Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry - Sorbonne Université Access content directly
Journal Articles Annals of the Rheumatic Diseases Year : 2021

Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry

Michael Putman
Yu Pei Eugenia Chock
  • Function : Author
Herman Tam
Alfred Kim
Sebastian Sattui
Maria Danila
  • Function : Author
Peter Korsten
Catalina Sanchez-Alvarez
Jeffrey Sparks
  • Function : Author
Laura Coates
Candace Palmerlee
  • Function : Author
Andrea Peirce
  • Function : Author
Arundathi Jayatilleke
  • Function : Author
Sindhu Johnson
  • Function : Author
Adam Kilian
  • Function : Author
Jean Liew
  • Function : Author
Larry Prokop
  • Function : Author
M. Hassan Murad
  • Function : Author
Rebecca Grainger
  • Function : Author
Zachary Wallace
  • Function : Author
Alí Duarte-García

Abstract

Objectives To determine factors associated with COVID-19-related death in people with rheumatic diseases. Methods Physician-reported registry of adults with rheumatic disease and confirmed or presumptive COVID-19 (from 24 March to 1 July 2020). The primary outcome was COVID-19-related death. Age, sex, smoking status, comorbidities, rheumatic disease diagnosis, disease activity and medications were included as covariates in multivariable logistic regression models. Analyses were further stratified according to rheumatic disease category. Results Of 3729 patients (mean age 57 years, 68% female), 390 (10.5%) died. Independent factors associated with COVID-19-related death were age (66–75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male sex (1.46, 1.11 to 1.91), hypertension combined with cardiovascular disease (1.89, 1.31 to 2.73), chronic lung disease (1.68, 1.26 to 2.25) and prednisolone-equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-modifying anti-rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were associated with higher odds of death, compared with methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-19-related death. Conclusion Among people with rheumatic disease, COVID-19-related death was associated with known general factors (older age, male sex and specific comorbidities) and disease-specific factors (disease activity and specific medications). The association with moderate/high disease activity highlights the importance of adequate disease control with DMARDs, preferably without increasing glucocorticoid dosages. Caution may be required with rituximab, sulfasalazine and some immunosuppressants.

Dates and versions

hal-03994586 , version 1 (17-02-2023)

Identifiers

Cite

Michael Putman, Yu Pei Eugenia Chock, Herman Tam, Alfred Kim, Sebastian Sattui, et al.. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Annals of the Rheumatic Diseases, 2021, 80 (7), pp.930-942. ⟨10.1002/art.41469⟩. ⟨hal-03994586⟩
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