Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry
Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry
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DOI：
10.1136/annrheumdis-2020-217871
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发表时间：
2020-07-01
影响因子：
27.4
通讯作者：
Robinson, Philip C.
中科院分区：
文献类型：
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作者：
Gianfrancesco, Milena;Hyrich, Kimme L.;Robinson, Philip C.
目标对于风湿性疾病患者的COVID-19结果仍然知之甚少。方法来自COVID-19全球风湿病联盟登记处的风湿病和COVID-19患者的病例系列：2020年3月24日至2020年4月20日。使用多变量logistic回归估计住院的OR和95% CI。年龄，性别，吸烟状况，风湿性疾病的诊断，合并症和风湿性疾病的药物治疗感染前立即进行了analyzed.Results共600例来自40个国家。近一半的病例住院治疗（277例，46%），55例（9%）死亡。在多变量校正模型中，泼尼松剂量>= 10 mg/天与较高的住院几率相关（OR 2.05，95% CI 1.06至3.96）。单独使用或与生物制剂/Janus激酶抑制剂联合使用常规疾病缓解抗风湿药（DMARD）与住院无关（OR分别为1.23，95% CI 0.70 - 2.17和OR 0.74，95% CI 0.37 - 1.46）。非甾体抗炎药（NSAID）的使用与住院状态无关（OR 0.64，95% CI 0.39 - 1.06）。肿瘤坏死因子抑制剂（抗肿瘤坏死因子）的使用与住院几率降低相关（OR 0.40，95% CI 0.19 - 0.81），而与抗疟药使用无关（或0.94，结论：我们发现糖皮质激素暴露≥ 10 mg/d与较高的住院率和抗肿瘤风险相关。TNF与风湿性疾病患者住院几率降低DMARD和NSAID暴露均与住院几率增加无关。
Objectives COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease.Methods Case series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed.Results A total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose >= 10 mg/ day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug ( NSAID) use was not associated with hospitalisation status (OR 0.64, 95% CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57) was observed.Conclusions We found that glucocorticoid exposure of >= 10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.