Study Hints at COVID-19 Risk for Rheumatic Disease Patients

August 27, 2020

Researchers in China write in the current issue of The Lancet Rheumatology that patients with autoimmune rheumatic disease might be more susceptible to COVID-19 infections than the general population.

Researchers in China write in the current issue of The Lancet Rheumatology that patients with autoimmune rheumatic disease might be more susceptible to COVID-19 infections than the general population.

The article appears in the Sept. 1 issue of the journal.

This was a short study conducted between March 20 and March 30 in the Hubei province, the epicentre of the COVID-19 outbreak in China. It included 6,228 patients with rheumatic disease (87 percent female, 45 years mean age). Most had rheumatoid arthritis (2,766), followed by systemic lupus erythematosus (1,964), Sjögren’s syndrome (652), IgG4-related disease (64), undifferentiated connective tissue disease (208) and 574 had other related conditions.

Researchers analyzed infection rates in the 42 families with confirmed COVID-19. Of 43 patients with rheumatic disease, 27 (63%) developed COVID-19. This compares to 28 patients (34%) of 83 family members without rheumatic disease who developed COVID-19. Similar results were observed in laboratory confirmed cases. Researchers found that the risk of contracting COVID-19 was higher with more advanced age and the presence of rheumatic disease (OR 1·04 [95% CI 1·01–1·06]; p=0·0081), but not sex (OR 0·60 [95% CI 0·26–1·35]; p=0·22; table 3).

And, rheumatic disease patients who were taking hydroxychloroquine, were found to have a lower risk of COVID-19 infection than patients taking other disease-modifying anti-rheumatic drugs.

"To the best of our knowledge, this is the first study based on a primary dataset of cases and close contacts to analyze the susceptibility of patients with autoimmune rheumatic disease to COVID-19. Patients with autoimmune rheumatic disease had a higher rate of COVID-19 than their family members living in the same household during the outbreak (63% vs 34%). This finding provides some insight into the risk of COVID-19 in patients with autoimmune rheumatic diseases," write Jixin Zhong, Guifen Shen, et al.

Still, researchers wrote, "The risk of COVID-19 in patients with rheumatic disease remains unclear. Although patients with rheumatic disease on certain medications are immunocompromised and vulnerable to infection, several anti-rheumatic medications have been proposed to have an antiviral effect. Nevertheless, data about the epidemiological characteristics of COVID-19 in patients with rheumatic disease are scarce."

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REFERENCE

Jixin Zhong, Guifen Shen, Huiqin Yang, Anbin Huang, et al. "COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study," The Lancet Rheumatology. First Published Online July 3, 2020; print Sept. 1; https://doi.org/10.1016/S2665-9913(20)30227-7