Risk of Severe COVID-19 Infection in Patients With Inflammatory Rheumatic Diseases

Objective. To describe the cohort of patients with inflammatory rheumatic diseases (IRD) hospitalized due to SARS- CoV-2 infection in the Ramon y Cajal Hospital, and to determine the increased risk of severe coronavirus disease 2019 (COVID-19) in patients with no IRD. Methods. This is a retrospective single-center observational study of patients with IRD actively monitored in the Department of Rheumatology who were hospitalized due to COVID-19. Results. Forty-one (1.8%) out of 2315 patients admitted due to severe SARS-CoV-2 pneumonia suffered from an IRD. The admission OR for patients with IRD was 1.91 against the general population, and it was considerably higher in patients with Sjogren syndrome, vasculitis, and systemic lupus erythematosus. Twenty-seven patients were receiving treatment for IRD with corticosteroids, 23 with conventional DMARDs, 12 with biologics (7 rituximab [RTX], 4 anti-tumor necrosis factor [anti-TNF], and 1 abatacept), and 1 with Janus kinase inhibitors. Ten deaths were registered among patients with IRD. A higher hospitalization rate and a higher number of deaths were observed in patients treated with RTX (OR 12.9) but not in patients treated with anti-TNF (OR 0.9). Conclusion. Patients with IRD, especially autoimmune diseases and patients treated with RTX, may be at higher risk of severe pneumonia due to SARS-CoV-2 compared to the general population. More studies are needed to analyze this association further in order to help manage these patients during the pandemic.

Automated summary

The study found that patients with inflammatory rheumatic diseases accounted for 1.8% of the total hospitalized population. Patients with diseases such as rheumatoid arthritis, vasculitis, and systemic lupus erythematosus had a higher risk of hospitalization. Rheumatoid arthritis patients also showed a higher mortality rate in COVID-19, especially those treated with RTX.