Gout, Rheumatoid Arthritis, and the Risk of Death Related to Coronavirus Disease 2019: An Analysis of the UK Biobank

Topless, Ruth; Phipps‐Green, Amanda; Leask, Megan; Dalbeth, Nicola; Stamp, Lisa K.; Robinson, Philip C; Merriman, Tony R.

doi:10.1002/acr2.11252

Cited by 40 publications

(64 citation statements)

References 33 publications

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“…Among these individuals, the risk for incident viral infections (e.g., herpes zoster) was rated as being higher than for the general population ( 20 , 21 , 22 ). There was also agreement that AIIRD patients are likely to be at increased risk for hospitalized SARS–CoV‐2 infection ( 23 , 24 , 25 , 26 , 27 ) and that age, race/ethnicity (especially for underrepresented minorities), and sex were important risk factors that needed to be considered ( 28 , 29 , 30 , 31 ) in evaluating risk at the individual patient level.…”

Section: Resultsmentioning

confidence: 95%

“…Despite these important methodologic caveats and acknowledged limitations in the evidence base, AIIRD patients were rated as having worse outcomes (e.g., need for intensive care unit [ICU] treatment, mechanical ventilation, persistent infection, death) following COVID‐19 compared to patients of similar age and sex without such conditions ( 23 , 24 , 25 , 26 , 27 , 34 ). In terms of the policy implications of this reasoning, the task force agreed that in general, AIIRD patients should be prioritized to be allocated to receive vaccination before the nonprioritized general population of similar age and sex ( 35 ).…”

Section: Resultsmentioning

confidence: 99%

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American College of Rheumatology Guidance for COVID‐19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 3

Curtis

Johnson

Anthony

et al. 2021

Arthritis & Rheumatology

161

170

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Objective To provide guidance to rheumatology providers on the use of coronavirus disease 2019 (COVID‐19) vaccines for patients with rheumatic and musculoskeletal diseases (RMDs). Methods A task force was assembled that included 9 rheumatologists/immunologists, 2 infectious disease specialists, and 2 public health physicians. After agreeing on scoping questions, an evidence report was created that summarized the published literature and publicly available data regarding COVID‐19 vaccine efficacy and safety, as well as literature for other vaccines in RMD patients. Task force members rated their agreement with draft consensus statements on a 9‐point numerical scoring system, using a modified Delphi process and the RAND/University of California Los Angeles Appropriateness Method, with refinement and iteration over 2 sessions. Consensus was determined based on the distribution of ratings. Results Despite a paucity of direct evidence, 74 draft guidance statements were developed by the task force and agreed upon with consensus to provide guidance for use of the COVID‐19 vaccines in RMD patients and to offer recommendations regarding the use and timing of immunomodulatory therapies around the time of vaccination. Conclusion These guidance statements, made in the context of limited clinical data, are intended to provide direction to rheumatology health care providers on how to best use COVID‐19 vaccines and to facilitate implementation of vaccination strategies for RMD patients.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

American College of Rheumatology Guidance for COVID‐19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 3

Curtis

Johnson

Anthony

et al. 2021

Arthritis & Rheumatology

161

170

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“…Increased risk of COVID-19-related death among patients with rheumatoid arthritis relative to healthy people was reported in a study of 473 139 UK Biobank participants. 25 However, despite the large sample size, the analysis was restricted to patients aged older than 50 years, data collection was limited to the first phase of the pandemic, and hospitalisation rates, disease activity, and concomitant therapies were not considered. Therefore, mild COVID-19 cases might have been underestimated, potentially leading to overestimated risk.…”

