First Look at COVID-19 Global Rheumatology Alliance Registry

Jack Cush, MD

Jun 01, 2020 3:22 pm

Gianfresco et al have published the first peer-reviewed analysis of COVID-19 infected, rheumatic disease patients entered into the Rheumatology Global Alliance registry; showing that a) rheumatic disease patient can be infected with COVID-19, b) that DMARD and biologic use has no apparent effect on outcomes and c) steroid increase and TNF inhibitor decrease the odds of hospitalization.

A voluntary, physician reported, worldwide registry accumulated 600 cases with rheumatic disease and COVID-19 between 24 March 2020 to 20 April 2020.

This report included 600 cases from 40 countries. Unlike most COVID series (mostly males), this cohort was predominantly female (~70%) reflecting the female predominance in the diagnoses included RA (38%), SLE (14%) and PsA (12%). Common comorbidities included hypertension (33%), lung disease (21%), diabetes (12%), cardiovascular disease (11%) and chronic renal insufficiency/end-stage renal disease (7%).

While 46% (277) were hospitalized, there were only 55 (9%) deaths in a voluntary registry that is likely to be skewed towards more severe cases.

While NSAIDS or conventional DMARDs (alone or in combination with biologics/Janus Kinase inhibitors) did not influence hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively); the use of tumour necrosis factor inhibitors was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81). Anti-TNF medication were the most common (52%) therapy amongst those taking biologic or targeted synthetic DMARDs.

A total of 22% of cases were taking antimalarials prior to hospitalisation. Yet, antimalarial use did not influence hospitalization rates (OR 0.94, 95% CI 0.57 to 1.57).

A greater risk of hospitalization was associated with prednisone doses ≥10 mg/day (OR 2.05, 95% CI 1.06 to 3.96).

As in the general population, people with rheumatic diseases who are older and/or have comorbidities had a higher odds of COVID-19-related hospitalisation.