Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/28016
Title: Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study.
Austin Authors: Sattui, Sebastian E;Conway, Richard;Putman, Michael S;Seet, Andrea M;Gianfrancesco, Milena A;Beins, Kaley;Hill, Catherine J ;Liew, David F L ;Mackie, Sarah L;Mehta, Puja;Neill, Lorna;Gomez, Gimena;Salinas, Maria Isabel Haye;Maldonado, Federico Nicolas;Mariz, Henrique Ataide;de Sousa Studart, Samia Araujo;Araujo, Nafice Costa;Knight, Ann;Rozza, Davide;Quartuccio, Luca;Samson, Maxime;Bally, Stéphane;Maria, Alexandre Tj;Chazerain, Pascal;Hasseli, Rebecca;Müller-Ladner, Ulf;Hoyer, Bimba F;Voll, Reinhard;Torres, Rita Pinheiro;Luis, Mariana;Ribeirio, Sandra Lucia Euzebio;Al-Emadi, Samar;Sparks, Jeffrey A;Hsu, Tiffany Y-T;D'Silva, Kristin M;Patel, Naomi J;Wise, Leanna;Gilbert, Emily;Almada, Maria Valenzuela;Duarte-García, Alí;Ugarte-Gil, Manuel;Jacobsohn, Lindsay;Izadi, Zara;Strangfeld, Anja;Mateus, Elsa F;Hyrich, Kimme L;Gossec, Laure;Carmona, Loreto;Lawson-Tovey, Saskia;Kearsley-Fleet, Lianne;Schaefer, Martin;Sirotich, Emily;Hausmann, Jonathan S;Sufka, Paul;Bhana, Suleman;Liew, Jean W;Grainger, Rebecca;Machado, Pedro M;Wallace, Zachary S;Yazdany, Jinoos;Robinson, Philip C
Affiliation: Vasculitis Foundation, Kansas City, MO, USA
Division of Rheumatology, Mayo Clinic Health System, Rochester, MN, USA
Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Boston Children's Hospital, Boston, MA, USA
HealthPartners, St Paul, MN, USA
Crystal Run Health, Middletown, NY, USA
CEDOC, Nova Medical School, Lisbon, Portugal
Rheumatology Service, Egas Moniz Hospital, Lisboa Occidental Hospital Centre, Lisbon, Portugal..
School of Medicine, University Cientifica del Sur, Lima, Peru
Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Peru..
Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, SA, Australia
Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, NY, USA
Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, USA
Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, UK
Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK
Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
Manchester Academic Health Science Centre, Manchester, UK
Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
Centre for Rheumatology and Department of Neuromuscular Diseases, University College London, UK
National Institute for Health Research, University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
Medical College of Wisconsin, Milwaukee, WI, USA
Rheumatology
Department of Medicine, University of Melbourne, VIC, Australia
Polymyalgia Rheumatica and Giant Cell Arteritis Scotland, Perth, Scotland, UK
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
School of Medicine, Universidade de Coimbra, Coimbra, Portugal..
Division of Rheumatology, Mayo Clinic Health System, Jacksonville, FL, USA
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris France
Department of Rheumatology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France..
McMaster University, Hamilton, ON, Canada
Canadian Arthritis Patient Alliance, Toronto, ON, Canada..
