COVID-19 in patients with rheumatic disease: most report mild disease

A new study presented during the ACR Convergence 2020 demonstrated that patients with rheumatic disease have a low incidence of COVID-19 with most patients having a mild disease course.

“When the pandemic started, there was concern on whether to continue or hold immune therapies among patients with rheumatic diseases because they are at increased risk for infection,” says the study’s co-author, Dr Akhil Sood (University of Texas Medical Branch, USA) [1]. To explore the risk for SARS-CoV-2 infection and outcomes in patients with rheumatic disease, the researchers performed a systematic literature search in PubMed/Medline and Scopus to identify relevant studies from January to June 2020 that reported the outcomes of COVID-19 among these patients.

The final review included 6,095 patients with rheumatic diseases from 8 observational cohort studies, with 28% having rheumatoid arthritis (RA) and 7% having psoriatic arthritis (PsA). Of the 6,095 patients, 123 (2%) tested positive or had a high clinical suspicion for COVID-19. Across all the studies used for the review, 68% of COVID-19 patients were taking biologics, with 31% taking anti-TNF drugs and 6% JAK inhibitors. Among patients infected with SARS-CoV-2, 91 (73%) were never hospitalised. 13 patients who were hospitalised required admission to an intensive care unit and 4 patients died. “The incidence of COVID-19 among patients with rheumatic disease was low,” Dr Sood concluded. “In our analysis, there was a small number of patients on biologics and targeted therapies to make definite conclusions on whether to continue or hold therapies,” said Dr Sood. Therefore, larger cohort studies are necessary to examine the outcomes of COVID-19 among biologic and non-biologic users. Finally, we must consider that rheumatology patients on DMARDs, especially higher-risk cases with cardiovascular and pulmonary disease, may have been shielding during the pandemic.

1. Sood A, et al. COVID-19 infection among patients with rheumatic disease on biologic & targeted therapies: a systematic review. P0008, ACR Convergence 2020, 5-9 Nov.

Posted on 18 January 2021