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Rigshospitalet - a part of Copenhagen University Hospital
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Incidence and severeness of COVID-19 hospitalization in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark

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  • René Cordtz
  • Jesper Lindhardsen
  • Bolette G Soussi
  • Jonathan Vela
  • Line Uhrenholt
  • Rasmus Westermann
  • Salome Kristensen
  • Henrik Nielsen
  • Christian Torp-Pedersen
  • Lene Dreyer
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OBJECTIVES: To estimate the incidence of COVID-19 hospitalization in patients with inflammatory rheumatic disease (IRD); in patients with RA treated with specific DMARDs; and the incidence of severe COVID-19 infection among hospitalized patients with RA.

METHODS: A nationwide cohort study from Denmark between 1 March and 12 August 2020. The adjusted incidence of COVID-19 hospitalization was estimated for patients with RA; spondyloarthritis including psoriatic arthritis; connective tissue disease; vasculitides; and non-IRD individuals. Further, the incidence of COVID-19 hospitalization was estimated for patients with RA treated and non-treated with TNF-inhibitors, HCQ or glucocorticoids, respectively. Lastly, the incidence of severe COVID-19 infection (intensive care, acute respiratory distress syndrome or death) among hospital-admitted patients was estimated for RA and non-IRD sp - individudals.

RESULTS: Patients with IRD (n = 58 052) had an increased partially adjusted incidence of hospitalization with COVID-19 compared with the 4.5 million people in the general population [hazard ratio (HR) 1.46, 95% CI: 1.15, 1.86] with strongest associations for patients with RA (n = 29 440, HR 1.72, 95% CI: 1.29, 2.30) and vasculitides (n = 4072, HR 1.82, 95% CI: 0.91, 3.64). There was no increased incidence of COVID-19 hospitalization associated with TNF-inhibitor, HCQ nor glucocorticoid use. COVID-19 admitted patients with RA had a HR of 1.43 (95% CI: 0.80, 2.53) for a severe outcome.

CONCLUSION: Patients with IRD were more likely to be admitted with COVID-19 than the general population, and COVID-19 admitted patients with RA could be at higher risk of a severe outcome. Treatment with specific DMARDs did not affect the risk of hospitalization.

Original languageEnglish
JournalRheumatology (Oxford, England)
Volume60
Issue numberSI
Pages (from-to)SI59-SI67
ISSN1462-0324
DOIs
Publication statusPublished - 9 Oct 2021

    Research areas

  • Adult, Aged, Antirheumatic Agents/therapeutic use, COVID-19/complications, Cohort Studies, Denmark/epidemiology, Female, Hospitalization/statistics & numerical data, Humans, Incidence, Male, Middle Aged, Rheumatic Diseases/epidemiology, SARS-CoV-2, Severity of Illness Index

ID: 61756043