Severe COVID-19 Risk and Chronic Inflammatory Rheumatic Disease: What’s the Connection?

For patients with chronic inflammatory rheumatic diseases hospitalized with COVID-19, having a connective tissue disease but not an inflammatory arthritis, appears to significantly increase the risk of poor outcomes, according to findings from a new study.

“Our data illustrate how [inflammatory arthritis] and [connective tissue disease] groups carry a different risk for severe COVID-19,” the researchers wrote. “Whether specific diagnostics within the heterogeneous connective tissue disease group may have a different risk cannot be ruled out.”

To identify risk factors for severe COVID-19 among hospitalized patients with chronic inflammatory or autoimmune rheumatic diseases, the researchers compared these patients’ outcomes with those of a matched cohort of patients also hospitalized with COVID-19 but without rheumatic disease. Severe COVID-19 was defined as death, invasive ventilation, intensive care unit admission, or serious complications.

The study included 228 patients with rheumatic disease and 228 control patients matched by age, gender, and COVID-19-positive date. Patients had a mean age of 63 years, and 41% of them were men. In all, 60% of patients with rheumatic disease had inflammatory arthritis, and the remaining 40% had connective tissue disease.

Severe COVID-19 occurred in 31.6% of patients with rheumatic disease and in 28.1% of patients without rheumatic disease, the researchers reported. 

Being older, being a man, and having a connective tissue disease were significantly associated with severe COVID-19, according to the study. Immunosuppressive therapies, however, were not associated with a greater risk of poor outcomes.

“This observation should help to tailor recommendations to specific diagnostic and therapeutic groups of patients with rheumatic diseases during this or future coronavirus pandemics,” the researchers concluded.

—Jolynn Tumolo

Reference:

Pablos JL, Galindo M, Carmona L, et al. Clinical outcomes of hospitalised patients with COVID-19 and chronic inflammatory and autoimmune rheumatic diseases: a multicentric matched cohort study. Ann Rheum Dis. 2020;79(12):1544-1549. doi:10.1136/annrheumdis-2020-218296