Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data
Objective 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. Methods W...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11328 |
| _version_ | 1828146512938401792 |
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| author | Gabriela Schmajuk Anna D. Montgomery Samuel Leonard Jing Li Milena Gianfrancesco Andrea Seet Zara Izadi Jinoos Yazdany Salomeh Keyhani |
| author_facet | Gabriela Schmajuk Anna D. Montgomery Samuel Leonard Jing Li Milena Gianfrancesco Andrea Seet Zara Izadi Jinoos Yazdany Salomeh Keyhani |
| author_sort | Gabriela Schmajuk |
| collection | DOAJ |
| description | Objective 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. Methods 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. Results 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). Conclusion 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. |
| first_indexed | 2024-04-11T20:49:12Z |
| format | Article |
| id | doaj.art-888753374c85464cb0a7b871bf0b9465 |
| institution | Directory Open Access Journal |
| issn | 2578-5745 |
| language | English |
| last_indexed | 2024-04-11T20:49:12Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj.art-888753374c85464cb0a7b871bf0b94652022-12-22T04:03:55ZengWileyACR Open Rheumatology2578-57452021-11-0131179680310.1002/acr2.11328Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs DataGabriela Schmajuk0Anna D. Montgomery1Samuel Leonard2Jing Li3Milena Gianfrancesco4Andrea Seet5Zara Izadi6Jinoos Yazdany7Salomeh Keyhani8San Francisco Department of Veterans Affairs Medical Center and University of California San FranciscoSan Francisco Department of Veterans Affairs Medical Center and University of California San FranciscoSan Francisco Department of Veterans Affairs Medical Center and University of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoSan Francisco Department of Veterans Affairs Medical Center and University of California San FranciscoObjective 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. Methods 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. Results 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). Conclusion 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.https://doi.org/10.1002/acr2.11328 |
| spellingShingle | Gabriela Schmajuk Anna D. Montgomery Samuel Leonard Jing Li Milena Gianfrancesco Andrea Seet Zara Izadi Jinoos Yazdany Salomeh Keyhani Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data ACR Open Rheumatology |
| title | Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data |
| title_full | Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data |
| title_fullStr | Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data |
| title_full_unstemmed | Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data |
| title_short | Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data |
| title_sort | factors associated with hospitalization and death after covid 19 diagnosis among patients with rheumatic disease an analysis of veterans affairs data |
| url | https://doi.org/10.1002/acr2.11328 |
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