Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases

  1. Jose L Pablos
  2. Lydia Abasolo
  3. Jose M Alvaro-Gracia
  4. Francisco J Blanco
  5. Ricardo Blanco
  6. Isabel Castrejón
  7. David Fernandez-Fernandez
  8. Benjamín Fernandez-Gutierrez
  9. María Galindo-Izquierdo
  10. Miguel A Gonzalez-Gay
  11. Sara Manrique-Arija
  12. Natalia Mena Vázquez
  13. Antonio Mera Varela
  14. Miriam Retuerto
  15. Alvaro Seijas-Lopez

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Abstract

The susceptibility of patients with rheumatic diseases and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown.

Methods

We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with severe acute respiratory syndrome coronavirus 2-positive PCR tests performed in the hospital to the same reference populations. Rates of PCR+ confirmed COVID-19 were compared among groups.

Results

Patients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Patients with systemic autoimmune or immune-mediated disease (AI/IMID) showed a significant increase, whereas patients with inflammatory arthritis (IA) or systemic lupus erythematosus did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. Patients with IA on targeted-synthetic or biological disease-modifying antirheumatic drugs (DMARDs), but not those on conventional-synthetic DMARDs, had a greater prevalence despite a similar age distribution.

Conclusion

Patients with AI/IMID show a variable risk of hospital-diagnosed COVID-19. Interplay of ageing, therapies and disease-specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyse the specific factors involved in COVID-19 susceptibility.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.11.20097808: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    With these limitations, we conclude that the different chronic inflammatory or autoimmune diseases patients and therapies have a different impact on the risk COVID-19. Our data on specific groups should be translated to current recommendations regarding alert on infection risk and prevention measures in rheumatic patients. Ongoing studies of the specific factors potentially involved in the observed differences will hopefully contribute to understand the impact of the SARS-CoV-2 pandemics in different risk groups.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1136/annrheumdis-2020-217763
  3. Version published to 10.1101/2020.05.11.20097808v2 on medRxiv
  4. Version published to 10.1101/2020.05.11.20097808v1 on medRxiv