TY - JOUR
T1 - COVID-19 admissions and mortality in patients with early inflammatory arthritis
T2 - Results from a UK national cohort
AU - Adas, Maryam A.
AU - Russell, Mark D.
AU - Cook, Emma
AU - Alveyn, Edward
AU - Hannah, Jennifer
AU - Balachandran, Sathiyaa
AU - Oyebanjo, Sarah
AU - Amlani-Hatcher, Paul
AU - Ledingham, Joanna
AU - Norton, Sam
AU - Galloway, James B.
N1 - Funding Information:
Disclosure statement: J.B.G. has received honoraria from AbbVie, Celgene, Chugai, Galapagos, Gilead, Janssen, Lilly, Pfizer, Roche and UCB. J.L. is a BSR trustee. M.D.R. has received honoraria from Pfizer, Lilly, Menarini, Janssen and UBC, and has received a research grant from the National Institute for Health Research (NIHR). All other authors declare no competing interests.
Funding Information:
The National Early Inflammatory Arthritis Audit (NEIAA) is commissioned by the Healthcare Quality Improvement Partnership (HQIP), funded by National Health Services (NHS) England and NHS Improvement and the Welsh government, and carried out by the British Society for Rheumatology, King’s College London, King’s College Hospital and Net Solving. We used data provided by patients and staff within the NHS. HQIP had no involvement in designing this study, collecting, analysing and interpreting the data, or writing this report. Approval to submit the article for publication was obtained.
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Objective: To describe the risks and predictors of coronavirus disease 2019 (COVID-19) hospitalization and mortality among patients with early inflammatory arthritis (EIA), recruited to the National Early Inflammatory Arthritis Audit (NEIAA). Methods: NEIAA is an observational cohort. We included adults with EIA from Feb 2020 to May 2021. Outcomes of interest were hospitalization and death due to COVID-19, using NHS Digital linkage. Cox proportional hazards were used to calculate hazard ratios for outcomes according to initial treatment strategy, with adjustment for confounders. Results: From 14 127 patients with EIA, there were 143 hospitalizations and 47 deaths due to COVID-19, with incidence rates per 100 person-years of 0.93 (95% CI 0.79, 1.10) for hospitalization and 0.30 (95% CI 0.23, 0.40) for death. Increasing age, male gender, comorbidities and ex-smoking were associated with increased risk of worse COVID-19 outcomes. Higher baseline DAS28 was not associated with COVID-19 admissions [confounder adjusted hazard ratio (aHR) 1.10; 95% CI 0.97, 1.24] or mortality (aHR 1.11; 95% CI 0.90, 1.37). Seropositivity was not associated with either outcome. Higher symptom burden on patient-reported measures predicted worse COVID-19 outcomes. In unadjusted models, CS associated with COVID-19 death (HR 2.29; 95% CI 1.02, 5.13), and SSZ monotherapy associated with COVID-19 admission (HR 1.92; 95% CI 1.04, 3.56). In adjusted models, associations for CS and SSZ were not statistically significant. Conclusion: Patient characteristics have stronger associations with COVID-19 than the initial treatment strategy in patients with EIA. An important limitation is that we have not looked at treatment changes over time.
AB - Objective: To describe the risks and predictors of coronavirus disease 2019 (COVID-19) hospitalization and mortality among patients with early inflammatory arthritis (EIA), recruited to the National Early Inflammatory Arthritis Audit (NEIAA). Methods: NEIAA is an observational cohort. We included adults with EIA from Feb 2020 to May 2021. Outcomes of interest were hospitalization and death due to COVID-19, using NHS Digital linkage. Cox proportional hazards were used to calculate hazard ratios for outcomes according to initial treatment strategy, with adjustment for confounders. Results: From 14 127 patients with EIA, there were 143 hospitalizations and 47 deaths due to COVID-19, with incidence rates per 100 person-years of 0.93 (95% CI 0.79, 1.10) for hospitalization and 0.30 (95% CI 0.23, 0.40) for death. Increasing age, male gender, comorbidities and ex-smoking were associated with increased risk of worse COVID-19 outcomes. Higher baseline DAS28 was not associated with COVID-19 admissions [confounder adjusted hazard ratio (aHR) 1.10; 95% CI 0.97, 1.24] or mortality (aHR 1.11; 95% CI 0.90, 1.37). Seropositivity was not associated with either outcome. Higher symptom burden on patient-reported measures predicted worse COVID-19 outcomes. In unadjusted models, CS associated with COVID-19 death (HR 2.29; 95% CI 1.02, 5.13), and SSZ monotherapy associated with COVID-19 admission (HR 1.92; 95% CI 1.04, 3.56). In adjusted models, associations for CS and SSZ were not statistically significant. Conclusion: Patient characteristics have stronger associations with COVID-19 than the initial treatment strategy in patients with EIA. An important limitation is that we have not looked at treatment changes over time.
KW - ankylosing spondylitis
KW - corticosteroids
KW - COVID-19
KW - COVID-19 admissions
KW - COVID-19 mortality
KW - DMARD
KW - early inflammatory arthritis
KW - inflammatory arthritis
KW - psoriatic arthritis
KW - rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85172297252&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kead018
DO - 10.1093/rheumatology/kead018
M3 - Article
AN - SCOPUS:85172297252
SN - 1462-0324
VL - 62
SP - 2979
EP - 2988
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 9
ER -