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Research ArticleOther Arthritides

COVID-19 Hospitalizations, Intensive Care Unit Stays, Ventilation, and Death Among Patients With Immune-mediated Inflammatory Diseases Compared to Controls

Lihi Eder, Ruth Croxford, Aaron M. Drucker, Arielle Mendel, Bindee Kuriya, Zahi Touma, Sindhu R. Johnson, Richard Cook, Sasha Bernatsky, Nigil Haroon and Jessica Widdifield
The Journal of Rheumatology May 2022, 49 (5) 523-530; DOI: https://doi.org/10.3899/jrheum.211012
Lihi Eder
1L. Eder, MD PhD, Women’s College Research Institute, University of Toronto, Toronto, Ontario;
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Ruth Croxford
2R. Croxford, MSc, ICES, Toronto, Ontario;
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Aaron M. Drucker
3A.M. Drucker, MD, ScM, Women’s College Research Institute, ICES, University of Toronto, Toronto, Ontario;
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Arielle Mendel
4A. Mendel, MD, MSc, S. Bernatsky, MD, PhD, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec;
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Bindee Kuriya
5 B. Kuriya, MD, MPH, Sinai Health System, University of Toronto, Toronto, Ontario;
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Zahi Touma
6Z. Touma, MD, PhD, Toronto Western Hospital, University of Toronto, Toronto, Ontario;
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  • ORCID record for Zahi Touma
Sindhu R. Johnson
7S.R. Johnson, MD, PhD, Toronto Western Hospital, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario;
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Richard Cook
8R. Cook, PhD, University of Waterloo, Waterloo, Ontario;
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Sasha Bernatsky
4A. Mendel, MD, MSc, S. Bernatsky, MD, PhD, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec;
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Nigil Haroon
9 N. Haroon, MD, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Western Hospital, University of Toronto, Toronto, Ontario;
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Jessica Widdifield
10J. Widdifield, PhD, Sunnybrook Research Institute, ICES, Institute of Health Policy, Management, & Evaluation, University of Toronto, Toronto, Ontario, Canada.
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Abstract

Objective To investigate coronavirus disease 2019 (COVID-19) hospitalization risk in patients with immune-mediated inflammatory diseases (IMIDs) compared with matched non-IMID comparators from the general population.

Methods We conducted a population-based, matched cohort study using health administrative data from January to July 2020 in Ontario, Canada. Cohorts for each of the following IMIDs were assembled: rheumatoid arthritis (RA), psoriasis, psoriatic arthritis (PsA), ankylosing spondylitis, systemic autoimmune rheumatic diseases (SARDs), multiple sclerosis (MS), iritis, inflammatory bowel disease, polymyalgia rheumatica, and vasculitis. Each patient was matched with 5 non-IMID comparators based on sociodemographic factors. We compared the cumulative incidence of hospitalizations for COVID-19 and their outcomes between IMID and non-IMID patients.

Results A total of 493,499 patients with IMID (417 hospitalizations) and 2,466,946 non-IMID comparators (1519 hospitalizations) were assessed. The odds of being hospitalized for COVID-19 were significantly higher in patients with IMIDs compared with their matched non-IMID comparators (matched unadjusted odds ratio [OR] 1.37, adjusted OR 1.23). Significantly higher risk of hospitalizations was found in patients with iritis (OR 1.46), MS (OR 1.83), PsA (OR 2.20), RA (OR 1.42), SARDs (OR 1.47), and vasculitis (OR 2.07). COVID-19 hospitalizations were associated with older age, male sex, long-term care residence, multimorbidity, and lower income. The odds of complicated hospitalizations were 21% higher among all IMID vs matched non-IMID patients, but this association was attenuated after adjusting for demographic factors and comorbidities.

Conclusion Patients with IMIDs were at higher risk of being hospitalized with COVID-19. This risk was explained in part by their comorbidities.

Key Indexing Terms:
  • autoimmune diseases
  • epidemiology
  • hospitalization
  • infection
  • rheumatoid arthritis
  • spondyloarthritis
  • Accepted for publication January 14, 2022.
  • Copyright © 2022 The Journal of Rheumatology. This is an Open Access article, which permits use, distribution, and reproduction, without modification, provided the original article is correctly cited and is not used for commercial purposes.
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The Journal of Rheumatology
Vol. 49, Issue 5
1 May 2022
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COVID-19 Hospitalizations, Intensive Care Unit Stays, Ventilation, and Death Among Patients With Immune-mediated Inflammatory Diseases Compared to Controls
Lihi Eder, Ruth Croxford, Aaron M. Drucker, Arielle Mendel, Bindee Kuriya, Zahi Touma, Sindhu R. Johnson, Richard Cook, Sasha Bernatsky, Nigil Haroon, Jessica Widdifield
The Journal of Rheumatology May 2022, 49 (5) 523-530; DOI: 10.3899/jrheum.211012

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COVID-19 Hospitalizations, Intensive Care Unit Stays, Ventilation, and Death Among Patients With Immune-mediated Inflammatory Diseases Compared to Controls
Lihi Eder, Ruth Croxford, Aaron M. Drucker, Arielle Mendel, Bindee Kuriya, Zahi Touma, Sindhu R. Johnson, Richard Cook, Sasha Bernatsky, Nigil Haroon, Jessica Widdifield
The Journal of Rheumatology May 2022, 49 (5) 523-530; DOI: 10.3899/jrheum.211012
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Keywords

AUTOIMMUNE DISEASES
EPIDEMIOLOGY
HOSPITALIZATION
INFECTION
RHEUMATOID ARTHRITIS
SPONDYLOARTHRITIS

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Keywords

  • autoimmune diseases
  • epidemiology
  • hospitalization
  • infection
  • rheumatoid arthritis
  • spondyloarthritis

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