Boston University School of Medicine, Boston, MA, USA
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
National Institute of Health Research Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Trust, Manchester, UK
University of Queensland, Brisbane, QLD, Australia
Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, Australia
Los Angeles County Hospital, Los Angeles, CA, USA
University of South California Medical Center, Los Angeles, CA, USA
Department of Rheumatology, St James's Hospital, Dublin, Ireland
Research Unit Argentine Society of Rheumatology, Buenos Aires, Argentina
Reumatologa CEMMA, Universidad Nacional de la Rioja, La Rioja, Argentina
Sanatorio Guemes, Buenos Aires, Argentina
Hospital das Clinicas, Universidade Federal de Pernanmbuco, Pernanmbuco, Brazil
Hospital Geral de Fortaleza, Fortaleza, Brazil
Instituto de Assistencia Medica ao Servidor Publico Estadual de Sao Paulo, Sao Paulo, Brazil
Rheumatology, Institute of Medical Sciences, Uppsala University, Uppsala, Sweden
Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy
Clinic of Rheumatology, Department of Medicine, University of Udine, School of Rheumatology, Santa Maria della Misericordia Academic Hospital, Udine, Italy
Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
Nephrology and Dialysis Service, Metropole Savoie Hospital Center, Chambery, France
Department of Internal Medicine and Multi-Organic Diseases, Saint-Eloi University Hospital of Montpellier, Montpellier, France
Department of Rheumatology and Internal Medicine, Diaconesses Croix Saint Simon Hospital, Paris, France
Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus Liebig University Giessen, Bad Nauheim, Germany
Department of Rheumatology and Clinical Immunology, Clinic for Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
Department of Rheumatology and Clinical Immunology, University Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
Federal University of Amazonas, Amazonas, Brazil
Hamad Medical Corporation, Doha, Qatar
German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
Portuguese League Against Rheumatic Diseases, Lisbon, Portugal
Instituto de Salud Musculoesquelética, Madrid, Spain
German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
University of Otago, Wellington, New Zealand
Issue Date: Dec-2021
Date: 2021-11-05
Publication information: The Lancet. Rheumatology 2021; 3(12): e855-e864
Abstract: Patients with primary systemic vasculitis or polymyalgia rheumatica might be at a high risk for poor COVID-19 outcomes due to the treatments used, the potential organ damage cause by primary systemic vasculitis, and the demographic factors associated with these conditions. We therefore aimed to investigate factors associated with COVID-19 outcomes in patients with primary systemic vasculitis or polymyalgia rheumatica. In this retrospective cohort study, adult patients (aged ≥18 years) diagnosed with COVID-19 between March 12, 2020, and April 12, 2021, who had a history of primary systemic vasculitis (antineutrophil cytoplasmic antibody [ANCA]-associated vasculitis, giant cell arteritis, Behçet's syndrome, or other vasculitis) or polymyalgia rheumatica, and were reported to the COVID-19 Global Rheumatology Alliance registry were included. To assess COVID-19 outcomes in patients, we used an ordinal COVID-19 severity scale, defined as: (1) no hospitalisation; (2) hospitalisation without supplemental oxygen; (3) hospitalisation with any supplemental oxygen or ventilation; or (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios (ORs), adjusting for age, sex, time period, number of comorbidities, smoking status, obesity, glucocorticoid use, disease activity, region, and medication category. Analyses were also stratified by type of rheumatic disease. Of 1202 eligible patients identified in the registry, 733 (61·0%) were women and 469 (39·0%) were men, and their mean age was 63·8 years (SD 17·1). A total of 374 (31·1%) patients had polymyalgia rheumatica, 353 (29·4%) had ANCA-associated vasculitis, 183 (15·2%) had giant cell arteritis, 112 (9·3%) had Behçet's syndrome, and 180 (15·0%) had other vasculitis. Of 1020 (84·9%) patients with outcome data, 512 (50·2%) were not hospitalised, 114 (11·2%) were hospitalised and did not receive supplemental oxygen, 239 (23·4%) were hospitalised and received ventilation or supplemental oxygen, and 155 (15·2%) died. A higher odds of poor COVID-19 outcomes were observed in patients who were older (per each additional decade of life OR 1·44 [95% CI 1·31-1·57]), were male compared with female (1·38 [1·05-1·80]), had more comorbidities (per each additional comorbidity 1·39 [1·23-1·58]), were taking 10 mg/day or more of prednisolone compared with none (2·14 [1·50-3·04]), or had moderate, or high or severe disease activity compared with those who had disease remission or low disease activity (2·12 [1·49-3·02]). Risk factors varied among different disease subtypes. Among patients with primary systemic vasculitis and polymyalgia rheumatica, severe COVID-19 outcomes were associated with variable and largely unmodifiable risk factors, such as age, sex, and number of comorbidities, as well as treatments, including high-dose glucocorticoids. Our results could be used to inform mitigation strategies for patients with these diseases. American College of Rheumatology and the European Alliance of Associations for Rheumatology.
URI: https://ahro.austin.org.au/austinjspui/handle/1/28016
DOI: 10.1016/S2665-9913(21)00316-7
Journal: The Lancet. Rheumatology
PubMed URL: 34778843
Type: Journal Article
Appears in Collections:Journal articles

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