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Effects of the COVI...
Effects of the COVID-19 pandemic on patients with inflammatory joint diseases in Sweden: from infection severity to impact on care provision
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- Bower, H. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.
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- Frisell, T. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.
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- di Giuseppe, D. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.
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- Delcoigne, B. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.
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- Alenius, Gerd-Marie, Docent, 1957- (author)
- Umeå University,Umeå universitet,Reumatologi,Umeå Univ, Dept Publ Hlth & Clin Med Rheumatol, Umeå, Sweden.
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- Baecklund, Eva, 1956- (author)
- Uppsala universitet,Uppsala University,Reumatologi
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- Chatzidionysiou, K. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Stockholm, Sweden.
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- Feltelius, Nils (author)
- Uppsala universitet,Uppsala University,Swedish medical products agency,Allmänmedicin och preventivmedicin,Swedish Med Prod Agcy, Uppsala, Sweden
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- Forsblad d'Elia, Helena, 1961 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research,Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Inst Med, Sahlgrenska Acad, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.
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- Kastbom, Alf (author)
- Linköping University,Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Reumatologiska kliniken i Östergötland,Linköpings Univ, Dept Biomed & Clin Sci, Linköping, Sweden.
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- Klareskog, L. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Stockholm, Sweden.
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- Lindqvist, Elisabet (author)
- Lund University,Lunds universitet,Lund Arthritis Research Group (LARG),Forskargrupper vid Lunds universitet,Lund University Research Groups,Lund Univ, Dept Clin Sci, Lund, Sweden.
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- Lindström, Ulf (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research,Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Inst Med, Sahlgrenska Acad, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.
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- Turesson, Carl (author)
- Lund University,Lunds universitet,Reumatologi,Forskargrupper vid Lunds universitet,Rheumatology,Lund University Research Groups,Lund Univ, Dept Clin Sci, Rheumatol, Malmö, Sweden.
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- Sjöwall, Christopher (author)
- Linköping University,Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Reumatologiska kliniken i Östergötland,Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden.
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- Askling, J. (author)
- Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.
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Artis Study Grp, Artis Study Grp (author)
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Karolinska Institute Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden (creator_code:org_t)
- 2021-12-08
- 2021
- English.
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In: Rmd Open. - : BMJ. - 2056-5933. ; 7:3
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Abstract
Subject headings
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- Objectives To compare risks for COVID-19-related outcomes in inflammatory joint diseases (IJDs) and across disease-modifying antirheumatic drugs (DMARDs) during the first two waves of the pandemic and to assess effects of the pandemic on rheumatology care provision. Methods Through nationwide multiregister linkages and cohort study design, we defined IJD and DMARD use annually in 2015-2020. We assessed absolute and relative risks of hospitalisation or death listing COVID-19. We also assessed the incidence of IJD and among individuals with IJD, rheumatologist visits, DMARD use and incidence of selected comorbidities. Results Based on 115 317 patients with IJD in 2020, crude risks of hospitalisation and death listing COVID-19 (0.94% and 0.33% across both waves, respectively) were similar during both waves (adjusted HR versus the general population 1.33, 95% CI 1.23 to 1.43, for hospitalisation listing COVID-19; 1.23, 95% CI 1.08 to 1.40 for death listing COVID-19). Overall, biological disease-modifying antirheumatic drugs (bDMARDs)/targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) did not increase risks of COVID-19 related hospitalisation (with the exception of a potential signal for JAK inhibitors) or death. During the pandemic, decreases were observed for IJD incidence (-7%), visits to rheumatology units (-16%), DMARD dispensations (+6.5% for bDMARD/tsDMARDs and -8.5% for conventional synthetic DMARDs compared with previous years) and for new comorbid conditions, but several of these changes were part of underlying secular trends. Conclusions Patients with IJD are at increased risk of serious COVID-19 outcomes, which may partially be explained by medical conditions other than IJD per se. The SARS-CoV-2 pandemic has exerted measurable effects on aspects of rheumatology care provision demonstrated, the future impact of which will need to be assessed.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Keyword
- rheumatoid arthritis
- COVID-19
- treatment
- antirheumatic agents
- Rheumatology
- antirheumatic agents
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Bower, H.
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Frisell, T.
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di Giuseppe, D.
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Delcoigne, B.
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Alenius, Gerd-Ma ...
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Baecklund, Eva, ...
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show more...
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Chatzidionysiou, ...
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Feltelius, Nils
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Forsblad d'Elia, ...
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Kastbom, Alf
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Klareskog, L.
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Lindqvist, Elisa ...
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Lindström, Ulf
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Turesson, Carl
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Sjöwall, Christo ...
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Askling, J.
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Artis Study Grp, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and General Practice
- Articles in the publication
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Rmd Open
- By the university
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University of Gothenburg
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Umeå University
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Linköping University
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Lund University
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Uppsala University
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Karolinska Institutet