Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry
Gianfrancesco et al.,
Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the..,
Annals of the Rheumatic Diseases, 79:7, 859-866, doi:10.1136/annrheumdis-2020-217871
Analysis of rheumatic disease patients showing no significant association between antimalarial therapy and hospitalisation, OR=0.94 [0.57-1.57], p=0.82 after adjustments.
This study is excluded in the after exclusion results of meta
analysis:
not fully adjusting for the baseline risk differences within systemic autoimmune patients.
risk of hospitalization, 3.3% lower, RR 0.97, p = 0.82, treatment 58 of 130 (44.6%), control 219 of 470 (46.6%), NNT 50, odds ratio converted to relative risk.
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Gianfrancesco et al., 28 May 2020, retrospective, database analysis, multiple countries, peer-reviewed, 28 authors.
Abstract: Epidemiology
Clinical science
Characteristics associated with hospitalisation for
COVID-19 in people with rheumatic disease: data
from the COVID-19 Global Rheumatology Alliance
physician-reported registry
Milena Gianfrancesco,1 Kimme L Hyrich,2,3 Sarah Al-Adely,2,3 Loreto Carmona,4
Maria I Danila,5 Laure Gossec ,6,7 Zara Izadi,1 Lindsay Jacobsohn,1 Patricia Katz,1
Saskia Lawson-Tovey,3,8 Elsa F Mateus,9 Stephanie Rush,1 Gabriela Schmajuk,1
Julia Simard,10 Anja Strangfeld,11 Laura Trupin,1 Katherine D Wysham,12
Suleman Bhana,13 Wendy Costello,14 Rebecca Grainger,15 Jonathan S Hausmann,16,17
Jean W Liew,12 Emily Sirotich,18,19 Paul Sufka,20 Zachary S Wallace,17,21
Jinoos Yazdany,1 Pedro M Machado ,22,23,24 Philip C Robinson ,25,26 On behalf of
the COVID-19 Global Rheumatology Alliance
Handling editor Josef S
Smolen
►► Additional material is
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please visit the journal online
(http://dx.doi.org/10.1136/
annrheumdis-2020-217871).
For numbered affiliations see
end of article.
Correspondence to
Dr Philip C Robinson, Faculty of
Medicine, The University of
Queensland, Herston, QLD
4029, Australia;
philip.robinson@uq.edu.au
MG and KLH contributed
equally.
JY, PMM and PCR contributed
equally.
Received 4 May 2020
Revised 10 May 2020
Accepted 11 May 2020
© Author(s) (or their
employer(s)) 2020. No
commercial re-use. See rights
and permissions. Published
by BMJ.
To cite: Gianfrancesco M,
Hyrich KL, Al-Adely S, et al.
Ann Rheum Dis Epub ahead
of print: [please include Day
Month Year]. doi:10.1136/
annrheumdis-2020-217871
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.
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