Factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy: results from the COVID-19 Global Rheumatology Alliance physician-reported registry
Year: 2022
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To investigate factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy (IIM). METHODS: Demographic data, clinical characteristics and COVID-19 outcome severity of adults with IIM were obtained from the COVID-19 Global Rheumatology Alliance physician-reported registry. A 3-point ordinal COVID-19 severity scale was defined: (1) no hospitalisation, (2) hospitalisation (and no death) and (3) death. ORs were estimated using multivariable ordinal logistic regression. Sensitivity analyses were performed using a 4-point ordinal scale: (1) no hospitalisation, (2) hospitalisation with no oxygen (and no death), (3) hospitalisation with oxygen/ventilation (and no death) and 4) death. RESULTS: Of 348 patients, 48% were not hospitalised, 39% were hospitalised (and did not die) and 13% died. Older age (OR=1.59/decade, 95% CI 1.31 to 1.91), high disease activity (OR=3.50, 95% CI 1.25 to 9.83; vs remission), ≥2 comorbidities (OR=2.63, 95% CI 1.39 to 4.98; vs none), prednisolone-equivalent dose >7.5 mg/day (OR=2.40, 95% CI 1.09 to 5.28; vs no intake) and exposure to rituximab (OR=2.71, 95% CI 1.28 to 5.72; vs conventional synthetic disease-modifying antirheumatic drugs only) were independently associated with severe COVID-19. In addition to these variables, in the sensitivity analyses, male sex (OR range: 1.65-1.83; vs female) was also significantly associated with severe outcomes, while COVID-19 diagnosis after 1 October 2020 (OR range: 0.51-0.59; vs on/before 15 June 2020) was significantly associated with less severe outcomes, but these associations were not significant in the main model (OR=1.57, 95% CI 0.95 to 2.59; and OR=0.61, 95% CI 0.37 to 1.00; respectively). CONCLUSIONS: This is the first large registry data on outcomes of COVID-19 in people with IIM. Older age, male sex, higher comorbidity burden, high disease activity, prednisolone-equivalent dose >7.5 mg/day and rituximab exposure were associated with severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with IIM.
Source: RMD Open
Authors: Su-Ann Yeoh, Milena Gianfrancesco, Saskia Lawson-Tovey, Kimme L Hyrich, Anja Strangfeld, Laure Gossec, Loreto Carmona, Elsa F Mateus, Martin Schäfer, Christophe Richez, Eric Hachulla, Marie Holmqvist, Carlo Alberto Scirè, Hanns-Martin Lorenz, Reinhard E Voll, Rebecca Hasseli, Arundathi Jayatilleke, Tiffany Y-T Hsu, Kristin M D’Silva, Victor R Pimentel-Quiroz, Monica Vasquez del Mercado, Samuel Katsuyuki Shinjo, Edgard Torres dos Reis Neto, Laurindo Ferreira da Rocha Junior, Ana Carolina de Oliveira e Silva Montandon, Guillermo J Pons-Estel, Sofía Ornella, Maria Eugenia D'Angelo Exeni, Edson Velozo, Paula Jordan, Emily Sirotich, Jonathan S Hausmann, Jean W Liew, Lindsay Jacobsohn, Monique Gore-Massy, Paul Sufka, Rebecca Grainger, Suleman Bhana, Zachary Wallace, Philip C Robinson, Jinoos Yazdany, Pedro M Machado
Institutions: University College London Hospitals NHS Foundation Trust, University College London, University of California, San Francisco, University of Manchester, Manchester University NHS Foundation Trust, Arthritis UK, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Centre for Epidemiology Versus Arthritis, German Rheumatism Research Centre, Inserm, Sorbonne Université, Pitié-Salpêtrière Hospital, Institut Pierre Louis d‘Épidémiologie et de Santé Publique, Instituto de Salud Musculoesquelética, Centre National de la Recherche Scientifique, Université de Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Immunology from Concept and Experiments to Translation, Université de Lille, Centre Hospitalier Universitaire de Lille, Lille Inflammation Research International Center, Karolinska Institutet, Società Italiana di Reumatologia, University Hospital Heidelberg, University of Freiburg, University Medical Center Freiburg, Justus-Liebig-Universität Gießen, Temple University, Brigham and Women's Hospital, Harvard University, Massachusetts General Hospital, Universidad Científica del Sur, Hospital Base Guillermo Almenara Irigoyen, Universidad de Guadalajara, Universidade de São Paulo, Universidade Federal de São Paulo, Instituto de Medicina Integral Professor Fernando Figueira, Universidade Federal de Goiás, Universidad Adventista del Plata, Sanatorio Adventista del Plata, Canadian Arthritis Patient Alliance, McMaster University, Boston Children's Hospital, Beth Israel Deaconess Medical Center, Boston University, Lupus Foundation of America, HealthPartners, University of Otago, Pfizer (United States), The University of Queensland, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, London North West Healthcare NHS Trust, Northwick Park Hospital, UCL Biomedical Research Centre
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,391
OpenAlex ID: W4295761925