Factors Associated With Hospitalization and Death After COVID-19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data.
Factors Associated With Hospitalization and Death After COVID-19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data.
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DOI：
10.1002/acr2.11328
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发表时间：
2021-11
影响因子：
3.4
通讯作者：
Keyhani S
中科院分区：
文献类型：
--
作者：
Schmajuk G;Montgomery AD;Leonard S;Li J;Gianfrancesco M;Seet A;Izadi Z;Yazdany J;Keyhani S
患有自身免疫性风湿病(RD)的人被认为感染风险增加。然而，很少有美国基于人群的研究评估这些患者与那些没有RD的患者相比，是否因新冠肺炎而住院或死亡的风险增加。我们使用国家退伍军人事务卫生保健系统的数据对SARS-CoV-2检测呈阳性的个人进行了一项回顾性队列研究。感兴趣的结果是在新冠肺炎确诊后30天内因任何原因住院或死亡。使用倾向分数匹配(PSM)和混合效应多变量Logistic回归对患有RD和没有RD的退伍军人的结局进行比较。在26,116名患有新冠肺炎的退伍军人中，501人(1.9%)有潜在的RD。在配型前，与对照组相比，RD患者的预后更差(37.7%比28.5%住院；6.4%比4.5%死亡)。在PSM分析中，RD不是不良结果的重要预测因子；然而，服用糖皮质激素处方的患者以剂量依赖的方式增加不良结果的几率(住院或死亡的优势比[95%可信区间]：剂量和≤10 mg/天：1.33[1.20-1.48]；剂量>；10 mg/天：1.29[1.09-1.52])。在使用新冠肺炎的美国退伍军人中，我们没有发现RD与住院或死亡之间的显著关联。不良结果似乎主要是由年龄和其他合并症推动的，与普通退伍军人群体类似。然而，我们观察到，在接受糖皮质激素治疗的患者中，即使每天的剂量低于或等于10毫克，不良结果的风险也会增加。
Individuals with autoimmune rheumatic disease (RD) are considered to be at increased risk for infection. However, few US population‐based studies have assessed whether these patients are at increased risk of hospitalization or death due to COVID‐19 compared with those without RD. We performed a retrospective cohort study using national Veterans Affairs Health Care System data for individuals who tested positive for SARS‐CoV‐2. Outcomes of interest were hospitalization or death due to any cause within 30 days of COVID‐19 diagnosis. Outcomes were compared among veterans with RD and those without RD by using propensity score matching (PSM) and mixed‐effects multivariate logistic regression. Of 26,116 veterans with COVID‐19, 501 (1.9%) had an underlying RD. Prior to matching, patients with RD were more likely to have poor outcomes compared with controls (37.7% vs. 28.5% hospitalized; 6.4% vs. 4.5% died). In the PSM analysis, RD was not a significant predictor for poor outcomes; however, patients with prescriptions for glucocorticoids had increased odds of poor outcomes in a dose‐dependent manner (odds ratio [95% confidence interval] for hospitalization or death: 1.33 [1.20‐1.48] for doses >0 and ≤10 mg/day; 1.29 [1.09‐1.52] for doses >10 mg/day). Among US veterans with COVID‐19, we did not find a significant association between RD and hospitalization or death. Poor outcomes appear to be mostly driven by age and other comorbidities, similar to the general veteran population. However, we observed an increased risk for poor outcomes among patients who received glucocorticoids, even at daily doses less than or equal to 10 mg.
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DOI：
10.1002/art.41619
发表时间：
2021-06
期刊：
Arthritis & rheumatology (Hoboken, N.J.)
影响因子：
--
作者：
D'Silva KM;Jorge A;Cohen A;McCormick N;Zhang Y;Wallace ZS;Choi HK
通讯作者：
Choi HK
影响因子：
13.3
作者：
England, Bryant R.;Roul, Punyasha;Mikuls, Ted R.
通讯作者：
Mikuls, Ted R.
影响因子：
5.5
作者：
Peach, Emily;Rutter, Megan;Pearce, Fiona
通讯作者：
Pearce, Fiona
影响因子：
27.4
作者：
Strangfeld A;Schäfer M;Gianfrancesco MA;Lawson-Tovey S;Liew JW;Ljung L;Mateus EF;Richez C;Santos MJ;Schmajuk G;Scirè CA;Sirotich E;Sparks JA;Sufka P;Thomas T;Trupin L;Wallace ZS;Al-Adely S;Bachiller-Corral J;Bhana S;Cacoub P;Carmona L;Costello R;Costello W;Gossec L;Grainger R;Hachulla E;Hasseli R;Hausmann JS;Hyrich KL;Izadi Z;Jacobsohn L;Katz P;Kearsley-Fleet L;Robinson PC;Yazdany J;Machado PM;COVID-19 Global Rheumatology Alliance
通讯作者：
COVID-19 Global Rheumatology Alliance
影响因子：
27.4
作者：
FAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors
通讯作者：
FAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors