| Title: |
Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry |
| Authors: |
Strangfeld, Anja; Schäfer, Martin; Gianfrancesco, Milena A; Lawson-Tovey, Saskia; Liew, Jean W; Ljung, Lotta; Mateus, Elsa F; Richez, Christophe; Santos, Maria J; Schmajuk, Gabriela; Scirè, Carlo A; Sirotich, Emily; Sparks, Jeffrey A; Sufka, Paul; Thomas, Thierry; Trupin, Laura; Wallace, Zachary S; Al-Adely, Sarah; Bachiller-Corral, Javier; Bhana, Suleman; Cacoub, Patrice; Carmona, Loreto; Costello, Ruth; Costello, Wendy; Gossec, Laure; Grainger, Rebecca; Hachulla, Eric; Hasseli, Rebecca; Hausmann, Jonathan S; Hyrich, Kimme L; Izadi, Zara; Jacobsohn, Lindsay; Katz, Patricia; Kearsley-Fleet, Lianne; Robinson, Philip C; Yazdany, Jinoos; Machado, Pedro M; Dahou, Brahim; Pinheiro, Marcelo; Ribeiro, Francinne M; Chassin-Trubert, Anne-Marie; Ibáñez, Sebastián; Dong, Lingli; Cajas, Lui; Hamoud, Hesham; Avouac, Jérôme; Belin, Véronique; Borie, Raphaël; Chazerain, Pascal; Chevalier, Xavier; Claudepierre, Pascal; Clavel, Gaëlle; Colette-Cedoz, Marie-Eve; Combe, Bernard; Constant, Elodie; Costedoat-Chalumeau, Nathalie; Desmurs, Marie; Devauchelle-Pensec, Valérie; Devaux, Mathilde; Dhote, Robin; Dieudonné, Yannick; Domont, Fanny; Duret, Pierre-Marie; Ebbo, Mikaël; Ebstein, Esther; Mahou, Soumaya El; Fautrel, Bruno; Felten, Renaud; Flipo, René-Marc; Foltz, Violaine; Froissart, Antoine; Galland, Joris; Gaud-Listrat, Véronique; Georgin-Lavialle, Sophie; Giraud-Morelet, Aude; Quitrec, Jeanine S Giraudet-Le; Goupille, Philippe; Govindaraju-Audouard, Sophie; Grados, Franck; Guillaume-Czitrom, Séverine; Hermet, Marion; Hittinger-Roux, Ambre; Hudry, Christophe; Kone-Paut, Isabelle; La Batide Alanore, Sylvain; Lafforgue, Pierre; Lahalle, Sophie; Lambrecht, Isabelle; Langlois, Vincent; Larbre, Jean-Paul; Ledoult, Emmanuel; Leroux, Christophe; Liote, Frédéric; Maria, Alexandre TJ; Marotte, Hubert; Mekinian, Arsène; Melki, Isabelle; Messer, Laurent; Michel, Catherine; Morel, Gauthier |
| Source: |
Annals of the Rheumatic Diseases, vol 80, iss 7 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2021 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); Women's Health (rcdc); Arthritis (rcdc); Coronaviruses (rcdc); Emerging Infectious Diseases (rcdc); Lung (rcdc); Autoimmune Disease (rcdc); Coronaviruses Disparities and At-Risk Populations (rcdc); Infectious Diseases (rcdc); Inflammatory and immune system (hrcs-hc); Cardiovascular (hrcs-hc); 3 Good Health and Well Being (sdg); Aged (mesh); Antirheumatic Agents (mesh); COVID-19 (mesh); Comorbidity (mesh); Female (mesh); Global Health (mesh); Glucocorticoids (mesh); Humans (mesh); Male (mesh); Middle Aged (mesh); Odds Ratio (mesh); Registries (mesh); Rheumatic Diseases (mesh); Rheumatology (mesh); SARS-CoV-2 (mesh); antirheumatic agents; autoimmune diseases |
| Subject Geographic: |
930 - 942 |
| Description: |
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 ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt28j8c62q; https://escholarship.org/uc/item/28j8c62q; https://escholarship.org/content/qt28j8c62q/qt28j8c62q.pdf |
| DOI: |
10.1136/annrheumdis-2020-219498 |
| Availability: |
https://escholarship.org/uc/item/28j8c62q; https://escholarship.org/content/qt28j8c62q/qt28j8c62q.pdf; https://doi.org/10.1136/annrheumdis-2020-219498 |
| Rights: |
CC-BY-NC |
| Accession Number: |
edsbas.85ABD2B9 |
| Database: |
BASE |