Highlights from

ACR 2020

ACR Convergence 2020

Virtual 5 - 9 November 2020

Rheumatic patients show a comparable risk for COVID-19

A Bostonian team found no increased risk for rheumatic patients with COVID-19 compared to the general population suffering from COVID-19. These findings provide reassurance for rheumatic disease patients.

“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). However, the situation is still not entirely clear and rheumatologists and their patients are concerned about potential risks. This encouraged the investigators to further research this previous finding [1]. “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 diagnosed with a 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% of patients were female, 52% were never-smokers, and the median Charlson comorbidity index (CCI) equalled 2. The corresponding features in the non-RMD group were: mean age 59, 76% female, 50% never-smokers, CCI 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%).

The unadjusted results of a Cox proportional hazard model indicated a higher risk only for mechanical ventilation with an HR of 1.75 (95% CI 1.12-2.74). But after adjustment for race, smoking and CCI, this increased risk no longer had significance (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 rheumatic disease patients, though close monitoring of patients with other comorbidities is warranted,” Dr Serling-Boyd closed her talk.

  1. 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 Virtual Annual Meeting, 5-9 November 2020.

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