Sociodemographic and clinical factors associated with poor COVID-19 outcomes in patients with rheumatic diseases: data from the SAR-COVID Registry
Retrospective 1,915 rheumatic disease patients with COVID-19 in Argentina, showing lower mortality, severe oxygen requirement, and hospitalization with CQ/HCQ (antimalarial) use in unadjusted results, statistically significant only for severe oxygen requirement.
risk of death, 33.9% lower, RR 0.66, p = 0.23, treatment 11 of 361 (3.0%), control 72 of 1,554 (4.6%), NNT 63, odds ratio converted to relative risk.
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risk of severe case, 48.0% lower, RR 0.52, p = 0.02, treatment 14 of 361 (3.9%), control 117 of 1,554 (7.5%), NNT 27, odds ratio converted to relative risk.
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risk of hospitalization, 17.0% lower, RR 0.83, p = 0.09, treatment 83 of 512 (16.2%), control 429 of 1,554 (27.6%), NNT 8.8, odds ratio converted to relative risk.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Isnardi et al., 6 Oct 2022, retrospective, Argentina, peer-reviewed, mean age 51.4, 199 authors, study period 13 August, 2020 - 31 July, 2021, trial
NCT04568421 (history).
Abstract: Clinical Rheumatology
https://doi.org/10.1007/s10067-022-06393-8
ORIGINAL ARTICLE
Sociodemographic and clinical factors associated with poor
COVID‑19 outcomes in patients with rheumatic diseases: data
from the SAR‑COVID Registry
Carolina A. Isnardi1 · Karen Roberts1 · Verónica Saurit2 · Ingrid Petkovic3 · Roberto M. Báez4 ·
Rosana Quintana5 · Yohana Tissera6 · Sofía Ornella7 · Maria Eugenia D.Angelo Exeni8 · Cecilia N. Pisoni9 ·
Vanessa V. Castro Coello10 · Guillermo Berbotto11 · María J. Haye Salinas12 · Edson Velozo13 ·
Álvaro A. Reyes Torres14 · Romina Tanten14 · Marcos D. Zelaya15 · Carla Gobbi16 · Carla G. Alonso17 ·
María de los Ángeles Severina18 · Florencia Vivero19 · Alba Paula20 · Adriana K. Cogo21 · Gelsomina Alle14 ·
Mariana Pera22 · Romina E. Nieto23 · Micaela Cosatti9 · Cecilia Asnal24 · Dora Pereira25 · Juan A. Albiero26 ·
Verónica G. Savio27 · Federico N. Maldonado10 · María Julieta Gamba28 · Noelia F. Germán29 ·
Andrea Baños30 · Josefina Gallino Yanzi31 · María Soledad Gálvez Elkin32 · Julieta S. Morbiducci33 ·
María Victoria Martire34 · Hernán Maldonado Ficco35 · Maria Marcela Schmid31 · Jaime A. Villafañe Torres36 ·
Maria de los Ángeles Correa37 · María Alejandra Medina38 · María Alejandra Cusa39 · Julia Scafati7 ·
Santiago E. Agüero40 · Nicolás M. Lloves Schenone41 · Enrique R. Soriano14 · Cesar Graf42 ·
Bernardo A. Pons‑Estel5 · Gimena Gomez1 · Margarita Landi1 · María Celina De la Vega42 ·
Guillermo J. Pons‑Estel1 · the S. A. R.–COVID Registry Investigators
Received: 15 June 2022 / Revised: 22 September 2022 / Accepted: 23 September 2022
© The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR) 2022
Abstract
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,..
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