Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a prospective cohort study

{ 'indexed': {'date-parts': [[2023, 3, 27]], 'date-time': '2023-03-27T04:14:37Z', 'timestamp': 1679890477596}, 'reference-count': 36, 'publisher': 'Oxford University Press (OUP)', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2023, 2, 28]], 'date-time': '2023-02-28T00:00:00Z', 'timestamp': 1677542400000}, 'content-version': 'vor', 'delay-in-days': 60, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2022, 12, 30]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>There is ' 'dearth of data regarding the outcomes of coronavirus disease 2019 (COVID-19) among rheumatic ' 'and musculoskeletal disease (RMD) patients from Southeast Asia. We report the ' 'clinicodemographic profile and identify predictors of COVID-19 outcomes in a large cohort of ' 'Indian RMD ' 'patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This ' 'prospective cohort study, carried out at the Postgraduate Institute of Medical Education and ' 'Research, Chandigarh (a tertiary care centre in India), included RMD patients affected with ' 'COVID-19 between April 2020 and October 2021. Demographic and clinical and laboratory details ' 'of COVID-19 and underlying RMD were noted. Predictors of mortality, hospitalization and ' 'severe COVID-19 were identified using stepwise multivariable logistic ' 'regression.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of ' '64 severe acute respiratory syndrome coronavirus-2-infected RMD patients [age 41.5 ' '(19–85)\u2009years; 46 (72%) females] were included. Eighteen (28%) patients had severe ' 'COVID-19. Twenty-three (36%) required respiratory support [11 (17%) required mechanical ' 'ventilation]. Thirty-six (56%) patients required hospitalization [median duration of stay 10 ' '(1–42) days]; 17 (27%) required intensive care unit admission. Presence of co-morbidities ' '[odds ratio (OR)\u2009=\u20094.5 (95% CI: 1.4, 14.7)] was found to be an independent ' 'predictor of COVID-19 severity. Co-morbidities [OR\u2009=\u200910.7 (95% CI: 2.5, 45.4)] and ' 'underlying lupus [OR\u2009=\u20097.0 (95% CI: 1.2, 40.8)] were independently associated with ' 'COVID-19 hospitalization. Ongoing rheumatic disease activity [OR\u2009=\u20096.8 (95% CI: ' '1.3, 35.4)] and underlying diagnosis of lupus [OR\u2009=\u20097.1 (95% CI: 1.2, 42.4)] and ' 'SSc [OR\u2009=\u20099.5 (95% CI: 1.5, 61.8)] were found to be strong independent predictors ' 'of mortality. Age, sex, underlying RMD-associated interstitial lung disease and choice of ' 'immunosuppressive therapy were not associated with COVID-19 severity or adverse ' 'outcomes.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The ' 'presence of co-morbidities was independently associated with COVID-19 severity and ' 'hospitalization. Ongoing rheumatic disease activity and the presence of lupus or SSc ' 'independently predicted mortality. Age, sex, type of immunosuppressive therapy and presence ' 'of RMD-associated interstitial lung disease did not affect COVID-19 severity or outcomes in ' 'Indian RMD patients.</jats:p></jats:sec>', 'DOI': '10.1093/rap/rkad025', 'type': 'journal-article', 'created': {'date-parts': [[2023, 2, 28]], 'date-time': '2023-02-28T12:14:00Z', 'timestamp': 1677586440000}, 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a ' 'prospective cohort study', 'prefix': '10.1093', 'volume': '7', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-7043-4654', 'authenticated-orcid': False, 'given': 'Jithin', 'family': 'Mathew', 'sequence': 'first', 'affiliation': [ { 'name': 'Division of Clinical Immunology and Rheumatology, Department of ' 'Internal Medicine, Postgraduate Institute of Medical Education ' 'and Research , Chandigarh, India'}]}, { 'ORCID': 'http://orcid.org/0000-0003-4065-5880', 'authenticated-orcid': False, 'given': 'Siddharth', 'family': 'Jain', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of Clinical Immunology and Rheumatology, Department of ' 'Internal Medicine, Postgraduate Institute of Medical Education ' 'and Research , Chandigarh, India'}]}, { 'given': 'Terence', 'family': 'Susngi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Internal Medicine, Postgraduate Institute of ' 'Medical Education and Research, Chandigarh, India'}]}, { 'ORCID': 'http://orcid.org/0000-0002-9727-044X', 'authenticated-orcid': False, 'given': 'Shankar', 'family': 'Naidu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of Clinical Immunology and Rheumatology, Department of ' 'Internal Medicine, Postgraduate Institute of Medical Education ' 'and Research , Chandigarh, India'}]}, { 'ORCID': 'http://orcid.org/0000-0002-3626-0694', 'authenticated-orcid': False, 'given': 'Varun', 'family': 'Dhir', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of Clinical Immunology and Rheumatology, Department of ' 'Internal Medicine, Postgraduate Institute of Medical Education ' 'and Research , Chandigarh, India'}]}, { 'given': 'Aman', 'family': 'Sharma', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of Clinical Immunology and Rheumatology, Department of ' 'Internal Medicine, Postgraduate Institute of Medical Education ' 'and Research , Chandigarh, India'}]}, { 'ORCID': 'http://orcid.org/0000-0002-0141-7655', 'authenticated-orcid': False, 'given': 'Sanjay', 'family': 'Jain', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of Clinical Immunology and Rheumatology, Department of ' 'Internal Medicine, Postgraduate Institute of Medical Education ' 'and Research , Chandigarh, India'}]}, { 'ORCID': 'http://orcid.org/0000-0002-8821-6652', 'authenticated-orcid': False, 'given': 'Shefali Khanna', 'family': 'Sharma', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of 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