Factors Associated with COVID-19 Deaths in Rheumatic Patients Save

Analysis of data from the COVID-19 Global Rheumatology Alliance shows that rheumatic diseases infected with COVID-19 had a greater risk of death with age, comorbidities, high disease activity and few specific therapies.

Rheumatic disease adults with a confirmed or presumptive COVID-19 diagnosis (from 24 March to 1 July 2020) were included in this analysis of risk factors associated with COVID-19-related death.

Among a total of 3729 patients (mean age 57 years), 390 (10.5%) died.

Independent factors associated with COVID-19-related death included:

• age 66–75 years (OR 3.00); >75 years (OR 6.18)
• male sex (OR 1.46)
• hypertension with cardiovascular disease (OR 1.89)
• Chronic lung disease (OR 1.68)
• Prednisolone-equivalent dosage >10 mg/day (OR 1.69)
• Moderate/high disease activity (OR 1.87)
• Rituximab (OR 4.04)
• Sulfasalazine (OR 3.60)
• Immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: OR 2.22)
• Not receiving DMARDs (OR 2.11)

Targeted synthetic or biologic DMARDs were not associated with an increased risk of COVID-19-related death.

An increased risk of COVID-19-related death was multifactorial and tended to impact the elderly, with comorbidity, or those taking steroids, rituximab, sulfasalazine, no DMARDs and certain immunosuppressants. Disease control was protective as those with moderate/high disease activity had a higher risk of death.