Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry

DOI record: { "DOI": "10.1136/annrheumdis-2020-217871", "ISSN": [ "0003-4967", "1468-2060" ], "URL": "http://dx.doi.org/10.1136/annrheumdis-2020-217871", "abstract": "<jats:sec><jats:title>Objectives</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>", "alternative-id": [ "10.1136/annrheumdis-2020-217871" ], "author": [ { "affiliation": [], "family": "Gianfrancesco", "given": "Milena", "sequence": "first" }, { "affiliation": [], "family": "Hyrich", "given": "Kimme L", "sequence": "additional" }, { "affiliation": [], "family": "Al-Adely", "given": "Sarah", "sequence": "additional" }, { "affiliation": [], "family": "Carmona", "given": "Loreto", "sequence": "additional" }, { "affiliation": [], "family": "Danila", "given": "Maria I", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-4528-310X", "affiliation": [], "authenticated-orcid": false, "family": "Gossec", "given": "Laure", "sequence": "additional" }, { "affiliation": [], "family": "Izadi", "given": "Zara", "sequence": "additional" }, { "affiliation": [], "family": "Jacobsohn", "given": "Lindsay", "sequence": "additional" }, { "affiliation": [], "family": "Katz", "given": "Patricia", "sequence": "additional" }, { "affiliation": [], "family": "Lawson-Tovey", "given": "Saskia", "sequence": "additional" }, { "affiliation": [], "family": "Mateus", "given": "Elsa F", "sequence": "additional" }, { "affiliation": [], "family": "Rush", "given": "Stephanie", "sequence": "additional" }, { "affiliation": [], "family": "Schmajuk", "given": "Gabriela", "sequence": "additional" }, { "affiliation": [], "family": "Simard", "given": "Julia", "sequence": "additional" }, { "affiliation": [], "family": "Strangfeld", "given": "Anja", "sequence": "additional" }, { "affiliation": [], "family": "Trupin", "given": "Laura", "sequence": "additional" }, { "affiliation": [], "family": "Wysham", "given": "Katherine D", "sequence": "additional" }, { "affiliation": [], "family": "Bhana", "given": "Suleman", "sequence": "additional" }, { "affiliation": [], "family": "Costello", "given": "Wendy", "sequence": "additional" }, { "affiliation": [], "family": "Grainger", "given": "Rebecca", "sequence": "additional" }, { "affiliation": [], "family": "Hausmann", "given": "Jonathan S", "sequence": "additional" }, { "affiliation": [], "family": "Liew", "given": "Jean W", "sequence": "additional" }, { "affiliation": [], "family": "Sirotich", "given": "Emily", "sequence": "additional" }, { "affiliation": [], "family": "Sufka", "given": "Paul", "sequence": "additional" }, { "affiliation": [], "family": "Wallace", "given": "Zachary S", "sequence": "additional" }, { "affiliation": [], "family": "Yazdany", "given": "Jinoos", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-8411-7972", "affiliation": [], "authenticated-orcid": false, "family": "Machado", "given": "Pedro M", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-3156-3418", "affiliation": [], "authenticated-orcid": false, "family": "Robinson", "given": "Philip C", "sequence": "additional" } ], "container-title": "Annals of the Rheumatic Diseases", "container-title-short": "Ann Rheum Dis", "content-domain": { "crossmark-restriction": true, "domain": [ "bmj.com" ] }, "created": { "date-parts": [ [ 2020, 5, 29 ] ], "date-time": "2020-05-29T22:38:20Z", "timestamp": 1590791900000 }, "deposited": { "date-parts": [ [ 2021, 5, 13 ] ], "date-time": "2021-05-13T06:16:02Z", "timestamp": 1620886562000 }, "indexed": { "date-parts": [ [ 2024, 4, 5 ] ], "date-time": "2024-04-05T00:54:42Z", "timestamp": 1712278482079 }, "is-referenced-by-count": 848, "issue": "7", "issued": { "date-parts": [ [ 2020, 5, 29 ] ] }, "journal-issue": { "issue": "7", "published-online": { "date-parts": [ [ 2020, 6, 14 ] ] }, "published-print": { "date-parts": [ [ 2020, 7 ] ] } }, "language": "en", "license": [ { "URL": "https://bmj.com/coronavirus/usage", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2020, 5, 29 ] ], "date-time": "2020-05-29T00:00:00Z", "timestamp": 1590710400000 } } ], "link": [ { "URL": "https://syndication.highwire.org/content/doi/10.1136/annrheumdis-2020-217871", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "239", "original-title": [], "page": "859-866", "prefix": "10.1136", "published": { "date-parts": [ [ 2020, 5, 29 ] ] }, "published-online": { "date-parts": [ [ 2020, 5, 29 ] ] }, "published-print": { "date-parts": [ [ 2020, 7 ] ] }, "publisher": "BMJ", "reference": [ { "DOI": "10.1093/rheumatology/kes305", "doi-asserted-by": "publisher", "key": "2021051223100631000_79.7.859.1" }, { "DOI": "10.7326/M20-1223", "doi-asserted-by": "crossref", "key": "2021051223100631000_79.7.859.2", "unstructured": "Kim AHJ , Sparks JA , Liew JW , et al . 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