COVID‐19 in Patients With Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and Disease‐Modifying Antirheumatic Drugs on Clinical Outcomes
Objective To characterize the hospitalization and death rates among patients with inflammatory arthritis (IA) affected by coronavirus disease 2019 (COVID‐19) and to analyze the associations of comorbidities and immunomodulatory medications with infection outcomes. Methods Data on clinical and demogr...
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Veröffentlicht in: | Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2020-12, Vol.72 (12), p.1981-1989 |
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container_end_page | 1989 |
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container_issue | 12 |
container_start_page | 1981 |
container_title | Arthritis & rheumatology (Hoboken, N.J.) |
container_volume | 72 |
creator | Haberman, Rebecca H. Castillo, Rochelle Chen, Alan Yan, Di Ramirez, Deborah Sekar, Vaish Lesser, Robert Solomon, Gary Neimann, Andrea L. Blank, Rebecca B. Izmirly, Peter Webster, Dan E. Ogdie, Alexis Troxel, Andrea B. Adhikari, Samrachana Scher, Jose U. |
description | Objective
To characterize the hospitalization and death rates among patients with inflammatory arthritis (IA) affected by coronavirus disease 2019 (COVID‐19) and to analyze the associations of comorbidities and immunomodulatory medications with infection outcomes.
Methods
Data on clinical and demographic features, maintenance treatment, disease course, and outcomes in individuals with IA (rheumatoid arthritis and spondyloarthritis) with symptomatic COVID‐19 infection were prospectively assessed via web‐based questionnaire followed by individual phone calls and electronic medical record review. Baseline characteristics and medication use were summarized for hospitalized and ambulatory patients, and outcomes with the different medication classes were compared using multivariable logistic regression.
Results
A total of 103 patients with IA were included in the study (80 with confirmed COVID‐19 and 23 with high suspicion of COVID‐19). Hospitalization was required in 26% of the participants, and 4% died. Patients who were hospitalized were significantly more likely to be older (P < 0.001) and have comorbid hypertension (P = 0.001) and chronic obstructive pulmonary disease (P = 0.02). IA patients taking oral glucocorticoids had an increased likelihood of being admitted for COVID‐19 (P < 0.001), while those receiving maintenance anticytokine biologic therapies did not.
Conclusion
Among patients with underlying IA, COVID‐19 outcomes were worse in those receiving glucocorticoids but not in patients receiving maintenance anticytokine therapy. Further work is needed to understand whether immunomodulatory therapies affect COVID‐19 incidence. |
doi_str_mv | 10.1002/art.41456 |
format | Article |
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To characterize the hospitalization and death rates among patients with inflammatory arthritis (IA) affected by coronavirus disease 2019 (COVID‐19) and to analyze the associations of comorbidities and immunomodulatory medications with infection outcomes.
Methods
Data on clinical and demographic features, maintenance treatment, disease course, and outcomes in individuals with IA (rheumatoid arthritis and spondyloarthritis) with symptomatic COVID‐19 infection were prospectively assessed via web‐based questionnaire followed by individual phone calls and electronic medical record review. Baseline characteristics and medication use were summarized for hospitalized and ambulatory patients, and outcomes with the different medication classes were compared using multivariable logistic regression.
Results
A total of 103 patients with IA were included in the study (80 with confirmed COVID‐19 and 23 with high suspicion of COVID‐19). Hospitalization was required in 26% of the participants, and 4% died. Patients who were hospitalized were significantly more likely to be older (P < 0.001) and have comorbid hypertension (P = 0.001) and chronic obstructive pulmonary disease (P = 0.02). IA patients taking oral glucocorticoids had an increased likelihood of being admitted for COVID‐19 (P < 0.001), while those receiving maintenance anticytokine biologic therapies did not.
