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Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry.
Ann Rheum Dis. 2020 07; 79(7):859-866.AR

Abstract

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 multivariable-adjusted 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 anti-inflammatory 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.

Authors+Show Affiliations

Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK. National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK.Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK. National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK.Instituto de Salud Musculoesquelética, Madrid, Spain.Division of Clinical Immunology and Rheumatology, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France. APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France.Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK. Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK.Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal.Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.Health Research & Policy, Division of Epidemiology and Department of Medicine, Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA.Forschungsbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany.Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.University of Washington, Seattle, Washington, USA.Crystal Run Healthcare, Middletown, New York, USA.Irish Children's Arthritis Network (iCAN), Tipperary, Ireland.Department of Medicine, University of Otago, Wellington, New Zealand.Boston Children's Hospital, Boston, Massachusetts, USA. Harvard Medical School, Boston, Massachusetts, USA.University of Washington, Seattle, Washington, USA.Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada.Healthpartners, St Paul, Minnesota, USA.Harvard Medical School, Boston, Massachusetts, USA. Massachusetts General Hospital, Boston, Massachusetts, USA.Department of Medicine, Division of Rheumatology, University of California San Francisco, San Francisco, California, USA.Centre for Rheumatology & Department of Neuromuscular Diseases, University College London (UCL), London, UK. University College London Hospitals (UCLH) National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK. Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS trust, London, UK.Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia philip.robinson@uq.edu.au. Metro North Hospital & Health Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32471903

Citation

Gianfrancesco, Milena, et al. "Characteristics Associated With Hospitalisation for COVID-19 in People With Rheumatic Disease: Data From the COVID-19 Global Rheumatology Alliance Physician-reported Registry." Annals of the Rheumatic Diseases, vol. 79, no. 7, 2020, pp. 859-866.
Gianfrancesco M, Hyrich KL, Al-Adely S, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2020;79(7):859-866.
Gianfrancesco, M., Hyrich, K. L., Al-Adely, S., Carmona, L., Danila, M. I., Gossec, L., Izadi, Z., Jacobsohn, L., Katz, P., Lawson-Tovey, S., Mateus, E. F., Rush, S., Schmajuk, G., Simard, J., Strangfeld, A., Trupin, L., Wysham, K. D., Bhana, S., Costello, W., ... Robinson, P. C. (2020). Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Annals of the Rheumatic Diseases, 79(7), 859-866. https://doi.org/10.1136/annrheumdis-2020-217871
Gianfrancesco M, et al. Characteristics Associated With Hospitalisation for COVID-19 in People With Rheumatic Disease: Data From the COVID-19 Global Rheumatology Alliance Physician-reported Registry. Ann Rheum Dis. 2020;79(7):859-866. PubMed PMID: 32471903.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. AU - Gianfrancesco,Milena, AU - Hyrich,Kimme L, AU - Al-Adely,Sarah, AU - Carmona,Loreto, AU - Danila,Maria I, AU - Gossec,Laure, AU - Izadi,Zara, AU - Jacobsohn,Lindsay, AU - Katz,Patricia, AU - Lawson-Tovey,Saskia, AU - Mateus,Elsa F, AU - Rush,Stephanie, AU - Schmajuk,Gabriela, AU - Simard,Julia, AU - Strangfeld,Anja, AU - Trupin,Laura, AU - Wysham,Katherine D, AU - Bhana,Suleman, AU - Costello,Wendy, AU - Grainger,Rebecca, AU - Hausmann,Jonathan S, AU - Liew,Jean W, AU - Sirotich,Emily, AU - Sufka,Paul, AU - Wallace,Zachary S, AU - Yazdany,Jinoos, AU - Machado,Pedro M, AU - Robinson,Philip C, AU - ,, Y1 - 2020/05/29/ PY - 2020/05/04/received PY - 2020/05/10/revised PY - 2020/05/11/accepted PY - 2020/5/31/pubmed PY - 2020/6/26/medline PY - 2020/5/31/entrez KW - arthritis, rheumatoid KW - hydroxychloroquine KW - lupus erythematosus, systemic KW - methotrexate KW - tumor necrosis factor inhibitors SP - 859 EP - 866 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 79 IS - 7 N2 - 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 multivariable-adjusted 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 anti-inflammatory 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. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/32471903/Characteristics_associated_with_hospitalisation_for_COVID_19_in_people_with_rheumatic_disease:_data_from_the_COVID_19_Global_Rheumatology_Alliance_physician_reported_registry_ DB - PRIME DP - Unbound Medicine ER -