Prevalence of Hospital PCR Confirmed Covid-19 Cases in Patients with Chronic Inflammatory and Autoimmune Rheumatic Diseases

Pablos, J. L.; Abasolo-Alcazar, L.; Alvaro-Gracia, J. M.; Blanco, F. J.; Blanco, R.; Castrejon, I.; Fernandez-Fernandez, D.; Fernandez-Gutierrez, B.; Galindo, M.; Gonzalez-Gay, M. A.; Manrique-Arija, S.; Mena-Vazquez, N.; Mera-Varela, A.; Retuerto, M.; Seijas-Lopez, A.; group, RIER investigators

ABSTRACT Background. The susceptibility of patients with rheumatic diseases, and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown. Methods. We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with SARS-CoV-2 positive PCR tests performed in the hospital to the same reference populations. Incidences of PCR+ confirmed COVID-19 were compared among groups. Results. Patients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Systemic autoimmune or immune mediated diseases (AI/IMID) patients showed a significant increase, whereas inflammatory arthritis (IA) or systemic lupus erythematosus (SLE) patients did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. IA patients on targeted-synthetic or biological disease-modifying antirheumatic drugs (ts/bDMARD), but not those on conventional-synthetic (csDMARD), had a greater prevalence despite a similar age distribution. Conclusion. Patients with AI/IMID show a variable risk of hospital diagnosed COVID-19. Interplay of aging, therapies, and disease specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyze the specific factors involved in COVID-19 susceptibility.