Similar COVID-19 Outcomes in Patients With Ankylosing Spondylitis, Nonradiographic Spondyloarthritis

COVID-19 outcomes were better among patients with axial spondyloarthritis compared with propensity score-matched control subjects, with the exception of venous thromboembolism. Researchers published their findings in Clinical Rheumatology.

“Axial spondyloarthritis is associated with higher risks for venous thromboembolism during COVID-19,” wrote researchers.

Of the 9766 patients with axial spondyloarthritis included in the study, 924 had ankylosing spondylitis and 8842 had nonradiographic spondyloarthritis. There were 691,862 patients without axial spondyloarthritis included in the study and all patients had developed COVID-19.

In the unmatched analysis, patients with axial spondyloarthritis had higher risk for all study outcomes: mortality, hospitalization, intensive care unit, ventilation, acute kidney injury, renal replacement therapy, acute respiratory distress syndrome, cerebral infarction, venous thromboembolism, and sepsis, according to the study.

However, when researchers compared COVID-19 outcomes for the 9766 patients with axial spondyloarthritis with control subjects matched for demographics and comorbidities, patients with axial spondyloarthritis had lower risk for mortality (0.707 risk ratio), severe COVID-19 (0.791 risk ratio), hospitalization (0.872 risk ratio), and acute kidney injury (0.902 risk ratio).  Venous thromboembolism was the sole outcome more common in patients with axial spondyloarthritis (1.219 relative risk), the study showed.

An analysis of the axial spondyloarthritis group found that male patients fared worse in all outcomes except venous thromboembolism and cerebral infarction, and Black patients had worse outcomes in all domains except for mortality and the need for renal replacement therapy. By specific diagnosis, patients with ankylosing spondylitis had similar rates for all outcomes as patients with non-radiographic spondyloarthritis except for hospitalization (1.457 risk ratio), researchers reported.

Use of tumor necrosis factor inhibitors in the year before COVID-19 infection did not influence outcomes.

“There is no difference in outcomes between ankylosing spondylitis and non-radiographic spondyloarthritis except in rates of hospitalization, which were higher in ankylosing spondylitis,” concluded study authors.

Reference:
Raiker R, Pakhchanian H, Kavadichanda C, Gupta L, Kardeş S, Ahmed S. Axial spondyloarthritis may protect against poor outcomes in COVID-19: propensity score matched analysis of 9766 patients from a nationwide multi-centric research network. Clinical Rheumatology. 2022;41(3):721-730. doi:10.1007/s10067-021-05979-y.