Risk of death among people with rare autoimmune diseases compared with the general population in England during the 2020 COVID-19 pandemic
Risk of death among people with rare autoimmune diseases compared with the general population in England during the 2020 COVID-19 pandemic
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DOI：
10.1093/rheumatology/keaa855
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发表时间：
2021-04-01
期刊：
影响因子：
5.5
通讯作者：
Pearce, Fiona
中科院分区：
文献类型：
--
作者：
Peach, Emily;Rutter, Megan;Pearce, Fiona
目标。旨在量化英国 2020 年 COVID-19 大流行期间罕见自身免疫性风湿病 (RAIRD) 患者与普通人群的死亡风险，并与新冠肺炎之前的风险进行比较。方法。我们从 2003 年起对英格兰医院病例统计进行了一项队列研究，并链接了来自 NHS 个人人口统计服务的数据。我们使用国家统计局公布的一般人群死亡率数据。结果。我们纳入了 2020 年 3 月 1 日记录在案的 168691 名 RAIRD 诊断患者。他们的中位年龄为 61.7 (IQR 41.5-75.4) 岁，其中 118379 名 (70.2%) 为女性。我们的病例确定方法的阳性预测值为 85%。 2020 年 3 月和 4 月期间，共有 1815 名参与者 (1.1%) 死亡。 RAIRD 患者的年龄标准化死亡率 (ASMR) (3669.3; 95% CI: 3500.4, 3838.1 每 100000 人年) 比 2020 年 3 月和 4 月期间平均 ASMR 高 1.44 (95% CI: 1.42, 1.45) 倍与过去 5 年的同月相比，英国普通人口的这一数字高出 1.38 倍。与新冠疫情前相比，RAIRD 患者的特定年龄死亡率从 35 岁以上开始较高，而在普通人群中，风险从 55 岁以上开始增加。与男性相比，女性在 COVID-19 期间的死亡率增加幅度更大。结论。在 COVID-19 期间，RAIRD 患者的全因死亡风险比一般人群更为显着增加。我们迫切需要量化 COVID-19 感染造成的风险有多大，以及医疗保健服务中断造成的风险有多大。
Objectives. To quantify the risk of death among people with rare autoimmune rheumatic diseases (RAIRD) during the UK 2020 COVID-19 pandemic compared with the general population, and compared with their pre-COVID risk.Methods. We conducted a cohort study in Hospital Episode Statistics for England from 2003 onwards, and linked data from the NHS Personal Demographics Service. We used ONS published data for general population mortality rates.Results. We included 168691 people with a recorded diagnosis of RAIRD alive on 1 March 2020. Their median age was 61.7 (IQR 41.5-75.4) years, and 118379 (70.2%) were female. Our case ascertainment methods had a positive predictive value of 85%. A total of 1815 (1.1%) participants died during March and April 2020. The age-standardized mortality rate (ASMR) among people with RAIRD (3669.3; 95% CI: 3500.4, 3838.1 per 100000 person-years) was 1.44 (95% CI: 1.42, 1.45) times higher than the average ASMR during the same months of the previous 5years, whereas in the general population of England it was 1.38 times higher. Age-specific mortality rates in people with RAIRD compared with the pre-COVID rates were higher from the age of 35 upwards, whereas in the general population the increased risk began from age 55 upwards. Women had a greater increase in mortality rates during COVID-19 compared with men.Conclusion. The risk of all-cause death is more prominently raised during COVID-19 among people with RAIRD than among the general population. We urgently need to quantify how much risk is due to COVID-19 infection and how much is due to disruption to health-care services.