Impact of Risk Factors on <scp>COVID</scp>‐19 Outcomes in Unvaccinated People With Rheumatic Diseases: A Comparative Analysis of Pandemic Epochs Using the <scp>COVID</scp>‐19 Global Rheumatology Alliance Registry - Sorbonne Université Access content directly
Journal Articles Arthritis Care & Research = Arthritis Care and Research Year : 2023

Impact of Risk Factors on COVID‐19 Outcomes in Unvaccinated People With Rheumatic Diseases: A Comparative Analysis of Pandemic Epochs Using the COVID‐19 Global Rheumatology Alliance Registry

Jinoos Yazdany
Anna Ware
Zachary S Wallace
Suleman Bhana
  • Function : Author
Rebecca Grainger
Christophe Richez
Patrice Cacoub
Jonathan S Hausmann
Jean W Liew
  • Function : Author
Emily Sirotich
  • Function : Author
Lindsay Jacobsohn
  • Function : Author
Anja Strangfeld
  • Function : Author
Elsa F Mateus
  • Function : Author
Kimme L Hyrich
Loreto Carmona
  • Function : Author
Saskia Lawson‐tovey
Lianne Kearsley‐fleet
Martin Schaefer
Sandra Lucia Euzebio Ribeiro
Samar Al‐emadi
Rebecca Hasseli
Ulf Müller‐ladner
  • Function : Author
Christof Specker
Hendrik Schulze‐koops
Miguel Bernardes
Vanessa Machado Fraga
Ana Maria Rodrigues
Jeffrey A Sparks
Lotta Ljung
Daniela Di Giuseppe
Liselotte Tidblad
Leanna Wise
Alí Duarte‐garcía
Manuel F Ugarte‐gil
Iris Jazmín Colunga‐pedraza
Marco Ulises Martínez‐martínez
Deshire Alpizar‐rodriguez
Ricardo Machado Xavier
  • Function : Author
Carolina A Isnardi
Mariana Pera
Guillermo Pons‐estel
Zara Izadi
  • Function : Author
Milena A Gianfrancesco
Greta Carrara
Carlo Alberto Scirè
Anna Zanetti
Pedro M Machado

Abstract

Objective Approximately one third of individuals worldwide have not received a COVID‐19 vaccine. Although studies have investigated risk factors linked to severe COVID‐19 among unvaccinated people with rheumatic diseases (RDs), we know less about whether these factors changed as the pandemic progressed. We aimed to identify risk factors associated with severe COVID‐19 in unvaccinated individuals in different pandemic epochs corresponding to major variants of concern. Methods Patients with RDs and COVID‐19 were entered into the COVID‐19 Global Rheumatology Alliance Registry between March 2020 and June 2022. An ordinal logistic regression model (not hospitalized, hospitalized, and death) was used with date of COVID‐19 diagnosis, age, sex, race and/or ethnicity, comorbidities, RD activity, medications, and the human development index (HDI) as covariates. The main analysis included all unvaccinated patients across COVID‐19 pandemic epochs; subanalyses stratified patients according to RD types. Results Among 19,256 unvaccinated people with RDs and COVID‐19, those who were older, male, had more comorbidities, used glucocorticoids, had higher disease activity, or lived in lower HDI regions had worse outcomes across epochs. For those with rheumatoid arthritis, sulfasalazine and B‐cell–depleting therapy were associated with worse outcomes, and tumor necrosis factor inhibitors were associated with improved outcomes. In those with connective tissue disease or vasculitis, B‐cell–depleting therapy was associated with worse outcomes. Conclusion Risk factors for severe COVID‐19 outcomes were similar throughout pandemic epochs in unvaccinated people with RDs. Ongoing efforts, including vaccination, are needed to reduce COVID‐19 severity in this population, particularly in those with medical and social vulnerabilities identified in this study.
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hal-04306050 , version 1 (24-11-2023)

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Jinoos Yazdany, Anna Ware, Zachary S Wallace, Suleman Bhana, Rebecca Grainger, et al.. Impact of Risk Factors on COVID‐19 Outcomes in Unvaccinated People With Rheumatic Diseases: A Comparative Analysis of Pandemic Epochs Using the COVID‐19 Global Rheumatology Alliance Registry. Arthritis Care & Research = Arthritis Care and Research, 2023, ⟨10.1002/acr.25220⟩. ⟨hal-04306050⟩
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