Mortality Rates Among Rheumatic Disease Patients During the First Wave of COVID-19

December 30, 2021

Research published in Rheumatology found that patients living with rare autoimmune rheumatic diseases (RAIRD) were at double the risk of death from COVID-19 than the general population during the first wave of the pandemic. Rare autoimmune rheumatic diseases include lupus, giant cell arteritis, Juvenile idiopathic arthritis, polymyositis, scleroderma, and Behcet’s disease, amongst others.

In order to determine mortality rates, researchers compared health records from Public Health England and the Office of National Statistics for the general population and 168,680 RAIRD patients. Within this cohort, 1,874 RAIRD patients tested positive for COVID-19. Records from March 1 – July 31, 2020 were included for analysis.

Researchers found that patients with rare autoimmune rheumatic diseases were 1.54x more likely to be infected with COVID-19, and the mortality rate was 2.41x higher. The median length of hospital stays within this cohort was 8 days, and the median length of stay for ICU admissions was 6 days. “Deaths due to cardiovascular disease were recorded in 703 (21.1%), COVID-19 652 (19.6%), malignancy 581 (17.4%), respiratory 404 (12.1%), dementia 280 (8.4%), underlying RAIRD 113 (3.4%) and non-COVID-19 infection 19 (0.6%), with the remaining 580 (17.4%) ascribed to other causes.”

These results show that COVID-19 infection was responsible for increased mortality within this cohort of patients, rather than rheumatic disease or other co-morbidities. Furthermore, those living with rare autoimmune rheumatic diseases are at an increased risk for COVID-19 compared to those with common rheumatic diseases; this may be due to the fact that those living with rare autoimmune rheumatic disease require long-term immunosuppression. Data on immunosuppressive medications was not included in this study.

Researchers noted that “further work is needed to describe the outcomes in the second wave, and assess the influence of immunosuppression, shielding policies and the vaccination programme.”





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