PT  - JOURNAL ARTICLE
AU  - Jeffrey R.  Curtis
AU  - Xiaofeng Zhou
AU  - David T.  Rubin
AU  - Walter Reinisch
AU  - Jinoos Yazdany
AU  - Philip C.  Robinson
AU  - Yan Chen
AU  - Birgitta Benda
AU  - Ann Madsen
AU  - Jamie Geier
TI  - Characteristics, Comorbidities, and Outcomes of SARS-CoV-2 Infection in Patients With Autoimmune Conditions Treated With Systemic Therapies: A Population-based Study
AID  - 10.3899/jrheum.210888
DP  - 2021 Nov 15
TA  - The Journal of Rheumatology
PG  - jrheum.210888
4099  - http://www.jrheum.org/content/early/2021/12/12/jrheum.210888.short
4100  - http://www.jrheum.org/content/early/2021/12/12/jrheum.210888.full
AB  - Objective To describe characteristics and coronavirus disease 2019 (COVID-19) clinical outcomes of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ulcerative colitis (UC) receiving systemic therapies vs the general population. Methods This descriptive retrospective cohort study used data from the United States Optum deidentified COVID-19 electronic health record dataset (2007–2020). Adults with COVID-19 were stratified into 3 disease cohorts (patients with RA, PsA, or UC who had received systemic therapy) and a comparator cohort not meeting these criteria. Incidence proportions of hospitalization and clinical manifestations of interest were calculated. Using logistic regression analyses, risk of endpoints was estimated, adjusting for demographics and demographics plus comorbidities. Results This analysis (February 1 to December 9, 2020) included 315,101 patients with COVID-19. Adjusting for demographics, COVID-19 patients with RA (n = 2306) had an increased risk of hospitalization (OR 1.54, 95% CI 1.39–1.70) and in-hospital death (OR 1.61, 95% CI 1.30–2.00) compared with the comparator cohort (n = 311,563). The increased risk was also observed when adjusted for demographics plus comorbidities (hospitalization OR 1.25, 95% CI 1.13–1.39 and in-hospital death OR 1.35, 95% CI 1.09–1.68]). The risk of hospitalization was lower in COVID-19 patients with RA receiving tumor necrosis factor inhibitors (TNFi) vs non-TNFi biologics (OR 0.32, 95% CI 0.20–0.53) and the comparator cohort (OR 0.77, 95% CI 0.51–1.17). The risk of hospitalization due to COVID-19 was similar between patients receiving tofacitinib and the comparator cohort. Conclusion Compared with the comparator cohort, patients with RA were at a higher risk of more severe or critical COVID-19 and, except for non-TNFi biologics, systemic therapies did not further increase the risk. (ENCePP; registration no. EU PAS 35384)