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

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 multivariableadjusted 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 antiinflammatory 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. InTrOduCTIOn The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is of particular concern for people with rheumatic disease or those who are immunosuppressed. Whether having a rheumatic disease or receiving immunosuppressive treatment is associated with severe infection and subsequent poor outcomes is unknown. In general, immunosuppression and the presence of comorbidities are associated with an increased risk of serious infection in people with Key messages What is already known about this subject? ► Data regarding outcomes for people with rheumatological disease and COVID-19 remain scarce and limited to small case series. ► Due to underlying immune system dysfunction and the common use of immunosuppressants, there is concern about poorer outcomes in this population and uncertainty about medication management during the pandemic. What does this study add? ► Moderate to high dose glucocorticoids were associated with a higher risk of hospitalisation for COVID-19. ► Biologic therapies, NSAIDs and antimalarial drugs like hydroxychloroquine were not associated with a higher risk of hospitalisation for COVID-19. How might..