Risk of Severe COVID-19 Infection in Patients With Inflammatory Rheumatic Diseases

Article Figures & Data

Table 1.

Demographics, baseline characteristics, and outcomes of patients with IRD admitted to hospital due to severe SARS-CoV-2 infection.

	Hospitalized, n = 41	Hospitalized and Surviving, n = 31	Hospitalized and Deceased, n = 10	P^{^*}
Age, yrs, median (range)	72 (36–87)	72 (36–84)	76 (61–87)	0.06
Female	25 (61)	20 (64)	5 (50)	0.41
Hospital stay, days, median	9	9	9	0.88
Deaths	10 (24)	0 (0)	10 (100)
Comorbidities
Hypertension	23 (56)	17 (54)	6 (60)	0.77
Lung disease^{^a}	14 (34)	8 (25)	6 (60)	0.04
Diabetes	9 (22)	6 (19)	3 (30)	0.47
Cardiovascular disease	7 (17)	4 (13)	3 (30)	0.21
Malignant tumor	5 (12)	3 (10)	2 (20)	0.38
Other comorbidities	9 (22)	5 (16)	4 (40)	0.11
None	6 (15)	6 (19)	0	0.13
Rheumatic disease
RA	16 (39)	12 (39)	4 (40)	0.94
SpA	3 (7)	3 (10)	0	0.30
PsA	4 (10)	4 (13)	0	0.23
SLE	4 (10)	2 (6)	2 (20)	0.20
Sjögren syndrome	4 (10)	4 (13)	0	0.23
Vasculitis	3 (7)	1 (3)	2 (20)	0.07
Inflammatory myopathy	1 (2)	1 (3)	0	0.56
PMR	6 (15)	4 (13)	2 (20)	0.58
Active IRD^{^b}	6 (15)	3 (10)	3 (30)	0.11
Disease duration, yrs, median	15	12	18	0.45
IRD treatment
No DMARDs	10 (24)	6 (19)	4 (40)	0.18
Conventional synthetic DMARDs^{^c}	23 (56)	19 (61)	4 (40)	0.23
Biologic DMARDs	12 (29)	9 (29)	3 (30)	0.95
Anti-TNF	4 (10)	4 (13)	0	0.23
RTX	7 (17)	4 (13)	3 (30)	0.21
ABA	1 (2)	1 (3)	0	0.56
JAK inhibitors	1 (2)	1 (3)	0	0.56
GC use	27 (66)	18 (58)	9 (90)	0.06
GC dose, mg, mean	5.2	5.4	4.6	0.54

Values are expressed as n (%) unless otherwise indicated. Values in bold are statistically significant.
↵a Lung disease included interstitial lung disease, chronic obstructive pulmonary disease, asthma, or smoking.
↵b Active rheumatic disease included high clinical activity, or newly diagnosed or recently started biologics treatment.
↵c Conventional synthetic DMARDs included methotrexate, hydroxychloroquine, sulfasalazine, leflunomide, azathioprine, and mycophenolate mofetil.
↵* Comparisons were between surviving and deceased patients. ABA: abatacept; DMARD: disease-modifying antirheumatic drug; GC: glucocorticoid; IRD: inflammatory rheumatic disease; JAK: Janus kinase; PMR: polymyalgia rheumatica; PsA: psoriatic arthritis; RA: rheumatoid arthritis; RTX: rituximab; SLE: systemic lupus erythematosus; SpA: spondyloarthritis; TNF: tumor necrosis factor.

Table 2.

COVID-19 hospital admission rate and ORs in patients with inflammatory rheumatic diseases.

	All Patients^{^a}, n	Hospitalized Patients, n	Hospitalization Rate, %	OR^{^*}	95% CI^{^*}
Total population	492,745	2315	0.47
Non-IRD patients	488,153	2274	0.47	1.00
IRD patients	4592	41	0.89	1.91	1.41–2.61
RA	1708	16	0.94	2.01	1.23–3.28
SpA	862	3	0.35	0.74	0.24–2.31
PsA	515	4	0.78	1.66	0.63–4.43
SLE	254	4	1.57	3.38	1.28–8.95
Sjögren syndrome	175	4	2.29	4.90	1.86–12.94
Vasculitis	165	3	1.82	3.90	1.27–11.99
Inflammatory myopathy	88	1	1.14	2.43	0.35–17.13
PMR	474	6	1.27	2.71	1.23–6.02
Others	351	0	0	0

Values in bold are statistically significant.
↵a Hospitalized and nonhospitalized patients.
↵* Comparisons were between each disease group and no inflammatory rheumatic disease patients. COVID-19: coronavirus disease 2019; IRD: inflammatory rheumatic disease; PMR: polymyalgia rheumatica; PsA: psoriatic arthritis; RA: rheumatoid arthritis; SLE: systemic lupus erythematosus; SpA: spondyloarthritis.

Table 3.

Biologics and JAK inhibitors in patients with IRD, including rates and ORs of hospitalization in relation to undergoing treatment.

	All Patients^{^a}, n	Hospitalized Patients, n	Hospitalization Rate, %	OR^{^*}	95% CI^{^*}
IRD patients without biologics/JAK inhibitors	3709	28	0.75	1
Anti-TNF	603	4	0.66	0.88	0.31–2.50
RTX	72	7	9.72	12.88	5.82–28.51
ABA	40	1	2.50	3.31	0.46–23.75
JAK inhibitors	18	1	5.55	7.36	1.06–51.22
Others	150	0	0	0

↵a Hospitalized and nonhospitalized patients, diagnosed with IRD and monitored by the Department of Rheumatology.
↵* Comparisons were between each treatment group and IRD patients without biologic/JAK inhibitor treatment. ABA: abatacept; IRD: inflammatory rheumatic disease; JAK: Janus kinase; RTX: rituximab; TNF: tumor necrosis factor.