Incidence and severeness of COVID-19 hospitalisation in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark

DOI record: { "DOI": "10.1093/rheumatology/keaa897", "ISSN": [ "1462-0324", "1462-0332" ], "URL": "http://dx.doi.org/10.1093/rheumatology/keaa897", "abstract": "<jats:title>Abstract</jats:title>\n <jats:sec>\n <jats:title>Objectives</jats:title>\n <jats:p>To estimate the incidence of COVID-19 hospitalization in patients with inflammatory rheumatic disease (IRD); in patients with RA treated with specific DMARDs; and the incidence of severe COVID-19 infection among hospitalized patients with RA.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>A nationwide cohort study from Denmark between 1 March and 12 August 2020. The adjusted incidence of COVID-19 hospitalization was estimated for patients with RA; spondyloarthritis including psoriatic arthritis; connective tissue disease; vasculitides; and non-IRD individuals. Further, the incidence of COVID-19 hospitalization was estimated for patients with RA treated and non-treated with TNF-inhibitors, HCQ or glucocorticoids, respectively. Lastly, the incidence of severe COVID-19 infection (intensive care, acute respiratory distress syndrome or death) among hospital-admitted patients was estimated for RA and non-IRD sp - individudals.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>Patients with IRD (n = 58 052) had an increased partially adjusted incidence of hospitalization with COVID-19 compared with the 4.5 million people in the general population [hazard ratio (HR) 1.46, 95% CI: 1.15, 1.86] with strongest associations for patients with RA (n = 29 440, HR 1.72, 95% CI: 1.29, 2.30) and vasculitides (n = 4072, HR 1.82, 95% CI: 0.91, 3.64). There was no increased incidence of COVID-19 hospitalization associated with TNF-inhibitor, HCQ nor glucocorticoid use. COVID-19 admitted patients with RA had a HR of 1.43 (95% CI: 0.80, 2.53) for a severe outcome.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>Patients with IRD were more likely to be admitted with COVID-19 than the general population, and COVID-19 admitted patients with RA could be at higher risk of a severe outcome. Treatment with specific DMARDs did not affect the risk of hospitalization.</jats:p>\n </jats:sec>", "author": [ { "ORCID": "http://orcid.org/0000-0002-5271-2574", "affiliation": [ { "name": "Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark" }, { "name": "Department of Rheumatology, Center for Rheumatology and Spine Diseases, Gentofte Hospital, Hellerup, Denmark" } ], "authenticated-orcid": false, "family": "Cordtz", "given": "René", "sequence": "first" }, { "affiliation": [ { "name": "Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark" } ], "family": "Lindhardsen", "given": "Jesper", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark" } ], "family": "Soussi", "given": "Bolette G", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-3385-0784", "affiliation": [ { "name": "Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark" } ], "authenticated-orcid": false, "family": "Vela", "given": "Jonathan", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-4047-7175", "affiliation": [ { "name": "Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark" } ], "authenticated-orcid": false, "family": "Uhrenholt", "given": "Line", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark" } ], "family": "Westermann", "given": "Rasmus", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark" }, { "name": "Department of Clinical Medicine, Aalborg University, Aalborg, Denmark" } ], "family": "Kristensen", "given": "Salome", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark" }, { "name": "Department of Clinical Medicine, Aalborg University, Aalborg, Denmark" } ], "family": "Nielsen", "given": "Henrik", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Cardiology, Nordsjællands Hospital, Hillerod, Denmark" } ], "family": "Torp-Pedersen", "given": "Christian", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark" }, { "name": "Department of Clinical Medicine, Aalborg University, Aalborg, Denmark" }, { "name": "The DANBIO Register, Denmark" } ], "family": "Dreyer", "given": "Lene", "sequence": "additional" } ], "container-title": "Rheumatology", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2020, 12, 12 ] ], "date-time": "2020-12-12T06:22:55Z", "timestamp": 1607754175000 }, "deposited": { "date-parts": [ [ 2021, 10, 11 ] ], "date-time": "2021-10-11T02:51:01Z", "timestamp": 1633920661000 }, "funder": [ { "DOI": "10.13039/100004326", 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