ACR 2020 | Daily Highlights

COVID-19 and rheumatic diseases

OUTCOMES OF CORONAROVIRUS DISEASE 2019 INFECTION AMONG PATIENTS LIVING WITH RHEUMATIC DISEASES: A MATCHED COHORT STUDY FROM A US MULTI-CENTER RESEARCH NETWORK

Abstract: 0430
Authors: Kristin D'Silva et al.

» zum Abstract

Key content:
In this American study based on large claims databases (insurance), the authors wanted to answer the question whether patients with systemic autoimmune rheumatic diseases (SARDs) are at higher risk for severe complications from SARS-CoV2 infection. The authors identified 716 patients with RA (45%), SLE or various connective tissue diseases (39%), vasculitis (9%) and AS or PSA (9%) who developed PCR confirmed COVID-19. Patients with SARDs were at higher risk of hospitalization for COVID (RR: 1.23), intensive care admission (RR 1.75), compared to matched patients without SARDs. Furthermore, patients with SARDs also were at significantly higher risk of end-stage organ failure (mechanical ventilation (RR 1.77), acute kidney failure (RR 1.83) or heart failure (RR 3.06).

Relevance:
This study confirms similar findings from the UK or Spain, namely that patients with systemic inflammatory diseases are at slightly higher risk for severe COVID-19. It is, however, not clear whether this increased risk in patients with autoimmune diseases is due to increased prevalence of comorbidities (more DM, more HT, more heart disease) or to concurrent therapies (glucocorticoid use or rituximab…). Overall the risk associated with a diagnosis of autoimmune disease for severe COVID-19 is modest, compared to the risk of obesity, pre-existing heart- or lung conditions, or increased age.

While we can probably no longer tell our patients that they have no increased risk for COVID-19 whatsoever, – we may still reassure them if they don’t have other comorbid conditions that would increase their risk.

Zusammenfassung und Kommentar von:
Prof. Dr. Axel Finckh
Genf