Open Access
Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry
Anja Strangfeld
1, 2
,
Martin Schäfer
1, 2
,
Milena A. Gianfrancesco
3, 4
,
Saskia Lawson Tovey
5, 6, 7, 8
,
Jean W. Liew
9, 10
,
Lotta Ljung
11, 12, 13, 14
,
Elsa F Mateus
15, 16
,
Christophe Richez
17
,
Maria José Santos
18, 19, 20, 21, 22
,
Gabriela Schmajuk
3, 4
,
Carlo Alberto Scirè
23, 24
,
Emily Sirotich
25, 26, 27
,
Jeffrey A. Sparks
28, 29
,
Paul Sufka
30
,
Thierry Thomas
31, 32, 33, 34, 35
,
Laura Trupin
3, 4
,
Zachary S. Wallace
36, 37
,
Sarah Al Adely
7, 8, 38, 39
,
Javier Bachiller-Corral
40, 41, 42
,
Suleman Bhana
43
,
Patrice Cacoub
44, 45, 46, 47
,
Loreto Carmona
48
,
Ruth E Costello
38, 39
,
Wendy Costello
49
,
Laure Gossec
50, 51, 52, 53
,
Rebecca Grainger
54
,
Eric Hachulla
55, 56
,
Rebecca Hasseli
57, 58
,
Jonathan S. Hausmann
59, 60, 61, 62
,
Kimme Hyrich
7, 8, 38, 39
,
Zara Izadi
3, 4
,
Lindsay Jacobsohn
3, 4
,
Patricia Katz
3, 4
,
Lianne Kearsley Fleet
38, 39
,
Philip C Robinson
63, 64, 65
,
Jinoos Yazdany
3, 4
,
Pedro M. Machado
32, 66, 67, 68, 69, 70
1
Epidemiology and Health Care Research
3
Division of Rheumatology, Department of Medicine
4
University Of California
|
5
Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research
7
National Institute of Health Research Manchester Biomedical Research Centre
8
9
Section of Rheumatology, Department of Medicine
11
Department of Public Health and Clinical Medicine/Rheumatology
13
Clinical Epidemiology Section, Department of Medicine Solna
|
15
Portuguese League Against Rheumatic Diseases (LPCDR)
16
European League Against Rheumatism (EULAR) Standing Committee of People with Arthritis/Rheumatism in Europe (PARE)
17
Club Rhumatismes et Inflammation (CRI) and Immune-Mediated Inflammatory Disease Alliance for Translational and Clinical Research Network (IMIDIATE)
|
18
Rheumatology Department
19
Hospital Garcia de Orta
20
Rheumatology Research Unit
21
Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa
22
Rheumatic Diseases Portuguese Register (Reuma.pt), Portuguese Society of Rheumatology (SPR)
23
Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy and Rheumatology Unit, Department of Medical Sciences
|
25
Department of Health Research Methods, Evidence, and Impact
27
Canadian Arthritis Patient Alliance
|
28
Division of Rheumatology, Inflammation, and Immunity
30
HealthPartners
31
Société Française de Rhumatologie (SFR)
32
Department of Rheumatology
36
Clinical Epidemiology Program and Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology
37
38
Centre for Epidemiology Versus Arthritis
39
43
Crystal Run Healthcare
44
Département de Médecine Interne et Immunologie Clinique
45
AP-HP, Groupe Hospitalier Pitié-Salpêtrière
47
Société Nationale Française de Médecine Interne (SNFMI)
48
Instituto de Salud Musculoesquelética
49
Irish Children's Arthritis Network (iCAN)
50
Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM
|
53
Pitié-Salpêtrière Hospital
57
Department of Rheumatology and Clinical Immunology, Campus Kerckhoff
59
Program in Rheumatology
61
Division of Rheumatology and Clinical Immunology
62
63
Faculty of Medicine
69
Centre for Rheumatology & Department of Neuromuscular Diseases
Publication type: Journal Article
Publication date: 2021-01-27
scimago Q1
wos Q1
SJR: 5.731
CiteScore: 33.2
Impact factor: 20.6
ISSN: 00034967, 14682060
PubMed ID:
33504483
General Biochemistry, Genetics and Molecular Biology
Immunology
Immunology and Allergy
Rheumatology
Abstract
Objectives
To determine factors associated with COVID-19-related death in people with rheumatic diseases.
Methods
Physician-reported registry of adults with rheumatic disease and confirmed or presumptive COVID-19 (from 24 March to 1 July 2020). The primary outcome was COVID-19-related death. Age, sex, smoking status, comorbidities, rheumatic disease diagnosis, disease activity and medications were included as covariates in multivariable logistic regression models. Analyses were further stratified according to rheumatic disease category.