Conclusion
Among patients with underlying IA, COVID‐19 outcomes were worse in those receiving glucocorticoids but not in patients receiving maintenance anticytokine therapy. Further work is needed to understand whether immunomodulatory therapies affect COVID‐19 incidence.</description><identifier>ISSN: 2326-5191</identifier><identifier>EISSN: 2326-5205</identifier><identifier>DOI: 10.1002/art.41456</identifier><identifier>PMID: 32725762</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antirheumatic Agents - therapeutic use ; Arthritis ; Arthritis, Psoriatic - complications ; Arthritis, Psoriatic - drug therapy ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - drug therapy ; Biological Products - therapeutic use ; Chronic obstructive pulmonary disease ; Clinical outcomes ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; Electronic health records ; Electronic medical records ; Female ; Glucocorticoids ; Glucocorticoids - therapeutic use ; Humans ; Hypertension ; Immunomodulation ; Infections ; Inflammation ; Inflammatory diseases ; Lung diseases ; Maintenance ; Male ; Medical treatment ; Middle Aged ; Obstructive lung disease ; Patients ; Prospective Studies ; Regression analysis ; Rheumatic diseases ; Rheumatoid arthritis ; Telephone calls ; Treatment Outcome ; Viral diseases</subject><ispartof>Arthritis & rheumatology (Hoboken, N.J.), 2020-12, Vol.72 (12), p.1981-1989</ispartof><rights>2020, American College of Rheumatology</rights><rights>2020, American College of Rheumatology.</rights><rights>2020 American College of Rheumatology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-19a3fdf8f1708d7cce1c944fba723fc8e9bd6f88cc7b15b10662b2e5d76fa25d3</citedby><cites>FETCH-LOGICAL-c3886-19a3fdf8f1708d7cce1c944fba723fc8e9bd6f88cc7b15b10662b2e5d76fa25d3</cites><orcidid>0000-0001-5445-2182 ; 0000-0002-7119-8136 ; 0000-0002-1072-6994</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fart.41456$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fart.41456$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32725762$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haberman, Rebecca H.</creatorcontrib><creatorcontrib>Castillo, Rochelle</creatorcontrib><creatorcontrib>Chen, Alan</creatorcontrib><creatorcontrib>Yan, Di</creatorcontrib><creatorcontrib>Ramirez, Deborah</creatorcontrib><creatorcontrib>Sekar, Vaish</creatorcontrib><creatorcontrib>Lesser, Robert</creatorcontrib><creatorcontrib>Solomon, Gary</creatorcontrib><creatorcontrib>Neimann, Andrea L.</creatorcontrib><creatorcontrib>Blank, Rebecca B.</creatorcontrib><creatorcontrib>Izmirly, Peter</creatorcontrib><creatorcontrib>Webster, Dan E.</creatorcontrib><creatorcontrib>Ogdie, Alexis</creatorcontrib><creatorcontrib>Troxel, Andrea B.</creatorcontrib><creatorcontrib>Adhikari, Samrachana</creatorcontrib><creatorcontrib>Scher, Jose U.</creatorcontrib><creatorcontrib>NYU WARCOV Investigators</creatorcontrib><creatorcontrib>the NYU WARCOV Investigators</creatorcontrib><title>COVID‐19 in Patients With Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and Disease‐Modifying Antirheumatic Drugs on Clinical Outcomes</title><title>Arthritis & rheumatology (Hoboken, N.J.)</title><addtitle>Arthritis Rheumatol</addtitle><description>Objective
To characterize the hospitalization and death rates among patients with inflammatory arthritis (IA) affected by coronavirus disease 2019 (COVID‐19) and to analyze the associations of comorbidities and immunomodulatory medications with infection outcomes.
Methods
Data on clinical and demographic features, maintenance treatment, disease course, and outcomes in individuals with IA (rheumatoid arthritis and spondyloarthritis) with symptomatic COVID‐19 infection were prospectively assessed via web‐based questionnaire followed by individual phone calls and electronic medical record review. Baseline characteristics and medication use were summarized for hospitalized and ambulatory patients, and outcomes with the different medication classes were compared using multivariable logistic regression.
Results
A total of 103 patients with IA were included in the study (80 with confirmed COVID‐19 and 23 with high suspicion of COVID‐19). Hospitalization was required in 26% of the participants, and 4% died. Patients who were hospitalized were significantly more likely to be older (P < 0.001) and have comorbid hypertension (P = 0.001) and chronic obstructive pulmonary disease (P = 0.02). IA patients taking oral glucocorticoids had an increased likelihood of being admitted for COVID‐19 (P < 0.001), while those receiving maintenance anticytokine biologic therapies did not.
