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Influenza outcomes in patients with inflammatory joint diseases and DMARDs: how do they compare to those of COVID-19?
Influenza outcomes in patients with inflammatory joint diseases and DMARDs: how do they compare to those of COVID-19?
- Source :
- Annals of the Rheumatic Diseases
- Publication Year :
- 2021
- Publisher :
- BMJ, 2021.
-
Abstract
- ObjectivesTo estimate absolute and relative risks for seasonal influenza outcomes in patients with inflammatory joint diseases (IJDs) and disease-modifying antirheumatic drugs (DMARDs). To contextualise recent findings on corresponding COVID-19 risks.MethodsUsing Swedish nationwide registers for this cohort study, we followed 116 989 patients with IJD and matched population comparators across four influenza seasons (2015–2019). We quantified absolute risks of hospitalisation and death due to influenza, and compared IJD to comparators via Cox regression. We identified 71 556 patients with IJD on active treatment with conventional synthetic DMARDs and biological disease-modifying antirheumatic drugs (bDMARDs)/targeted synthetic disease-modifying antirheumatic drug (tsDMARDs) at the start of each influenza season, estimated risks for the same outcomes and compared these risks across DMARDs via Cox regression.ResultsPer season, average risks for hospitalisation listing influenza were 0.25% in IJD and 0.1% in the general population, corresponding to a crude HR of 2.38 (95% CI 2.21 to 2.56) that decreased to 1.44 (95% CI 1.33 to 1.56) following adjustments for comorbidities. For death listing influenza, the corresponding numbers were 0.015% and 0.006% (HR=2.63, 95% CI 1.93 to 3.58, and HR=1.46, 95% CI 1.07 to 2.01). Absolute risks for influenza outcomes were half (hospitalisation) and one-tenth (death) of those for COVID-19, but relative estimates comparing IJD to the general population were similar.ConclusionsIn absolute terms, COVID-19 in IJD outnumbers that of average seasonal influenza, but IJD entails a 50%–100% increase in risk for hospitalisation and death for both types of infections, which is largely dependent on associated comorbidities. Overall, bDMARDs/tsDMARDs do not seem to confer additional risk for hospitalisation or death related to seasonal influenza.
- Subjects :
- Male
Risk
rheumatoid arthritis
medicine.medical_specialty
antirheumatic agents
Coronavirus disease 2019 (COVID-19)
Epidemiology
Immunology
Population
General Biochemistry, Genetics and Molecular Biology
Arthritis, Rheumatoid
Rheumatology
Internal medicine
Influenza, Human
medicine
Humans
Immunology and Allergy
In patient
education
Aged
Proportional Hazards Models
Sweden
education.field_of_study
SARS-CoV-2
Proportional hazards model
business.industry
COVID-19
Middle Aged
medicine.disease
Hospitalization
Antirheumatic Agents
Influenza A virus
biological therapy
Rheumatoid arthritis
Relative risk
Female
Seasons
business
Cohort study
Subjects
Details
- ISSN :
- 14682060 and 00034967
- Volume :
- 81
- Database :
- OpenAIRE
- Journal :
- Annals of the Rheumatic Diseases
- Accession number :
- edsair.doi.dedup.....3899376d972a4504d697d00a6021249b
- Full Text :
- https://doi.org/10.1136/annrheumdis-2021-221461