CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases

• Published in: Frontiers in medicine Vol. 10
• Main Authors: Chevalier, Kevin, Genin, Michaël, Jean, Thomas Petit, Avouac, Jerôme, Flipo, Rene-Marc, Georgin-Lavialle, Sophie, El Mahou, Soumaya, Pertuiset, Edouard, Pham, Thao, Servettaz, Amelie, Marotte, Hubert, Domont, Fanny, Chazerain, Pascal, Devaux, Mathilde, Mekinian, Arsene, Sellam, Jérémie, Fautrel, Bruno, Rouzaud, Diane, Ebstein, Esther, Costedoat-Chalumeau, Nathalie, Richez, Christophe, Hachulla, Eric, Mariette, Xavier, Seror, Raphaèle
• Format: Journal Article
• Language: English
• Published: Frontiers media 22.03.2023
• Subjects: Life Sciences
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2023.1152587

Introduction Autoimmune/inflammatory rheumatic diseases (AIRDs) patients might be at-risk of severe COVID-19. However, whether this is linked to the disease or to its treatment is difficult to determine. This study aimed to identify factors associated with occurrence of severe COVID-19 in AIRD patients and to evaluate whether having an AIRD was associated with increased risk of severe COVID-19 or death. Materials and methods Two databases were analyzed: the EDS (Entrepôt des Données de Santé, Clinical Data Warehouse), including all patients followed in Paris university hospitals and the French multi-center COVID-19 cohort [French rheumatic and musculoskeletal diseases (RMD)]. First, in a combined analysis we compared patients with severe and non-severe COVID-19 to identify factors associated with severity. Then, we performed a propensity matched score case–control study within the EDS database to compare AIRD cases and non-AIRD controls. Results Among 1,213 patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher risk of severe COVID-19 [aOR = 1.43 (1.08–1.87), p = 0.01] but analysis restricted to rheumatoid arthritis and spondyloarthritis found no increased risk of severe COVID-19 [aOR = 1.11 (0.68–1.81)]. Conclusion In this multicenter study, we confirmed that AIRD patients treated with rituximab or corticosteroids and/or having vasculitis, auto-inflammatory disease, and sarcoidosis had increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of severe COVID-19 compares general population.