Conclusion
Among patients with underlying IA, COVID‐19 outcomes were worse in those receiving glucocorticoids but not in patients receiving maintenance anticytokine therapy. Further work is needed to understand whether immunomodulatory therapies affect COVID‐19 incidence.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis</subject><subject>Arthritis, Psoriatic - complications</subject><subject>Arthritis, Psoriatic - drug therapy</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Biological Products - therapeutic use</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Clinical outcomes</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Female</subject><subject>Glucocorticoids</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Immunomodulation</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Inflammatory diseases</subject><subject>Lung diseases</subject><subject>Maintenance</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Obstructive lung disease</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Rheumatic diseases</subject><subject>Rheumatoid arthritis</subject><subject>Telephone calls</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><issn>2326-5191</issn><issn>2326-5205</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFu1DAQhiMEolXpgRdAlrjAYVvbSRyHW5QtdKVWW0GBY-TY466rxF5sB5Qbj8Bj9Ll4ErzdlgMSvtgaff5mNH-WvST4hGBMT4WPJwUpSvYkO6Q5ZYuS4vLp45vU5CA7DuEWp1NXmOHyeXaQ04qWFaOH2V27_rJa_v75i9TIWHQlogEbA_pq4gatrB7EOIro_IwaHzfeRBPeoQZdeRe2IKP5DuhTnNSMnEVxA-hM61QOyGnUutH53qj0BwISVqGlCSACpG6XThk9G3uDGhuN38CUuhiJln66CTtXOxhrpBjQeorSjRBeZM-0GAIcP9xH2ef3Z9ft-eJi_WHVNhcLmXPOFqQWuVaaa1Jhriopgci6KHQvKppryaHuFdOcS1n1pOwJZoz2FEpVMS1oqfKj7M3eu_Xu2wQhdqMJEoZBWHBT6GhBeUE4LoqEvv4HvXWTt2m6RLGC54zwHfV2T8m0s-BBd1tvRuHnjuBul2CXEuzuE0zsqwfj1I-g_pKPeSXgdA_8MAPM_zd1zcfrvfIP3fyorw</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Haberman, Rebecca H.</creator><creator>Castillo, Rochelle</creator><creator>Chen, Alan</creator><creator>Yan, Di</creator><creator>Ramirez, Deborah</creator><creator>Sekar, Vaish</creator><creator>Lesser, Robert</creator><creator>Solomon, Gary</creator><creator>Neimann, Andrea L.</creator><creator>Blank, Rebecca B.</creator><creator>Izmirly, Peter</creator><creator>Webster, Dan E.</creator><creator>Ogdie, Alexis</creator><creator>Troxel, Andrea B.</creator><creator>Adhikari, Samrachana</creator><creator>Scher, Jose U.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5445-2182</orcidid><orcidid>https://orcid.org/0000-0002-7119-8136</orcidid><orcidid>https://orcid.org/0000-0002-1072-6994</orcidid></search><sort><creationdate>202012</creationdate><title>COVID‐19 in Patients With Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and Disease‐Modifying Antirheumatic Drugs on Clinical Outcomes</title><author>Haberman, Rebecca H. ; Castillo, Rochelle ; Chen, Alan ; Yan, Di ; Ramirez, Deborah ; Sekar, Vaish ; Lesser, Robert ; Solomon, Gary ; Neimann, Andrea L. ; Blank, Rebecca B. ; Izmirly, Peter ; Webster, Dan E. ; Ogdie, Alexis ; Troxel, Andrea B. ; Adhikari, Samrachana ; Scher, Jose U.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-19a3fdf8f1708d7cce1c944fba723fc8e9bd6f88cc7b15b10662b2e5d76fa25d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antirheumatic Agents - therapeutic use</topic><topic>Arthritis</topic><topic>Arthritis, Psoriatic - complications</topic><topic>Arthritis, Psoriatic - drug therapy</topic><topic>Arthritis, Rheumatoid - complications</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Biological Products - therapeutic use</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Clinical outcomes</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Female</topic><topic>Glucocorticoids</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Immunomodulation</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Inflammatory diseases</topic><topic>Lung diseases</topic><topic>Maintenance</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Obstructive lung disease</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Rheumatic diseases</topic><topic>Rheumatoid arthritis</topic><topic>Telephone calls</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haberman, Rebecca H.</creatorcontrib><creatorcontrib>Castillo, Rochelle</creatorcontrib><creatorcontrib>Chen, Alan</creatorcontrib><creatorcontrib>Yan, Di</creatorcontrib><creatorcontrib>Ramirez, Deborah</creatorcontrib><creatorcontrib>Sekar, Vaish</creatorcontrib><creatorcontrib>Lesser, Robert</creatorcontrib><creatorcontrib>Solomon, Gary</creatorcontrib><creatorcontrib>Neimann, Andrea L.