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
Hauptverfasser: 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.
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container_end_page 1989
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
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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 &lt; 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 &lt; 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 &amp; 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 &amp; 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 &lt; 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 &lt; 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. 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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 &amp; 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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 &lt; 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 &lt; 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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