Abstract: EPIDEMIOLOGICAL SCIENCE Factors associated with COVID-­19-­related death in people with rheumatic diseases: results from the COVID-­19 Global Rheumatology Alliance physician-­reported registry Handling editor Josef S Smolen Anja Strangfeld ‍ ‍,1 Martin Schäfer,1 Milena A Gianfrancesco,2 Saskia Lawson-­Tovey,3,4 Jean W Liew,5 Lotta Ljung ‍ ‍,6,7 Elsa F Mateus,8,9 Christophe Richez ‍ ‍,10 Maria J Santos ‍ ‍,11,12,13 Gabriela Schmajuk,2 Carlo A Scirè ‍ ‍,14 Emily Sirotich,15,16 Jeffrey A Sparks,17 Paul Sufka,18 Thierry Thomas,19,20,21 Laura Trupin,2 Zachary S Wallace,22 Sarah Al-­Adely,4,23 Javier Bachiller-­Corral ‍ ‍,24,25 Suleman Bhana,26 Patrice Cacoub,27,28,29 Loreto Carmona ‍ ‍,30 Ruth Costello ‍ ‍,23 Wendy Costello,31 Laure Gossec ‍ ‍,32,33 Rebecca Grainger,34 Eric Hachulla ‍ ‍,35 Rebecca Hasseli ‍ ‍,36 Jonathan S Hausmann ‍ ‍,37,38 Kimme L Hyrich ‍ ‍,4,23 Zara Izadi,2 Lindsay Jacobsohn,2 Patricia Katz,2 Lianne Kearsley-­Fleet ‍ ‍,23 Philip C Robinson ‍ ‍,39,40 Jinoos Yazdany,2 Pedro M Machado ‍ ‍,41,42,43 COVID-­19 Global Rheumatology Alliance ABSTRACT Objectives To determine factors associated with COVID-­19-­related death in people with rheumatic diseases. Methods Physician-­reported registry of adults with rheumatic disease and confirmed or presumptive For numbered affiliations see end of article. COVID-­19 (from 24 March to 1 July 2020). The primary outcome was COVID-­19-­related death. Age, sex, smoking Correspondence to status, comorbidities, rheumatic disease diagnosis, Dr Pedro M Machado, Centre for disease activity and medications were included as Rheumatology, UCL Division of covariates in multivariable logistic regression models. Medicine, University College Analyses were further stratified according to rheumatic London, London WC1E 6JF, UK; ​p.​machado@u​ cl.​ac.​uk disease category. Results Of 3729 patients (mean age 57 years, 68% AS and MS contributed equally. female), 390 (10.5%) died. Independent factors PCR, JY and PMM contributed associated with COVID-­19-­related death were age equally. (66–75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 Received 11 November 2020 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male Revised 17 December 2020 sex (1.46, 1.11 to 1.91), hypertension combined with Accepted 2 January 2021 cardiovascular disease (1.89, 1.31 to 2.73), chronic Published Online First 27 January 2021 lung disease (1.68, 1.26 to 2.25) and prednisolone-­ equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), ​ard.​bmj.​com immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-­modifying anti-­ © Author(s) (or their rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were employer(s)) 2021. Re-­use associated with higher odds of death, compared with permitted under CC BY. Published by BMJ. methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-­19-­related To cite: Strangfeld A, death. Schäfer M, Conclusion Among people with rheumatic disease, Gianfrancesco MA, et al. Ann Rheum Dis COVID-­19-­related death was associated with known 2021;80:930–942. general factors (older age, male sex and specific ► Additional material is published online only. To view, please visit the journal..