Results
Of 3729 patients (mean age 57 years, 68% female), 390 (10.5%) died. Independent factors associated with COVID-19-related death were age (66–75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male sex (1.46, 1.11 to 1.91), hypertension combined with cardiovascular disease (1.89, 1.31 to 2.73), chronic lung disease (1.68, 1.26 to 2.25) and prednisolone-equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-modifying anti-rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were associated with higher odds of death, compared with methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-19-related death.
Conclusion
Among people with rheumatic disease, COVID-19-related death was associated with known general factors (older age, male sex and specific comorbidities) and disease-specific factors (disease activity and specific medications). The association with moderate/high disease activity highlights the importance of adequate disease control with DMARDs, preferably without increasing glucocorticoid dosages. Caution may be required with rituximab, sulfasalazine and some immunosuppressants.
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515
Total citations:
515
Citations from 2024:
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(19.06%)
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GOST
Copy
Strangfeld A. et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry // Annals of the Rheumatic Diseases. 2021. Vol. 80. No. 7. pp. 930-942.
GOST all authors (up to 50)
Copy
Strangfeld A. et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry // Annals of the Rheumatic Diseases. 2021. Vol. 80. No. 7. pp. 930-942.
Cite this
RIS
Copy
TY - JOUR
DO - 10.1136/annrheumdis-2020-219498
UR - https://doi.org/10.1136/annrheumdis-2020-219498
TI - Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry
T2 - Annals of the Rheumatic Diseases
AU - Strangfeld, Anja
AU - Schäfer, Martin
AU - Gianfrancesco, Milena A.
AU - Lawson Tovey, Saskia
AU - Liew, Jean W.
AU - Ljung, Lotta
AU - Mateus, Elsa F
AU - Richez, Christophe
AU - Santos, Maria José
AU - Schmajuk, Gabriela
AU - Scirè, Carlo Alberto
AU - Sirotich, Emily
AU - Sparks, Jeffrey A.
AU - Sufka, Paul
AU - Thomas, Thierry
AU - Trupin, Laura
AU - Wallace, Zachary S.
AU - Al Adely, Sarah
AU - Bachiller-Corral, Javier
AU - Bhana, Suleman
AU - Cacoub, Patrice
AU - Carmona, Loreto
AU - Costello, Ruth E
AU - Costello, Wendy
AU - Gossec, Laure
AU - Grainger, Rebecca
AU - Hachulla, Eric
AU - Hasseli, Rebecca
AU - Hausmann, Jonathan S.
AU - Hyrich, Kimme
AU - Izadi, Zara
AU - Jacobsohn, Lindsay
AU - Katz, Patricia
AU - Kearsley Fleet, Lianne
AU - Robinson, Philip C
AU - Yazdany, Jinoos
AU - Machado, Pedro M.
PY - 2021
DA - 2021/01/27
PB - Elsevier
SP - 930-942
IS - 7
VL - 80
PMID - 33504483
SN - 0003-4967
SN - 1468-2060
ER -
Cite this
BibTex (up to 50 authors)
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@article{2021_Strangfeld,
author = {Anja Strangfeld and Martin Schäfer and Milena A. Gianfrancesco and Saskia Lawson Tovey and Jean W. Liew and Lotta Ljung and Elsa F Mateus and Christophe Richez and Maria José Santos and Gabriela Schmajuk and Carlo Alberto Scirè and Emily Sirotich and Jeffrey A. Sparks and Paul Sufka and Thierry Thomas and Laura Trupin and Zachary S. Wallace and Sarah Al Adely and Javier Bachiller-Corral and Suleman Bhana and Patrice Cacoub and Loreto Carmona and Ruth E Costello and Wendy Costello and Laure Gossec and Rebecca Grainger and Eric Hachulla and Rebecca Hasseli and Jonathan S. Hausmann and Kimme Hyrich and Zara Izadi and Lindsay Jacobsohn and Patricia Katz and Lianne Kearsley Fleet and Philip C Robinson and Jinoos Yazdany and Pedro M. Machado and others},
title = {Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry},
journal = {Annals of the Rheumatic Diseases},
year = {2021},
volume = {80},
publisher = {Elsevier},
month = {jan},
url = {https://doi.org/10.1136/annrheumdis-2020-219498},
number = {7},
pages = {930--942},
doi = {10.1136/annrheumdis-2020-219498}
}
Cite this
MLA
Copy
Strangfeld, Anja, et al. “Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry.” Annals of the Rheumatic Diseases, vol. 80, no. 7, Jan. 2021, pp. 930-942. https://doi.org/10.1136/annrheumdis-2020-219498.
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