RT Journal Article
SR Electronic
T1 Prevalence, risk factors, and outcomes of gout flare in patients hospitalized for PCR-confirmed COVID-19: A multicenter retrospective cohort study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.220762
DO 10.3899/jrheum.220762
A1 Kanon Jatuworapruk
A1 Panchalee Satpanich
A1 Philip C.  Robinson
A1 Rebecca Grainger
YR 2022
UL http://www.jrheum.org/content/early/2022/11/10/jrheum.220762.abstract
AB Objective The study aimed to describe the prevalence and outcomes of gout flare in patients with comorbid gout hospitalized for COVID-19. Factors associated with gout flare, and hospital length of stay were explored. Methods This retrospective cohort study included adults with comorbid gout who were hospitalized for PCR-confirmed COVID-19 between March 2020 and December 2021 in three hospitals in Thailand. Prevalence, characteristics, and outcomes of gout flare were described. Factors associated with gout flare were explored using LASSO selection and multivariate logistic regression. Association between gout flare and hospital length of stay was explored using multivariate linear regression. Results Among 8697 patients hospitalized for COVID-19, 146 patients with comorbid gout were identified and gout flare occurred in 26 (18%). Compared to those without flare, patients with gout flare had higher baseline serum urate and lower prevalence of use of urate-lowering therapy (ULT) and gout flare prophylaxis medications. One-third of gout flare episodes were treated with two or more anti-inflammatory medications. Logistic regression identified GOUT-36 rule ≥2, a predictive index for inpatient gout flare, as the only factor associated with gout flare (OR 5.46, 95%CI 1.18 to 25.37). Gout flare was found to be independently associated with hospital length of stay and added three days to hospital course. Conclusion Gout flare occurred in 18% of patients with comorbid gout hospitalized for COVID-19 and added up to three days to hospital length of stay. Patients with suboptimal ULT appeared to be at high risk for gout flare during COVID-19 hospitalization.