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Factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy: results from the COVID-19 Global Rheumatology Alliance physician-reported registry

Objectives To investigate factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy (IIM). - Methods Demographic data, clinical characteristics and COVID-19 outcome severity of adults with IIM were obtained from the COVID-19 Global Rheumatology Alliance physician-report...

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Main Authors: Yeoh, Su-Ann (Author) , Gianfrancesco, Milena (Author) , Lawson-Tovey, Saskia (Author) , Hyrich, Kimme L. (Author) , Strangfeld, Anja (Author) , Gossec, Laure (Author) , Carmona, Loreto (Author) , Mateus, Elsa F. (Author) , Schäfer, Martin (Author) , Richez, Christophe (Author) , Hachulla, Eric (Author) , Holmqvist, Marie (Author) , Scirè, Carlo Alberto (Author) , Lorenz, Hanns-Martin (Author) , Voll, Reinhard (Author) , Hasseli, Rebecca (Author) , Jayatilleke, Arundathi (Author) , Hsu, Tiffany Y.-T. (Author) , D’Silva, Kristin M. (Author) , Pimentel-Quiroz, Victor R. (Author) , Mercado, Monica Vasquez del (Author) , Shinjo, Samuel Katsuyuki (Author) , Neto, Edgard Torres dos Reis (Author) , Junior, Laurindo Ferreira da Rocha (Author) , Montandon, Ana Carolina de Oliveira e Silva (Author) , Pons-Estel, Guillermo J. (Author) , Ornella, Sofía (Author) , Exeni, Maria Eugenia D'Angelo (Author) , Velozo, Edson (Author) , Jordan, Paula (Author) , Sirotich, Emily (Author) , Hausmann, Jonathan S. (Author) , Liew, Jean W. (Author) , Jacobsohn, Lindsay (Author) , Gore-Massy, Monique (Author) , Sufka, Paul (Author) , Grainger, Rebecca (Author) , Bhana, Suleman (Author) , Wallace, Zachary (Author) , Robinson, Philip C. (Author) , Yazdany, Jinoos (Author) , Machado, Pedro M. (Author)
Format: Article (Journal)
Language:English
Published: 13 September 2022
In: RMD Open
Year: 2022, Volume: 8, Issue: 2, Pages: 1-8
ISSN:2056-5933
DOI:10.1136/rmdopen-2022-002508
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1136/rmdopen-2022-002508
Verlag, lizenzpflichtig, Volltext: https://rmdopen.bmj.com/content/8/2/e002508
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Author Notes:Su-Ann Yeoh, Milena Gianfrancesco, Saskia Lawson-Tovey, Kimme L. Hyrich, Anja Strangfeld, Laure Gossec, Loreto Carmona, Elsa F. Mateus, Martin Schäfer, Christophe Richez, Eric Hachulla, Marie Holmqvist, Carlo Alberto Scirè, Hanns-Martin Lorenz, Reinhard E. Voll, Rebecca Hasseli, Arundathi Jayatilleke, Tiffany Y.-T. Hsu, Kristin M. D’Silva, Victor R. Pimentel-Quiroz, Monica Vasquez del Mercado, Samuel Katsuyuki Shinjo, Edgard Torres dos Reis Neto, Laurindo Ferreira da Rocha Junior, Ana Carolina de Oliveira e Silva Montandon, Guillermo J. Pons-Estel, Sofía Ornella, Maria Eugenia D'Angelo Exeni, Edson Velozo, Paula Jordan, Emily Sirotich, Jonathan S. Hausmann, Jean W. Liew, Lindsay Jacobsohn, Monique Gore-Massy, Paul Sufka, Rebecca Grainger, Suleman Bhana, Zachary Wallace, Philip C. Robinson, Jinoos Yazdany, Pedro M. Machado, on behalf of the COVID-19 Global Rheumatology Alliance
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Summary:Objectives To investigate factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy (IIM). - Methods Demographic data, clinical characteristics and COVID-19 outcome severity of adults with IIM were obtained from the COVID-19 Global Rheumatology Alliance physician-reported registry. A 3-point ordinal COVID-19 severity scale was defined: (1) no hospitalisation, (2) hospitalisation (and no death) and (3) death. ORs were estimated using multivariable ordinal logistic regression. Sensitivity analyses were performed using a 4-point ordinal scale: (1) no hospitalisation, (2) hospitalisation with no oxygen (and no death), (3) hospitalisation with oxygen/ventilation (and no death) and 4) death. - Results Of 348 patients, 48% were not hospitalised, 39% were hospitalised (and did not die) and 13% died. Older age (OR=1.59/decade, 95% CI 1.31 to 1.91), high disease activity (OR=3.50, 95% CI 1.25 to 9.83; vs remission), ≥2 comorbidities (OR=2.63, 95% CI 1.39 to 4.98; vs none), prednisolone-equivalent dose >7.5 mg/day (OR=2.40, 95% CI 1.09 to 5.28; vs no intake) and exposure to rituximab (OR=2.71, 95% CI 1.28 to 5.72; vs conventional synthetic disease-modifying antirheumatic drugs only) were independently associated with severe COVID-19. In addition to these variables, in the sensitivity analyses, male sex (OR range: 1.65-1.83; vs female) was also significantly associated with severe outcomes, while COVID-19 diagnosis after 1 October 2020 (OR range: 0.51-0.59; vs on/before 15 June 2020) was significantly associated with less severe outcomes, but these associations were not significant in the main model (OR=1.57, 95% CI 0.95 to 2.59; and OR=0.61, 95% CI 0.37 to 1.00; respectively). - Conclusions This is the first large registry data on outcomes of COVID-19 in people with IIM. Older age, male sex, higher comorbidity burden, high disease activity, prednisolone-equivalent dose >7.5 mg/day and rituximab exposure were associated with severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with IIM.
Item Description:Gesehen am 24.10.2022
Physical Description:Online Resource
ISSN:2056-5933
DOI:10.1136/rmdopen-2022-002508

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