21 April 2020

Early data reveals COVID-19 death rate in rheumatology patients

COVID-19

The COVID-19 Global Rheumatology Alliance, which was established in March to collect data on patients with CVOID-19 and rheumatic disease, has published data about the first 110 patients included on the registry.

While this is very early data, it is of such interest and importance that the alliance has published the results in Lancet Rheumatology as a comment.

As of 1 April, the registry included 110 patients with rheumatic disease diagnosed with COVID-19 from six continents: Europe, North America, South America, Asia, Africa, and Oceania.

Six (5%) of these patients died of COVID-19, while 39 (35%) were admitted to hospital.

Around 36% had RA, 17% had psoriatic arthritis, 17% had SLE and the rest had other rheumatic diseases.

The majority of patients were taking conventional synthetic DMARDs (63%), while 45% were taking biologics, 25% were on NSAIDs, 25% were on glucocorticoids and 5% were on JAK inhibitors.

Most patients who caught COVID-19 had a fever and cough, while around half experienced shortness of breath and myalgia. Around 37% had a sore throat.

The most common comorbid conditions were hypertension (28%), lung disease (20%), CVD (11%), obesity (8%) and diabetes (8%).

The authors said the results should be interpreted carefully as the registry was “not without limitations”, including  potential selection bias towards more severe cases, unreported cases due to rheumatologists working on the frontlines of the pandemic instead of with their usual patients, the risk of duplicate entries and small sample size.

“As the whole denominator of individuals with rheumatic diseases who acquire COVID-19 is unknown, the database will be unable to provide accurate estimates of the risk of specific outcomes across the entire rheumatic disease population or in association with specific treatments,” the authors said.

Lancet Rheumatology 2020, 16 April