Clinical Course and Outcomes of coronavirus disease 2019 (COVID-19) in Rheumatic Disease Patients on Immunosuppression: A case Cohort Study at a Single Center with a Significantly Diverse Population
Arleo et al.,
Clinical Course and Outcomes of coronavirus disease 2019 (COVID-19) in Rheumatic Disease Patients on..,
medRxiv, doi:10.1101/2020.10.26.20219154 (Preprint)
Retrospective hospitalized rheumatic disease patients showing 50% lower mortality for patients on HCQ.
risk of death, 50.0% lower, RR 0.50, p = 0.67, treatment 1 of 20 (5.0%), control 5 of 50 (10.0%), NNT 20, all patients.
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risk of death, 52.0% lower, RR 0.48, p = 0.64, treatment 1 of 10 (10.0%), control 5 of 24 (20.8%), NNT 9.2, inpatients.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Arleo et al., 27 Oct 2020, retrospective, USA, preprint, 5 authors.
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.10.26.20219154; this version posted October 27, 2020. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
Article Title: Clinical Course and Outcomes of coronavirus disease 2019 (COVID-19) in
Rheumatic Disease Patients on Immunosuppression: A case Cohort Study at a Single Center with
a Significantly Diverse Population
Authors: Timothy Arleo, B.S.1; David Tong, M.D.2; Julie Shabto, B.A4; Ghazala O’Keefe,
M.D.3 ; Arezou Khosroshahi, M.D.5
From Emory University School of Medicine, Atlanta, GA1,4; Division of Hospital Medicine,
Emory University School of Medicine, Atlanta, GA2; Department of Ophthalmology, Emory
University School of Medicine, Atlanta, GA3; Division of Rheumatology, Emory University
School of Medicine, Atlanta, GA5.
Corresponding author:
Arezou Khosroshahi, MD
Associate Professor of Medicine
Emory University School of Medicine
Rheumatology Division
244 Whitehead Bldg., 615 Michael Street
Atlanta, GA, 30322
akhosroshahi@emory.edu
Phone: 404 778 6638
Conflicts of Interest: None declared
Word count: 2786
Figure count: 6
1
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
medRxiv preprint doi: https://doi.org/10.1101/2020.10.26.20219154; this version posted October 27, 2020. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
ABSTRACT
Objectives
To determine clinical course and outcomes in rheumatic disease patients with coronavirus
disease 2019 (COVID-19) and compare results to uninfected patients.
Methods
We conducted a case cohort study of autoimmune disease patients with COVID-19 (confirmed
by severe acute respiratory syndrome coronavirus 2 PCR) from 02/01/2020 to 07/31/2020 and
compared them in a 1:3 ratio with uninfected patients who were matched based on race, age, sex,
and comorbidity index. Patient demographics, clinical course, and outcomes were compared
among these patient groups.
Results
A total of 70 rheumatic disease patients with COVID-19 (mean age, 56.6 years; 64% African
American) were identified. The 34 (49%) patients who were hospitalized used oral
glucocorticoids more frequently (p<0.01). All 10 patients on anti-TNFα medications were treated
as outpatients (p<0.01). Those hospitalized with COVID-19 more often required ICU admission
(17 (50%) vs 27 (26%), OR=2.78 (95% CI: 1.24 to 6.20)) and intubation (10 (29%) vs 6 (6%),
OR=6.67 (95% CI: 2.20 to 20.16)) than uninfected patients. They also had higher mortality rates
(6 (18%) vs 3 (3%), OR=7.21 (95% CI: 1.70 to 30.69)). Of the six COVID-19 patients who died,
one was of African ancestry (p=0.03).
Conclusions
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medRxiv preprint doi: https://doi.org/10.1101/2020.10.26.20219154; this version posted October 27, 2020. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
Rheumatic disease patients infected with COVID-19 were more likely to require ICU..
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