</creatorcontrib><creatorcontrib>Blank, Rebecca B.</creatorcontrib><creatorcontrib>Izmirly, Peter</creatorcontrib><creatorcontrib>Webster, Dan E.</creatorcontrib><creatorcontrib>Ogdie, Alexis</creatorcontrib><creatorcontrib>Troxel, Andrea B.</creatorcontrib><creatorcontrib>Adhikari, Samrachana</creatorcontrib><creatorcontrib>Scher, Jose U.</creatorcontrib><creatorcontrib>NYU WARCOV Investigators</creatorcontrib><creatorcontrib>the NYU WARCOV Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haberman, Rebecca H.</au><au>Castillo, Rochelle</au><au>Chen, Alan</au><au>Yan, Di</au><au>Ramirez, Deborah</au><au>Sekar, Vaish</au><au>Lesser, Robert</au><au>Solomon, Gary</au><au>Neimann, Andrea L.</au><au>Blank, Rebecca B.</au><au>Izmirly, Peter</au><au>Webster, Dan E.</au><au>Ogdie, Alexis</au><au>Troxel, Andrea B.</au><au>Adhikari, Samrachana</au><au>Scher, Jose U.</au><aucorp>NYU WARCOV Investigators</aucorp><aucorp>the NYU WARCOV Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>COVID‐19 in Patients With Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and Disease‐Modifying Antirheumatic Drugs on Clinical Outcomes</atitle><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle><addtitle>Arthritis Rheumatol</addtitle><date>2020-12</date><risdate>2020</risdate><volume>72</volume><issue>12</issue><spage>1981</spage><epage>1989</epage><pages>1981-1989</pages><issn>2326-5191</issn><eissn>2326-5205</eissn><abstract>Objective
To characterize the hospitalization and death rates among patients with inflammatory arthritis (IA) affected by coronavirus disease 2019 (COVID‐19) and to analyze the associations of comorbidities and immunomodulatory medications with infection outcomes.
Methods
Data on clinical and demographic features, maintenance treatment, disease course, and outcomes in individuals with IA (rheumatoid arthritis and spondyloarthritis) with symptomatic COVID‐19 infection were prospectively assessed via web‐based questionnaire followed by individual phone calls and electronic medical record review. Baseline characteristics and medication use were summarized for hospitalized and ambulatory patients, and outcomes with the different medication classes were compared using multivariable logistic regression.
Results
A total of 103 patients with IA were included in the study (80 with confirmed COVID‐19 and 23 with high suspicion of COVID‐19). Hospitalization was required in 26% of the participants, and 4% died. Patients who were hospitalized were significantly more likely to be older (P < 0.001) and have comorbid hypertension (P = 0.001) and chronic obstructive pulmonary disease (P = 0.02). IA patients taking oral glucocorticoids had an increased likelihood of being admitted for COVID‐19 (P < 0.001), while those receiving maintenance anticytokine biologic therapies did not.
Conclusion
Among patients with underlying IA, COVID‐19 outcomes were worse in those receiving glucocorticoids but not in patients receiving maintenance anticytokine therapy. Further work is needed to understand whether immunomodulatory therapies affect COVID‐19 incidence.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32725762</pmid><doi>10.1002/art.41456</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5445-2182</orcidid><orcidid>https://orcid.org/0000-0002-7119-8136</orcidid><orcidid>https://orcid.org/0000-0002-1072-6994</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Aged, 80 and over Antirheumatic Agents - therapeutic use Arthritis Arthritis, Psoriatic - complications Arthritis, Psoriatic - drug therapy Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - drug therapy Biological Products - therapeutic use Chronic obstructive pulmonary disease Clinical outcomes Coronaviruses COVID-19 COVID-19 - complications Electronic health records Electronic medical records Female Glucocorticoids Glucocorticoids - therapeutic use Humans Hypertension Immunomodulation Infections Inflammation Inflammatory diseases Lung diseases Maintenance Male Medical treatment Middle Aged Obstructive lung disease Patients Prospective Studies Regression analysis Rheumatic diseases Rheumatoid arthritis Telephone calls Treatment Outcome Viral diseases |
title | COVID‐19 in Patients With Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and Disease‐Modifying Antirheumatic Drugs on Clinical Outcomes |
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