Sociodemographic and clinical factors associated with poor COVID-19 outcomes in patients with rheumatic diseases: data from the SAR-COVID Registry
Clinical Rheumatology, doi:10.1007/s10067-022-06393-8
Background/objective This study aims to describe the course and to identify poor prognostic factors of SARS-CoV-2 infection in patients with rheumatic diseases. Methods Patients ≥ 18 years of age, with a rheumatic disease, who had confirmed SARS-CoV-2 infection were consecutively included by major rheumatology centers from Argentina, in the national, observational SAR-COVID registry between August 13, 2020 and July 31, 2021. Hospitalization, oxygen requirement, and death were considered poor COVID-19 outcomes. Results A total of 1915 patients were included. The most frequent rheumatic diseases were rheumatoid arthritis (42%) and systemic lupus erythematosus (16%). Comorbidities were reported in half of them (48%). Symptoms were reported by 95% of the patients, 28% were hospitalized, 8% were admitted to the intensive care unit (ICU), and 4% died due to COVID-19. During hospitalization, 9% required non-invasive mechanical ventilation (NIMV) or high flow oxygen devices and 17% invasive mechanical ventilation (IMV). In multivariate analysis models, using poor COVID-19 outcomes as dependent variables, older age, male gender, higher disease activity, treatment with glucocorticoids or rituximab, and the presence of at least one comorbidity and a greater number of them were associated with worse prognosis. In addition, patients with public health insurance and Mestizos were more likely to require hospitalization. Conclusions In addition to the known poor prognostic factors, in this cohort of patients with rheumatic diseases, high disease activity, and treatment with glucocorticoids and rituximab were associated with worse COVID-19 outcomes. Furthermore, patients with public health insurance and Mestizos were 44% and 39% more likely to be hospitalized, respectively. Study registration This study has been registered in ClinicalTrials.gov under the number NCT04568421.
Key Points • High disease activity, and treatment with glucocorticoids and rituximab were associated with poor COVID-19 outcome in patients with rheumatic diseases. • Some socioeconomic factors related to social inequality, including non-Caucasian ethnicity and public health insurance, were associated with hospitalization due to COVID-19.
Appendix List of SAR-COVID investigators Author contribution All authors listed in this manuscript made substantial contributions to the acquisition, analysis, or interpretation of data and were involved in drafting or revising this article critically for important intellectual content. All authors approved the final version to be published. A list of all the SAR-COVID registry sub-investigators is included in the Appendix.
Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: SAR-COVID, as a strategic registry from the Argentine Society of Rheumatology, has received unrestricted research grants to carry out this project from Pfizer, AbbVie, and Elea Phoenix. In addition, two grants from the International League of Associations of Rheumatology have been obtained.
Data availability All data and materials generated and analyzed during the current study belong to the SAR-COVID registry and the Argentine Society of Rheumatology. They are available from the corresponding author on reasonable request. The authors declare that all relevant data is included in the article and its supplementary information files. More information about the registry is available in https:// www. unisar. reuma tolog ia. org. ar/ regis tros_ sarco vid. php.
Declarations Ethics approval This study is being conducted in accordance with Good Clinical Practice (GCP) guidelines, the International Conference on..
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