Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry.
Milena A. Gianfrancesco,Kimme L. Hyrich,Sarah Al-Adely,Loreto Carmona,Maria I. Danila,Maria I. Danila,Laure Gossec,Zara Izadi,Lindsay Jacobsohn,Patricia P. 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 Grainger,Jonathan S. Hausmann,Jonathan S. Hausmann,Jean W. Liew,Emily Sirotich,Paul Sufka,Zachary S. Wallace,Jinoos Yazdany,Pedro Machado,Philip Robinson,Philip Robinson +30 more
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TLDR
It is found that glucocorticoid exposure of ≥10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds ofospitalisation in patients with rheumatic disease.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: 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.read more
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Comment on 'Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry' by Gianfrancesco et al . Disease activity, rather than glucocorticoid therapy, may be associated with COVID-19 severity in patients with rheumatic musculoskeletal diseases.
Alessandro Giollo,Eugenia Bertoldo,Giovanni Adami,Adam Jerzy Cybulski,Angelo Fassio,Giovanni Orsolini,Luca Idolazzi,Davide Gatti,Ombretta Viapiana,Maurizio Rossini +9 more
TL;DR: In this article, the authors investigated the relationship between disease activity and COVID-19 severity and found that only 18% of patients had moderate and just 2% high disease activity, respectively.
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