Incidence and clinical course of COVID-19 in patients with rheumatologic diseases: A population-based study

Abstract

Objectives Patients with rheumatologic diseases might be more susceptible to COVID-19 and carry a poorer prognosis. The aim of this study is to examine the incidence and outcomes of all COVID-19 patients with rheumatologic conditions in Hong Kong. Methods This is a population-based retrospective study. All patients tested positive for SARS-CoV-2 by PCR with a previous diagnosis of rheumatologic diseases were reviewed. The incidence of COVID-19 in patients with rheumatologic conditions was calculated and compared to the general population in Hong Kong. Descriptive data of those rheumatologic patients with COVID-19 and the clinical course of the index infection were presented. Results Up till 27 May 2020, there were 1067 cases of COVID-19 diagnosed in Hong Kong which had a population of 7.5 million. Out of the 39,835 patients with underlying rheumatologic diseases, we identified 5 PCR confirmed COVID-19 cases. The estimated incidence of COVID-19 was 0.0126% patients with rheumatologic diseases, compared to 0.0142% in the general population. All 5 patients had inflammatory arthropathies. One patient was on hydroxychloroquine and sulphasalazine, and one was on methotrexate. None of the 3534 patients on b/tsDMARDs was infected. Four patients had leucopenia/lymphopenia and stool viral PCR was positive in 3 patients. All patients made uneventful recovery without complications or flare of underlying diseases. Conclusions We found no alarming signals of increased frequency or severity of COVID-19 in patients with rheumatologic diseases, although extrapolation of the results to other populations with different infection control strategies should be made with caution.

Incidence of COVID-19 in patients with rheumatic disease: is prior health education more important than shielding advice during the pandemic?

“…Although prevalence of certain chronic conditions such as diabetes in patients with COVID-19 infection has been studied [9], there was initial paucity of published incidence of COVID-19 infection in patients with rheumatology conditions. A recent study in Hong Kong showed incidence of COVID-19 in rheumatology patients similar to incidence seen in their general population (0.0126% in patients with rheumatologic diseases, compared to 0.0142% in the general population) [10]. Their estimated incidences were much lower than those we are reporting in this study, but differences in local testing protocols and reporting methodology may mean that these results are not directly comparable.…”

Predictors of hospitalization for COVID-19 in patients with autoimmune rheumatic diseases: results from a community cohort follow-up

“…In a study from the USA, a higher incidence of COVID-19 infections in ARD patients of Latin origin (17.97%) was found with respect to those of non-Latin origin (4.69 to 5.89%); the non-ARD Latin patients also had a higher infection rate than the non-Latin ones (1.54 to 3.43%) patients [ 21 ]. By contrast, in a study from China, a higher incidence of COVID-19 in the general population as compared to ARD patients (0.0142 vs 0.0126%) [ 22 ] was found. Finally, a systematic review and meta-analysis of 26 observational studies showed that patients with ARD had an increased risk of developing COVID-19 compared with the general population [ 23 ].…”

Risk and clinical outcomes of COVID-19 in patients with rheumatic diseases compared with the general population: a systematic review and meta-analysis

“…Meta-analysis of fourteen studies [23][24][25][26][27][28][29][30][31][32][33][34][35][36] showed that patients with RD had a significantly higher risk of developing COVID-19 than the general population (OR = 1.53, 95% CI 1.24-1.88, P = 0.000; I 2 = 62.4%, P = 0.001) ( Fig. 2).…”