OR range: 0.51-0.59; vs on/before 15 June 2020) was significantly associated with less severe outcomes, but these associations were not significant in the main model (OR=1.57, 95% CI 0.95 to 2.59; and OR=0.61, 95% CI 0.37 to 1.00; respectively). CONCLUSIONS: This is the first large registry data on outcomes of COVID-19 in people with IIM. Older age, male sex, higher comorbidity burden, high disease activity, prednisolone-equivalent dose >7.5 mg/day and rituximab exposure were associated with severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with IIM.
KW - COVID-19
KW - dermatomyositis
KW - epidemiology
KW - outcome assessment, health care
KW - polymyositis
U2 - 10.1136/rmdopen-2022-002508
DO - 10.1136/rmdopen-2022-002508
M3 - Article
C2 - 36100295
AN - SCOPUS:85137826729
SN - 2056-5933
VL - 8
JO - RMD Open
JF - RMD Open
IS - 2
M1 - e002508
ER -
SDG 3 Good Health and Well-being