Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid Arthritis
Objective To investigate the clinical outcomes of patients with rheumatoid arthritis (RA) with COVID‐19. Methods This retrospective study consisted of 361 patients with RA+ and 45,954 patients with RA− (March 2020 to August 2022) who tested positive for SARS‐CoV‐2 by polymerase‐chain‐reaction in the...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11580 |
| _version_ | 1797684835995615232 |
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| author | Jai Mehrotra‐Varma Anand Kumthekar Sonya Henry Roman Fleysher Wei Hou Tim Q. Duong |
| author_facet | Jai Mehrotra‐Varma Anand Kumthekar Sonya Henry Roman Fleysher Wei Hou Tim Q. Duong |
| author_sort | Jai Mehrotra‐Varma |
| collection | DOAJ |
| description | Objective To investigate the clinical outcomes of patients with rheumatoid arthritis (RA) with COVID‐19. Methods This retrospective study consisted of 361 patients with RA+ and 45,954 patients with RA− (March 2020 to August 2022) who tested positive for SARS‐CoV‐2 by polymerase‐chain‐reaction in the Montefiore Health System, which serves a large low‐income, minority‐predominant population in the Bronx and was an epicenter of the initial pandemic and subsequent surges. Primary outcomes were hospitalization, critical illness, and all‐cause mortality associated with SARS‐CoV‐2 infection. Comparisons were made with and without adjustment for covariates, as well as with 1083 matched controls of patients with RA− and COVID‐19. Results Patients with RA+ and COVID‐19 were older (62.2 ± 23.5 vs. 45.5 ± 26.3; P < 0.001), were more likely females (83.1% vs. 55.8%; P < 0.001), were Black (35.5% vs. 30.3%; P < 0.05), and had higher rates of comorbidities (P < 0.05), hospitalization (52.4% vs. 32.5%; P < 0.005), critical illness (10.5% vs. 6.9%; P < 0.05), and mortality (11.1% vs. 6.2%; P < 0.01) compared with patients with RA− and COVID‐19. Patients with RA+ with COVID‐19 had higher odds of critical illness (adjusted odds ratio [aOR] = 1.46, 95% confidence interval [CI]: 1.09‐1.93; P = 0.008) but no differences in hospitalization (aOR = 1.18 [95% CI: 0.93‐1.49]; P = 0.16) and mortality (aOR = 1.34 [95% CI: 0.92‐1.89]; P = 0.10) after adjusting for covariates. Odds ratio analysis identified age, hospitalization status, female sex, chronic kidney disease, chronic obstructive pulmonary disease, and Black race to be significant risk factors for COVID‐19‐related mortality. Pre‐COVID‐19 steroid and biologic therapy to treat RA were not significantly associated with worse outcomes (P > 0.05). Outcomes were not different between patients with RA+ and propensity‐matched RA− controls (P > 0.05). Conclusion Our findings suggest that risk factors for adverse COVID‐19 outcomes were not attributed to RA per se but rather age and preexisting medical conditions of patients with RA. |
| first_indexed | 2024-03-12T00:36:32Z |
| format | Article |
| id | doaj.art-c776b99414064d4da6cffe6cf8030b8a |
| institution | Directory Open Access Journal |
| issn | 2578-5745 |
| language | English |
| last_indexed | 2024-03-12T00:36:32Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj.art-c776b99414064d4da6cffe6cf8030b8a2023-09-15T09:36:43ZengWileyACR Open Rheumatology2578-57452023-09-015946547310.1002/acr2.11580Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid ArthritisJai Mehrotra‐Varma0Anand Kumthekar1Sonya Henry2Roman Fleysher3Wei Hou4Tim Q. Duong5Department of Radiology Albert Einstein College of Medicine and Montefiore Medical Center Bronx New YorkDepartment of Medicine, Division of Rheumatology, Albert Einstein College of Medicine and Montefiore Medical Center Bronx New YorkDepartment of Radiology Albert Einstein College of Medicine and Montefiore Medical Center Bronx New YorkDepartment of Radiology Albert Einstein College of Medicine and Montefiore Medical Center Bronx New YorkDepartment of Radiology Albert Einstein College of Medicine and Montefiore Medical Center Bronx New YorkDepartment of Radiology Albert Einstein College of Medicine and Montefiore Medical Center Bronx New YorkObjective To investigate the clinical outcomes of patients with rheumatoid arthritis (RA) with COVID‐19. Methods This retrospective study consisted of 361 patients with RA+ and 45,954 patients with RA− (March 2020 to August 2022) who tested positive for SARS‐CoV‐2 by polymerase‐chain‐reaction in the Montefiore Health System, which serves a large low‐income, minority‐predominant population in the Bronx and was an epicenter of the initial pandemic and subsequent surges. Primary outcomes were hospitalization, critical illness, and all‐cause mortality associated with SARS‐CoV‐2 infection. Comparisons were made with and without adjustment for covariates, as well as with 1083 matched controls of patients with RA− and COVID‐19. Results Patients with RA+ and COVID‐19 were older (62.2 ± 23.5 vs. 45.5 ± 26.3; P < 0.001), were more likely females (83.1% vs. 55.8%; P < 0.001), were Black (35.5% vs. 30.3%; P < 0.05), and had higher rates of comorbidities (P < 0.05), hospitalization (52.4% vs. 32.5%; P < 0.005), critical illness (10.5% vs. 6.9%; P < 0.05), and mortality (11.1% vs. 6.2%; P < 0.01) compared with patients with RA− and COVID‐19. Patients with RA+ with COVID‐19 had higher odds of critical illness (adjusted odds ratio [aOR] = 1.46, 95% confidence interval [CI]: 1.09‐1.93; P = 0.008) but no differences in hospitalization (aOR = 1.18 [95% CI: 0.93‐1.49]; P = 0.16) and mortality (aOR = 1.34 [95% CI: 0.92‐1.89]; P = 0.10) after adjusting for covariates. Odds ratio analysis identified age, hospitalization status, female sex, chronic kidney disease, chronic obstructive pulmonary disease, and Black race to be significant risk factors for COVID‐19‐related mortality. Pre‐COVID‐19 steroid and biologic therapy to treat RA were not significantly associated with worse outcomes (P > 0.05). Outcomes were not different between patients with RA+ and propensity‐matched RA− controls (P > 0.05). Conclusion Our findings suggest that risk factors for adverse COVID‐19 outcomes were not attributed to RA per se but rather age and preexisting medical conditions of patients with RA.https://doi.org/10.1002/acr2.11580 |
| spellingShingle | Jai Mehrotra‐Varma Anand Kumthekar Sonya Henry Roman Fleysher Wei Hou Tim Q. Duong Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid Arthritis ACR Open Rheumatology |
| title | Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid Arthritis |
| title_full | Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid Arthritis |
| title_fullStr | Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid Arthritis |
| title_full_unstemmed | Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid Arthritis |
| title_short | Hospitalization, Critical Illness, and Mortality Outcomes of COVID‐19 in Patients With Rheumatoid Arthritis |
| title_sort | hospitalization critical illness and mortality outcomes of covid 19 in patients with rheumatoid arthritis |
| url | https://doi.org/10.1002/acr2.11580 |
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