“Early in the pandemic we observed a higher risk of mechanical ventilation in patients with rheumatic diseases compared with the general population in a small cohort study,” stated Dr Naomi Serling-Boyd (Massachusetts General Hospital, USA) [1]. However, the situation is still not entirely clear [2]. “Therefore, we conducted a comparative cohort study of patients with COVID-19 as confirmed by PCR between January and July 2020 in our multicentre healthcare system,” she further explained.
Out of 12,866 COVID-19 cases during this period, 143 patients already diagnosed with rheumatic disease (RMD) were matched by age, sex, and date of COVID-19 PCR with up to 5 comparators without RMD (n=688). Within the RMD group, mean age was 60 years, 76% were female, 52% never-smokers, and the median Charlson comorbidity index (CCI) equalled 2. In the non-RMD group mean age was 59, 76% were female, 50% never-smokers, and CCI equalled 0. The most common rheumatic diagnoses were rheumatoid arthritis (31%) and systemic lupus erythematosus (19%). The rheumatic patients had ongoing treatments with corticosteroids (36%), hydroxychloroquine (21%), conventional synthetic DMARDs (31%), and biologic DMARDs (29%).
No disparities in risk for intensive care, hospital admission, or death were found between the groups. The unadjusted results of a Cox proportional hazard model pointed to a higher risk only for mechanical ventilation with an HR of 1.75 (95% CI 1.12–2.74). Nonetheless, after adjustment for race, smoking, and CCI, this increased risk was no longer significant (HR 1.51; 95% CI 0.93–2.44). Hence, RMD and non-RMD patients had a similar outcome risk for COVID-19. “These findings provide reassurance for RMD patients, though close monitoring of patients with other comorbidities is warranted,” Dr Serling-Boyd closed her talk. As the world is in the throws of the second peak of the COVID-19 pandemic, the overall data presented in relationship to RMD and, more importantly, immunosuppressive therapy is very reassuring. Indeed, more than one class of rheumatic drug has evidence for efficacy in severe COVID-19.
- D’Silva KM, et al. Ann Rheum Dis. 2020;79:1156-62.
- Serling-Boyd N, et al. Outcomes of COVID-19 infection in patients with rheumatic diseases in a multicenter healthcare system: a comparative cohort study. L01, ACR Convergence 2020, 5-9 Nov.
- Presented By
- Prof. Thomas MacDonald, University of Dundee, UK
- Presented By
- Dr Maria Cinta Cid, Hospital Clínic of Barcelona, Spain
- Presented By
- Prof. Dinesh Khanna, University of Michigan Scleroderma Program, USA
- Presented By
- Prof. Atul Deodhar, Oregon Health & Science University, USA
- Presented By
- Prof. Josef Smolen, Medical University of Vienna, Austria
- Presented By
- Prof. Daniel Aletaha, Medical University Vienna, Austria
- Presented By
- Prof. Joan Bathon, Columbia University, USA
- Presented By
- Dr Akhil Sood, University of Texas Medical Branch, USA
- Presented By
- Prof. Rebecca Grainger, University of Otago, New Zealand
- Presented By
- Dr Naomi Serling-Boyd, Massachusetts General Hospital, USA
- Presented By
- Prof. Chaim Putterman, Albert Einstein College of Medicine, USA
- Presented By
- Prof. Joan T. Merrill, Oklahoma Medical Research Foundation, USA
- Presented By
- Prof. Denis Poddubnyy, Charité Universitätsmedizin Berlin, Germany
- Presented By
- Prof. Dennis McGonagle, University of Leeds, UK
- Presented By
- Prof. Philip J. Mease, University of Washington, USA
- Presented By
- Dr Anisha Dua, Northwestern Medical Group, USA
- Presented By
- Dr Peter Grayson, National Institutes of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, USA
- Presented By
- Prof. Biswadip Ghosh, Institute of Post Graduate Medical Education and Research, India
- Presented By
- Dr Priyanka Ballal, Boston University Medical Center, USA
- Presented By
- Prof. Jinoos Yazdany, University of California San Francisco, USA
- Presented By
- Dr Giovanni Adami, University of Verona, Italy
- Presented By
- Dr Justin J. Bucci, Boston University School of Medicine, USA
- Presented By
- Dr Elizabeth Park, Columbia University Irving Medical Center, USA
- Presented By
- Dr Jonathan S. Hausmann, Harvard Medical School and Boston Children’s Hospital, USA
- Presented By
- Ms Emily Sirotich, COVID‐19 Global Rheumatology Alliance Steering Committee and McMaster University, Canada
Posted on
Table of Contents: ACR 2020
Featured articles
Late-Breaking News
Gout treatment with febuxostat: no higher cardiovascular mortality
New agent with great potential for the treatment of giant cell arteritis in the pipeline
Autotaxin inhibitor successful in the first trial in diffuse cutaneous systemic sclerosis
JAK inhibition as a treatment option for ankylosing spondylitis
Spotlight on Rheumatoid Arthritis
Persuasive long-term results for JAK inhibition in rheumatoid arthritis
Rheumatoid arthritis: new EULAR treatment guidelines
Rheumatoid arthritis and interstitial lung disease: a deadly combination
COVID-19 – What Rheumatologists Need to Know
COVID-19 in patients with rheumatic disease: most report mild disease
Poor disease control: a risk factor for severe COVID-19
No heightened outcome risk for rheumatic patients with COVID-19
What Is Hot in Lupus Nephritis?
Lupus nephritis biomarkers: moving toward an omic-driven approach
Lupus nephritis: new therapies on the horizon in 2020
Spondyloarthritis – The Beat Goes On
Artificial intelligence can help in the diagnosis of axSPA
Resolution of dactylitis or enthesitis is associated with improvements in joint and skin symptoms
Promising novel treatment option for psoriatic arthritis
How to Diagnose Large Vessel Vasculitis: Promises and Pitfalls
How to choose imaging modalities in large vessel vasculitis
Diagnosis of large vessel vasculitis with imaging
Osteoarthritis – Novel Developments
Knee osteoarthritis patients with indicators of inflammation could profit from methotrexate
Anticoagulation with vitamin K antagonist is associated with risk of knee and hip replacement
Osteoporosis – New Data
Bisphosphonate use: Asian American women have a smaller treatment benefit
Inflammatory disease as a risk factor for fractures
Best of the Posters
No progression of osteoarthritis with corticosteroid injections
Hydroxychloroquine use: no indication for arrhythmias in RA and SLE patients
Children with rheumatic disease have no greater risk of a COVID-19 infection
Insufficient antimalarial supply for rheumatic disease treatment in the early COVID-19 pandemic
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