Original Paper Summarized:
Gianfrancesco M, Hyrich KL, Al-Adely S, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Annals of the Rheumatic Diseases. [Epub ahead of print 29 May 2020]. doi: 10.1136/annrheumdis-2020-217871
Lay Summary Contributed to by: Emily Sirotich, Philip Robinson, Pedro Machado, Bimba F Hoyer, Zac Wallace, Jinoos Yazdany, Kristen J. Young, Akpabio Akpabio, Rebecca Grainger and the C19-GRA Lay Research Summaries Team
What was done:
Reports from patients with rheumatic diseases like rheumatoid arthritis and lupus who had COVID-19 were collected from doctors all over the world. A total of 600 people from 40 countries are summarised in this report. Hospitalization was chosen as an indication of the seriousness of the COVID-19 disease. We reported the types of rheumatic disease, the rheumatic disease treatments, and compared hospitalized patients to non-hospitalized patients.
What was found:
Many of the 600 patients were women (71%) and younger (33%) than 50 years of age. In this report, 46% (277 patients) were hospitalized and 9% (55) died from COVID19. Patients taking 10mg or more of prednisolone/prednisone daily (or equivalent doses of another steroid) were more likely to be hospitalized than patients on lower doses of steroids or no steroids at all. Taking non-steroidal anti-inflammatory drugs, oral arthritis medications like hydroxychloroquine or methotrexate, biologics or JAK inhibitors did not increase the risk of being hospitalized compared to those not taking these medications. Patients taking TNF inhibitors had a lower rate of hospitalization compared to those not taking any medications. Patients with other health conditions like high blood pressure, diabetes, lung or kidney disease were more likely to be admitted to the hospital for their COVID-19. Older age additionally increased the risk for hospitalization. Overall, the course of the illness in patients with rheumatic diseases was about two weeks until recovery, or death.
What does it mean:
Based on this data, risk factors for hospitalization for COVID-19 in patients with rheumatic diseases are largely similar to the general population, and include older age and medical comorbidities. Most patients with rheumatic diseases do not seem to be at an increased risk of hospitalization, even when taking medication for their rheumatic disease. It is important to be aware that these data were not collected across the entire global population, so it is not possible to know the rate of hospitalization or death in rheumatic disease patients overall and whether the country you are living in will influence your outcome. It is likely that patients with more severe COVID-19 were collected in the registry due to testing being limited to more severe cases.