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

Abstract

ObjectivesTo investigate factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy (IIM).MethodsDemographic 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.ResultsOf 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).ConclusionsThis 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.

Characteristics associated with poor COVID-19 outcomes in people with psoriasis, psoriatic arthritis and axial spondyloarthritis: data from the COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries

“…Further details of the registries have been described elsewhere. [13][14][15][16][17][18] We used data collected on or before 25 October 2021.…”

Illuminating the connection: Unearthing the mechanisms linking COVID‐19 and rheumatoid arthritis

“…This registry serves as a valuable source of data, allowing for comprehensive analysis and understanding of the impact of COVID‐19 on individuals with rheumatic conditions. This registry unveils many discoveries in the association between COVID‐19 and prognosis, disease activity, vaccination, and management 3–6 …”

Factors associated with the severity of COVID‐19 outcomes in people with neuromuscular diseases: Data from the International Neuromuscular COVID‐19 Registry

“…Data from previous literature on patients with multiple sclerosis [ 39 ], myasthenia gravis [ 26 ] and rheumatic disease [ 34 ] show similar results, except for B‐cell‐depleting therapies. Therefore, guidelines generally suggest continuation of immunosuppressive medications at COVID‐19 diagnosis [ 14 , 34 , 40 ].…”

“…To date there have been few studies that have investigated COVID‐19 outcomes and factors associated with these outcomes in patients with NMDs, and most of them have looked at small numbers of subjects and/or a single NMD [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. NMDs are often rare conditions when considered individually, and currently there is a knowledge gap regarding the clinical outcome of COVID‐19 in this patient group.…”