{"id":995,"date":"2021-02-09T14:49:11","date_gmt":"2021-02-09T14:49:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/rheumsummaries\/?p=995"},"modified":"2021-12-16T12:41:38","modified_gmt":"2021-12-16T12:41:38","slug":"covid-19-related-death-in-rheumatic-diseases","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2021\/02\/09\/covid-19-related-death-in-rheumatic-diseases\/","title":{"rendered":"COVID-19-related death in rheumatic diseases"},"content":{"rendered":"

This is the lay version of a paper published on behalf of the COVID-19 Global Rheumatology Alliance
\nConsortium. It examines COVID-19-related death in people with rheumatic diseases. The original publication can be downloaded from the EULAR website: www.eular.org<\/a>.<\/p>\n

Strangfeld A, et al. Factors Associated with COVID-19-related Death in People with Rheumatic Diseases:
\nResults from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis
\nPublished Online First: 27 January 2021. doi: 10.1136\/annrheumdis-2020-219498<\/p>\n

Introduction<\/strong>
\nEULAR gives advice to doctors, nurses and patients about the best way to treat and manage rheumatic
\ndiseases. As part of the current global effort to understand and combat COVID-19, EULAR gave financial
\nsupport to this registry project.<\/p>\n

What do we already know?<\/strong>
\nThere are more than 200 rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus. Many of these diseases are autoimmune conditions that cause inflammation in the body. Rheumatic diseases typically affect joints, muscle, or connective tissue. They can also affect a person\u2019s internal organs.<\/p>\n

People with rheumatic diseases are more prone to infection. This can be because of the disease itself and the way it affects the immune system, but also affected by some of the medicines used to treat the rheumatic disease. COVID-19 is the disease caused by a new type of coronavirus called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical information for people with COVID-19 who have a rheumatic disease is limited, especially about factors that might make them more likely to die from the infection.<\/p>\n

What does the paper say?<\/strong>
\nThe registry collected information on 3729 people with rheumatic disease who had either a confirmed or
\nhighly likely case of COVID-19, or had symptoms of this infection. In total, 390 people died \u2013 just over 10%. The authors looked to see if there were any common factors in the people who died compared to those who recovered from the COVID-19 infection.<\/p>\n

\u2022 Older age and male sex are associated with COVID-19-related death.<\/strong>
\nOf those who died, over two-thirds were over the age of 65. The risk of dying was even higher in
\npeople in over the age of 75, and for men compared to women. This is similar to what has been
\nfound in the general population.<\/p>\n

\u2022 Comorbidities are more common in people who die from COVID-19.<\/strong>
\nAcross all 3729 people included, most people had at least one other disease (comorbidity). The most
\ncommon were hypertension (high blood pressure), chronic lung disease, and obesity. In the whole
\ngroup, 21% of people had three or more comorbidities. When the authors looked only at the people
\nwho had died, 43% had three or more comorbidities. This is similar to what has been found in the
\ngeneral population.<\/p>\n

\u2022 Cardiovascular and chronic lung disease are more common in people dying from COVID-19.<\/strong>
\nOther factors associated with dying from COVID-19 included chronic lung disease, or having cardiovascular disease combined with hypertension. Chronic kidney disease was also a risk for
\npeople with connective tissue disease or vasculitis, but did not increase the risk of death for people
\nwith other types of rheumatic disease.<\/p>\n

\u2022 Disease-specific factors are associated with COVID-19-related death.<\/strong>
\nPeople with moderate or high disease activity were more likely to die from COVID-19 than those with
\nlow disease activity or people who were in remission (no current signs and symptoms of their
\nrheumatic disease).<\/p>\n

\u2022 Certain medications are associated with COVID-19-related death.<\/strong>
\nPeople taking rituximab or sulfasalazine were more likely to die from COVID-19. A similar
\nassociation was seen for a mixed group of immunosuppressants (azathioprine, cyclophosphamide,
\nciclosporin, mycophenolate and tacrolimus) compared to those using immunomodulators such as
\ndisease-modifying anti-rheumatic drugs (often shortened to DMARDs). However, the numbers were
\ntoo low to allow individual analysis by immunosuppressive drug, making it difficult to interpret these
\nresults. Moderate to high doses of glucocorticoids (steroids) \u2013 more than 10 mg per day \u2013 were also
\nassociated with a higher risk of dying across all rheumatic diseases.<\/p>\n

What does this mean for me?<\/strong>
\nThese finding will help patients and doctors reach a shared understanding of risk of COVID-19 severe
\noutcomes in patients with RMDs. If you have been in contact with a COVID-19 patient or have symptoms of
\nCOVID-19, you should contact your local health authorities and your rheumatologist. Generally, patients with RMD should continue to comply with all preventive and control measures and vaccination efforts prescribed by the health authorities in their countries, such as hand hygiene, wearing masks (ideally FFP2 masks) and holding distance of at least 2 meters from others.<\/p>\n

Summary<\/strong>
\nOverall, the papers highlights that the risk of dying from COVID-19 varies according to people\u2019s underlying disease activity and what medicine they are taking. It is important for people with a rheumatic disease to continue to control their disease activity with DMARDs, but preferably without increasing the dose of any glucocorticoids, if possible. Withdrawal of effective treatments should be based on sound evidence, even during a pandemic.<\/p>\n

If you have any questions or concerns about your disease or your medication, you should speak to a health professional involved in your care.<\/p>\n

Disclaimer<\/strong>\u00a0: This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be fully relevant nor accurate as medical science is constantly changing and errors can occur. It is therefore very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care and only rely on the Summary if directed to do so by their medical professional. Please view our full\u00a0Website Terms and Conditions<\/a>.<\/p>\n

Copyright<\/strong> \u00a9 2021 BMJ Publishing Group Ltd & European Alliance of Associations for Rheumatology. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our\u00a0Rights and Licensing Team<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

This is the lay version of a paper published on behalf of the COVID-19 Global Rheumatology Alliance Consortium. It examines COVID-19-related death in people with rheumatic diseases. The original publication can be downloaded from the EULAR website: www.eular.org. Strangfeld A, et al. Factors Associated with COVID-19-related Death in People with Rheumatic Diseases: Results from the […]<\/p>\n

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