Section: Risk Of Severe Covid-19 and Adverse Outcomesmentioning

confidence: 99%

COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses

Fagni

Simón

Taşçılar

et al. 2021

The Lancet Rheumatology

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At the beginning of the COVID-19 pandemic, patients with immune-mediated inflammatory diseases were considered to be at high risk for SARS-CoV-2 infection and the development of severe COVID-19. Data collected over the past year, however, suggest that a diagnosis of inflammatory arthritis, psoriasis, or inflammatory bowel diseases does not increase risk for SARS-CoV-2 infection or severe COVID-19 compared with people without these diseases. Furthermore, substantial data suggest that certain medications frequently used in patients with immune-mediated inflammatory diseases, in particular cytokine inhibitors, might even lower the risk for severe COVID-19. Conversely, glucocorticoids and potentially B-cell-depleting treatments seem to worsen COVID-19 outcomes. Additionally, the first data on SARS-CoV-2 vaccination in patients with these diseases suggest that tolerability of vaccination in patients with immune-mediated inflammatory diseases is good, although the immune response to vaccination can be somewhat reduced in this patient group, particularly those taking methotrexate or CD20-targeted treatment.

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“…Our previous study 3 in the UK Biobank cohort on outcomes for people with gout and COVID-19 comprised 2059 individuals diagnosed with COVID-19 before Aug 25, 2020; our multivariable-adjusted analysis reported no evidence for gout as a risk factor for COVID-19-related death (odds ratio [OR] 1·2, 95% CI 0·8–1·7). The aim of the present study was to repeat the testing for an association between gout and COVID-19 diagnosis and death in a larger number of individuals diagnosed with COVID-19 in the UK Biobank, up to April 6, 2021.…”

Section: Introductionmentioning

confidence: 96%

Gout and the risk of COVID-19 diagnosis and death in the UK Biobank: a population-based study

Topless

Gaffo

Stamp

et al. 2022

The Lancet Rheumatology

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Background There is a paucity of data on outcomes for people with gout and COVID-19. We aimed to assess whether gout is a risk factor for diagnosis of COVID-19 and COVID-19-related death, and to test for sex- and drug-specific differences in risk. Methods We used data from the UK Biobank, which included 15 871 people with gout. We used multivariable-adjusted logistic regression in the following analyses using a case-control study design: to test for an association between gout and COVID-19 diagnosis in the entire UK Biobank cohort (n=459 837); to test for an association between gout and COVID-19-related death in people who were known to have died or survived with COVID-19 (n=15 772); to test for an association between gout and COVID-19-related death in the entire UK Biobank cohort (n=459 837); and to assess risk of COVID-19-related death in a subset of patients from the UK Biobank cohort with prescription data, stratified by prescription of urate-lowering therapy and colchicine (n=341 398). Models 1 and 2 were adjusted for age group, sex, ethnicity, Townsend deprivation index, BMI, and smoking status. Model 2 was also adjusted for diagnosis of 16 other diseases that are established comorbidities of gout or established risk factors for COVID-19-related death. Findings Gout was associated with diagnosis of COVID-19 (odds ratio [OR] 1·20, 95% CI 1·11–1·29) but not with risk of COVID-19-related death in the cohort of patients diagnosed with COVID-19 (1·20, 0·96–1·51). In the entire cohort, gout was associated with COVID-19-related death (1·29, 1·06–1·56); women with gout had an increased risk of COVID-19-related death (1·98, 1·34–2·94), whereas men with gout did not (1·16, 0·93–1·45). We found no significant differences in the risk of COVID-19-related death according to prescription of urate-lowering therapy or colchicine. When patients with gout were stratified by vaccination status, the risk of diagnosis with COVID-19 was significant in the non-vaccinated group (1·21, 1·11–1·30) but not the vaccinated group (1·09, 0·65–1·85). Interpretation Gout is a risk factor for COVID-19-related death in the UK Biobank cohort, with an increased risk in women with gout, which was driven by risk factors independent of the metabolic comorbidities of gout. Funding Health Research Council of New Zealand.

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Gout, Rheumatoid Arthritis, and the Risk of Death Related to Coronavirus Disease 2019: An Analysis of the UK Biobank

Cited by 40 publications

References 33 publications

American College of Rheumatology Guidance for COVID‐19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 3

American College of Rheumatology Guidance for COVID‐19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 3

COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses

Gout and the risk of COVID-19 diagnosis and death in the UK Biobank: a population-based study

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