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Shielding reduced incidence of COVID-19 in patients with inflammatory arthritis but vulnerability is associated with increased mortality.
- Source :
-
Rheumatology . 2022 Special Issue, Vol. 61, pSI120-SI128. 9p. - Publication Year :
- 2022
-
Abstract
- Objectives Investigate whether individuals with inflammatory arthritis (IA), their treatments and shielding status affect the risk of adverse outcomes from COVID-19 for the entire population of Wales, UK. Methods Retrospective, population-based cohort study using linked, anonymized electronic health data from SAIL Databank, including primary/secondary care, rheumatology, Office for National Statistics Mortality and COVID-19 laboratory data. Individuals aged 18 years and over testing positive for COVID-19 between March 2020 and May 2021 with READ Codes present for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis formed the study cases. Results A total of 1966 people with IA and 166 602 without tested positive for COVID-19. The incidence rate was 3.5% (1966/56 914) in IA, vs 6% in the general population (166 602/2 760 442), (difference: 2.5%, 95% CI: 2.4%, 2.7%, P  ≤0.001). In an adjusted Cox proportional hazard model, IA was not associated with higher mortality (HR: 0.56, 95% CI: 0.18, 1.64, P =0.286). Significant risk factors included shielding (HR: 1.52, 95% CI: 1.40, 1.64, P  ≤0.001), hospitalization for previous infections (HR: 1.20, 95% CI: 1.12, 1.28, P  ≤0.001), hospitalizations one year pre-pandemic (HR: 1.34, 95% CI: 1.25, 1.44, P  ≤0.001) and glucocorticoid use (HR: 1.17, 95% CI: 1.09, 1.25, P  ≤0.001). Conclusions Individuals with IA had a lower incidence of COVID-19, probably due to shielding. IA was not associated with increased mortality following COVID-19 infection; being vulnerable (shielded), comorbidities and other factors were associated with increased risk. These key risk factors can identify individuals with IA at greater risk from COVID-19 and advised to shield during high community prevalence. [ABSTRACT FROM AUTHOR]
- Subjects :
- *INFLAMMATION treatment
*ADVERSE health care events
*DATABASES
*COVID-19
*CONFIDENCE intervals
*PSYCHOLOGICAL vulnerability
*DISEASE incidence
*RETROSPECTIVE studies
*RISK assessment
*DESCRIPTIVE statistics
*ARTHRITIS
*POPULATION health
*ELECTRONIC health records
*LONGITUDINAL method
*PROPORTIONAL hazards models
MORTALITY risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 14620324
- Volume :
- 61
- Database :
- Academic Search Index
- Journal :
- Rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 157803325
- Full Text :
- https://doi.org/10.1093/rheumatology/keac283