COVID-19 infection, hospitalisation and death Amongst People with Rare Autoimmune Rheumatic Disease in England. Results from the RECORDER Project.

Rutter, M.; Lanyon, P. C.; Grainge, M. J.; Hubbard, R.; Peach, E.; Bythell, M.; Stilwell, P.; Ashton, J.; Stevens, S.; Pearce, F. A.

Objectives: To calculate the rates of COVID19 infection and COVID19 related death among people with rare autoimmune rheumatic diseases (RAIRD) during the first wave of the COVID19 pandemic in England compared to the general population. Methods: We used Hospital Episode Statistics to identify all people alive 01 March 2020 with ICD10 codes for RAIRD from the whole population of England. We used linked national health records (demographic, death certificate, admissions and PCR testing data) to calculate rates of COVID19 infection and death up to 31 July 2020. Our primary definition of COVID19 related death was mention of COVID19 on the death certificate. General population data from Public Health England and the Office for National Statistics were used for comparison. We also describe COVID19 related hospital admissions and all cause deaths. Results: We identified a cohort of 168,680 people with RAIRD, of whom 1874 (1.11%) had a positive COVID19 PCR test. The age standardised infection rate was 1.54 (95% CI 1.50, 1.59) times higher than in the general population. 713 (0.42%) people with RAIRD died with COVID19 on their death certificate and the age sex standardised mortality rate for COVID19 related death was 2.41 (2.30, 2.53) times higher than in the general population. There was no evidence of an increase in deaths from other causes in the RAIRD population. Conclusions: During the first wave of COVID19 in England, people with RAIRD had a 54% increased risk of COVID19 infection and more than twice the risk of COVID19 related death compared to the general population. These increases were seen despite shielding policies.