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Factors associated ...
Factors associated with COVID-19-related death in people with rheumatic diseases : results from the COVID-19 Global Rheumatology Alliance physician-reported registry
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- Strangfeld, Anja (author)
- Epidemiology and Health Care Research, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany
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- Schäfer, Martin (author)
- Epidemiology and Health Care Research, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany
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- Gianfrancesco, Milena A. (author)
- Division of Rheumatology, Department of Medicine, University of California, CA, San Francisco, United States
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- Lawson-Tovey, Saskia (author)
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom; National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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- Liew, Jean W. (author)
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, MA, Boston, United States
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- Ljung, Lotta, 1964- (author)
- Karolinska Institutet,Umeå universitet,Reumatologi,Clinical Epidemiology Section, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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- Mateus, Elsa F. (author)
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal; European League Against Rheumatism (EULAR), Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Kilchberg, Switzerland
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- Richez, Christophe (author)
- Club Rhumatismes et Inflammation (CRI), Immune-Mediated Inflammatory Disease Alliance for Translational and Clinical Research Network (IMIDIATE), Bordeaux, France
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- Santos, Maria J. (author)
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Lisboa, Portugal
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- Schmajuk, Gabriela (author)
- Division of Rheumatology, Department of Medicine, University of California, CA, San Francisco, United States
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- Scirè, Carlo A. (author)
- Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy; Rheumatology Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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- Sirotich, Emily (author)
- Department of Health Research Methods Evidence, and Impact, McMaster University, ON, Hamilton, Canada; Canadian Arthritis Patient Alliance, ON, Toronto, Canada
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- Sparks, Jeffrey A. (author)
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, MA, Boston, United States
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- Sufka, Paul (author)
- Healthpartners, MN, St. Paul, United States
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- Thomas, Thierry (author)
- Société Française de Rhumatologie (SFR), Saint Etienne, France; Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France; INSERM U1059, Université de Lyon-Université Jean Monnet, Saint-Etienne, France
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- Trupin, Laura (author)
- Division of Rheumatology, Department of Medicine, University of California, CA, San Francisco, United States
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- Wallace, Zachary S. (author)
- Clinical Epidemiology Program and Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, MA, Boston, United States
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- Al-Adely, Sarah (author)
- National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom; Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
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- Bachiller-Corral, Javier (author)
- Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto de investigación IRYCIS, Universidad de Alcalá, Madrid, Spain
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- Bhana, Suleman (author)
- Crystal Run Healthcare, Middletown, United States
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- Cacoub, Patrice (author)
- Département de Médecine Interne et Immunologie Clinique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France; Société Nationale Française de Médecine Interne (SNFMI), Paris, France
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- Carmona, Loreto (author)
- Instituto de Salud Musculoesquelética, Madrid, Spain
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- Costello, Ruth (author)
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
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- Costello, Wendy (author)
- Irish Children's Arthritis Network (iCAN), Tipperary, Ireland
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- Gossec, Laure (author)
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Université, Paris, France; AP-HP.Sorbonne Université, Rheumatology department, Pitié-Salpêtrière hospital, Paris, France
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- Grainger, Rebecca (author)
- University of Otago, Wellington, New Zealand
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- Hachulla, Eric (author)
- Filière des maladies Auto-Immunes et Autoinflammatoires Rares (FAI2R), Lille University, France, Lille University, Lille, France
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- Hasseli, Rebecca (author)
- Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Ustus-Liebig-University Giessen, Giessen, Germany
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- Hausmann, Jonathan S. (author)
- Program in Rheumatology, Boston Children's Hospital, MA, Boston, United States; Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, Harvard Medical School, MA, Boston, United States
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- Hyrich, Kimme L. (author)
- National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom; Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
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- Izadi, Zara (author)
- Division of Rheumatology, Department of Medicine, University of California, CA, San Francisco, United States
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- Jacobsohn, Lindsay (author)
- Division of Rheumatology, Department of Medicine, University of California, CA, San Francisco, United States
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- Katz, Patricia (author)
- Division of Rheumatology, Department of Medicine, University of California, CA, San Francisco, United States
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- Kearsley-Fleet, Lianne (author)
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
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- Robinson, Philip C. (author)
- Faculty of Medicine, University of Queensland, QLD, Brisbane, Australia; Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, QLD, Herston, Australia
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- Yazdany, Jinoos (author)
- Division of Rheumatology, Department of Medicine, University of California, CA, San Francisco, United States
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- Machado, Pedro M. (author)
- National Institute for Health Research (NIHR), University College London Hospitals Biomedical Research Centre, University College London Hospitals National Health Service (NHS) Trust, London, United Kingdom; Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare, NHS TrustLondon North West University Healthcare NHS Trust, London, United Kingdom; Centre for Rheumatology, UCL Division of Medicine, Department of Neuromuscular Diseases, University College London, London, United Kingdom
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(creator_code:org_t)
- 2021-01-27
- 2021
- English.
