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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
Yeoh, Su-Ann Gianfrancesco, Milena Lawson-Tovey, Saskia Hyrich, Kimme L. Strangfeld, Anja Gossec, Laure Carmona, Loreto Mateus, Elsa F. Schafer, Martin Richez, Christophe
Yeoh, Su-Ann
Gianfrancesco, Milena
Lawson-Tovey, Saskia
Hyrich, Kimme L.
Strangfeld, Anja
Gossec, Laure
Carmona, Loreto
Mateus, Elsa F.
Schafer, Martin
Richez, Christophe
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Journal article
Date
2022-09-13
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Medicine
Section of Rheumatology
Section of Rheumatology
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https://doi.org/10.1136/rmdopen-2022-002508
Abstract
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.
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Yeoh S, Gianfrancesco M, Lawson-Tovey S On behalf of the COVID-19 Global Rheumatology Alliance, et alFactors associated with severe COVID-19 in people with idiopathic inflammatory myopathy: results from the COVID-19 Global Rheumatology Alliance physician-reported registryRMD Open 2022;8:e002508. doi: 10.1136/rmdopen-2022-002508
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BMJ Publishing Group
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RMD Open, Vol. 8, Iss. 2
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