COVID-19 in patients with rheumatic diseases: Survey-based assessment of the risk of hospitalization

Karateev, D.; Pchelnikova, P.; Luchikhina, E.; Boboshko, T.

Background: Prognosis of the need for in-hospital treatment in patients suffered with COVID-19 is crucial to optimize the use of medical resources. Risk factors of hospitalization due to COVID-19 are not sufficiently studied in patients with rheumatic diseases (RD). Objectives: To reveal factors associated with the risk of hospitalization of patients with RD due to SARS-CoV-2 (COVID-19) infection. Methods: We analyzed data based on the preliminary results of the patients registry from the ongoing project “Patient's Opinion on COVID-19 in Rheumatic Diseases (POPCORD)”. The registry contains data collected directly from Russian-speaking patients with different RD who completed a special questionnaire, located on the website https://revmo-covid.ru/. The questionnaire includes information on whether the patient had COVID-19 and related information, as well as information on rheumatic disease and its treatment. Results: 1050 patients (92% from Russian Federation, 8% from other locations) completed the survey -93% females, mean age 40,28±11,26 (M±SD, median 38 [32;48]), BMI 24,52±5,38 (median 23,42 [21;27]), disease duration 7,91±8,46 (median 5,00 [2;11]). Diagnoses reported: rheumatoid arthritis (49%), ankylosing spondylitis (14%), systemic lupus erythematosus (13%), psoriatic arthritis (6%), Sjogren's disease (5%), systemic sclerosis (3%), other (10%). 51% of respondents indicated concomitant conditions: arterial hypertension (19%), obesity (15%), kidney disease (11%), cardiovascular disease (7%), liver disease (6%), IBD (5%), other lung diseases, including ILD (5%). 96% of patients reported constant intake of antirheumatic drugs: steroids (37%), NSAIDs (46%), hydroxychloroquine (22%), csDMARDs (66%), bDMARDs (17%), tsDMARDs (2%). 344 (31,8%) patients reported COVID-19 or suspected SASR-CoV2 viral pneumonia, 282 (84,4%) were treated as outpatients, 52 (15,6%) were hospitalized. Relatives or physicians reported 3 cases of death related to COVID-19 (0,9% of total mortality, 5,8% of in-hospital mortality). Table 1 contains odds ratios for the main factors, related to hospitalization, based on the results of the survey. Analysis of the survey participants' parameters (patients' characteristics, treatments etc.) did not reveal any significant variables, related to increased risk of hospitalization. No increased risk related to any groups of anti-rheumatic drugs or any particular medications was found either. Risk of hospitalization was significantly lower in patients with ankylosing spondylitis. Conclusion: Survey of patients with RD did not show significantly increased risk for hospitalization due to COVID-19 in relation with specific diagnosis, any anti-rheumatic medications, as well as comorbid conditions and main patient characteristics. Diagnosis of ankylosing spondylitis related to significantly lower risk of hospitalization.