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In: Annals of the Rheumatic Diseases. - : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 80:7, s. 930-942
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Abstract
Subject headings
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- Objectives: To determine factors associated with COVID-19-related death in people with rheumatic diseases.Methods: Physician-reported registry of adults with rheumatic disease and confirmed or presumptive COVID-19 (from 24 March to 1 July 2020). The primary outcome was COVID-19-related death. Age, sex, smoking status, comorbidities, rheumatic disease diagnosis, disease activity and medications were included as covariates in multivariable logistic regression models. Analyses were further stratified according to rheumatic disease category.Results: Of 3729 patients (mean age 57 years, 68% female), 390 (10.5%) died. Independent factors associated with COVID-19-related death were age (66-75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male sex (1.46, 1.11 to 1.91), hypertension combined with cardiovascular disease (1.89, 1.31 to 2.73), chronic lung disease (1.68, 1.26 to 2.25) and prednisolone-equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-modifying anti-rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were associated with higher odds of death, compared with methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-19-related death.Conclusion: Among people with rheumatic disease, COVID-19-related death was associated with known general factors (older age, male sex and specific comorbidities) and disease-specific factors (disease activity and specific medications). The association with moderate/high disease activity highlights the importance of adequate disease control with DMARDs, preferably without increasing glucocorticoid dosages. Caution may be required with rituximab, sulfasalazine and some immunosuppressants.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- antirheumatic agents
- autoimmune diseases
- epidemiology
- glucocorticoids
- health care
- outcome assessment
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Strangfeld, Anja
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Schäfer, Martin
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Gianfrancesco, M ...
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Lawson-Tovey, Sa ...
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Liew, Jean W.
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Ljung, Lotta, 19 ...
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show more...
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Mateus, Elsa F.
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Richez, Christop ...
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Santos, Maria J.
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Schmajuk, Gabrie ...
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Scirè, Carlo A.
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Sirotich, Emily
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Sparks, Jeffrey ...
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Sufka, Paul
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Thomas, Thierry
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Trupin, Laura
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Wallace, Zachary ...
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Al-Adely, Sarah
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Bachiller-Corral ...
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Bhana, Suleman
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Cacoub, Patrice
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Carmona, Loreto
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Costello, Ruth
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Costello, Wendy
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Gossec, Laure
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Grainger, Rebecc ...
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Hachulla, Eric
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Hasseli, Rebecca
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Hausmann, Jonath ...
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Hyrich, Kimme L.
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Izadi, Zara
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Jacobsohn, Linds ...
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Katz, Patricia
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Kearsley-Fleet, ...
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Robinson, Philip ...
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Yazdany, Jinoos
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Machado, Pedro M ...
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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 ...
- Articles in the publication
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Annals of the Rh ...
- By the university
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Umeå University
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Karolinska Institutet