Factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy: results from the COVID-19 Global Rheumatology Alliance physician-reported registry

Yeoh S.-A.; Gianfrancesco M.; Lawson-Tovey S.; Hyrich K.L.; Strangfeld A.; Gossec L.; Carmona L.; Mateus E.F.; Schäfer M.; Richez C.; Hachulla E.; Holmqvist M.; Scirè C.A.; Lorenz H.-M.; Voll R.E.; Hasseli R.; Jayatilleke A.; Hsu T.Y.-T.; D'Silva K.M.; Pimentel-Quiroz V.R.; Vasquez Del Mercado M.; Shinjo S.K.; Neto E.T.D.R.; Junior L.F.D.R.; De Oliveira E Silva Montandon A.C.; Pons-Estel G.J.; Ornella S.; D'Angelo Exeni M.E.; Velozo E.; Jordan P.; Sirotich E.; Hausmann J.S.; Liew J.W.; Jacobsohn L.; Gore-Massy M.; Sufka P.; Grainger R.; Bhana S.; Wallace Z.; Robinson P.C.; Yazdany J.; MacHado P.M. · RMD Open (2022) · DOI: 10.1136/rmdopen-2022-002508

Resumen

Objectives To investigate factors associated with severe COVID-19 in people with idiopathic inflammatory myopathy (IIM). Methods Demographic data, clinical characteristics and COVID-19 outcome severity of adults with IIM were obtained from the COVID-19 Global Rheumatology Alliance physician-reported registry. A 3-point ordinal COVID-19 severity scale was defined: (1) no hospitalisation, (2) hospitalisation (and no death) and (3) death. ORs were estimated using multivariable ordinal logistic regression. Sensitivity analyses were performed using a 4-point ordinal scale: (1) no hospitalisation, (2) hospitalisation with no oxygen (and no death), (3) hospitalisation with oxygen/ventilation (and no death) and 4) death. Results Of 348 patients, 48% were not hospitalised, 39% were hospitalised (and did not die) and 13% died. Older age (OR=1.59/decade, 95% CI 1.31 to 1.91), high disease activity (OR=3.50, 95% CI 1.25 to 9.83; vs remission), ≥2 comorbidities (OR=2.63, 95% CI 1.39 to 4.98; vs none), prednisolone-equivalent dose >7.5 mg/day (OR=2.40, 95% CI 1.09 to 5.28; vs no intake) and exposure to rituximab (OR=2.71, 95% CI 1.28 to 5.72; vs conventional synthetic disease-modifying antirheumatic drugs only) were independently associated with severe COVID-19. In addition to these variables, in the sensitivity analyses, male sex (OR range: 1.65-1.83; vs female) was also significantly associated with severe outcomes, while COVID-19 diagnosis after 1 October 2020 (OR range: 0.51-0.59; vs on/before 15 June 2020) was significantly associated with less severe outcomes, but these associations were not significant in the main model (OR=1.57, 95% CI 0.95 to 2.59; and OR=0.61, 95% CI 0.37 to 1.00; respectively). Conclusions This is the first large registry data on outcomes of COVID-19 in people with IIM. Older age, male sex, higher comorbidity burden, high disease activity, prednisolone-equivalent dose >7.5 mg/day and rituximab exposure were associated with severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with IIM. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Instituciones: Universidad Científica del Sur