Risk of severe coronavirus infection (COVID-19) in patients with inflammatory rheumatic diseases.

Bachiller-Corral, Javier; Boteanu, Alina; Garcia-Villanueva, Maria Jesus; de la Puente, Carlos; Revenga, Marcelino; Diaz-Miguel, M Consuelo; Rodriguez-Garcia, Ana; Morell-Hita, Jose Luis; Valero, Marta; Larena, Carmen; Blazquez-Cañamero, Maria; Guillen-Astete, Carlos A; Garrote, Sandra; Sobrino, Cristina; Medina-Quiñones, Carmen; Vazquez-Diaz, Mónica

OBJECTIVE To describe the cohort of patients with inflammatory rheumatic diseases (IRD) hospitalized due to SARS-CoV-2 infection in our hospital and to determine the increased risk of severe coronavirus disease regarding no IRD patients. METHODS Retrospective single-center observational study of patients with IRD actively monitored in the Department of Rheumatology who were hospitalized due to COVID- 19. RESULTS 41 (1,8%) out of 2,315 patients admitted due to severe SARS-CoV-2 pneumonia suffered from an IRD. The admission Odds ratio (OR) for IRD patients was 1.87 against the general population, and it was higher in patients with Sjögren's syndrome, vasculitis and systemic lupus erythematosus. Twenty-seven patients were receiving treatment for IRD with corticosteroids, 23 with conventional DMARDs, 12 with biologics (7 rituximab, 4 anti-TNF and 1 abatacept) and 1 with JAK inhibitors. Ten deaths were registered among patients with IRD. A higher hospitalization rate and a higher number of deaths were observed in patients treated with rituximab (OR=12.8) but not in patients treated with anti-TNF (OR=0.9). CONCLUSION Patients with IRD, especially autoimmune diseases and patients treated with rituximab, may be at higher risk of severe pneumonia due to SARS-Cov 2, compared to the general population. More studies are needed to analyze this association further in order to help managing these patients during the pandemic.