Characteristics Associated with Hospitalisation for COVID-19 in People with Rheumatic Disease: Data from the COVID-19 Global Rheumatology Alliance Physician-Reported Registry

Milena Gianfrancesco (1) , Kimme L Hyrich (2) , Sarah Al-Adely (2) , Loreto Carmona (3) , Maria I Danila , Laure Gossec (4, 5) , Zara Izadi (1) , Lindsay Jacobsohn (1) , Patricia Katz (1) , Saskia Lawson-Tovey (2) , Elsa F Mateus , Stephanie Rush (1) , Gabriela Schmajuk (1) , Julia Simard , Anja Strangfeld (6) , Laura Trupin (1) , Katherine D Wysham (7) , Suleman Bhana , Wendy Costello , Rebecca Grainger (8) , Jonathan S Hausmann (9) , Jean W Liew (7) , Emily Sirotich (10, 11) , Paul Sufka , Zachary S Wallace (9, 12) , Jinoos Yazdany (1) , Pedro M Machado , Philip C Robinson

1 UC - University of California
2 University of Manchester [Manchester]
3 InMusc - Instituto de Salud Musculoesqueletica
4 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
5 CHU Pitié-Salpêtrière [AP-HP]
6 DRFZ - Deutsches Rheuma-ForschungsZentrum
7 University of Washington [Seattle]
8 University of Otago [Dunedin, Nouvelle-Zélande]
9 HMS - Harvard Medical School [Boston]
10 McMaster University [Hamilton, Ontario]
11 CAPA - Canadian Arthritis Patient Alliance [Toronto, ON, Canada]
12 Massachusetts General Hospital [Boston]

Objectives COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease. Methods Case series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed. Results A total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥q10\,mg/day was associated with higher odds of hospitalisation (OR 2.05, 95%\,CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95%\,CI 0.70 to 2.17 and OR 0.74, 95%\,CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95%\,CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95%\,CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95%\,CI 0.57 to 1.57) was observed. Conclusions We found that glucocorticoid exposure of ≥q10\,mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.

Mots clés: arthritis; rheumatoid; hydroxychloroquine; lupus erythematosus; systemic; methotrexate; tumor necrosis factor inhibitors

Domaines: Sciences du Vivant [q-bio]

Milena Gianfrancesco, Kimme L Hyrich, Sarah Al-Adely, Loreto Carmona, Maria I Danila, et al.. Characteristics Associated with Hospitalisation for COVID-19 in People with Rheumatic Disease: Data from the COVID-19 Global Rheumatology Alliance Physician-Reported Registry. Annals of the Rheumatic Diseases, 2020, 79 (7), pp.859--866. ⟨10.1136/annrheumdis-2020-217871⟩. ⟨hal-03849959⟩