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COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study
Jixin Zhong1, Guifen Shen1, Huiqin Yang2
1Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Insights
Patients with autoimmune rheumatic diseases may face a higher risk of COVID-19 infection. Hydroxychloroquine use was associated with a reduced risk in these patients.
Area of Science:
- Rheumatology
- Infectious Diseases
- Epidemiology
Background:
- Susceptibility to COVID-19 in patients with rheumatic diseases was unclear during the pandemic.
- Autoimmune rheumatic diseases affect immune system regulation.
- Understanding COVID-19 risk in this population is crucial for public health.
Purpose of the Study:
- To investigate the susceptibility of patients with autoimmune rheumatic diseases to COVID-19.
- To identify risk factors associated with COVID-19 infection in this cohort.
- To explore potential protective effects of medications.
Main Methods:
- Multicentre retrospective study in Hubei province, China.
- Telephone-based survey of 6228 patients with autoimmune rheumatic diseases.
- Follow-up of families with documented COVID-19 exposure.
Main Results:
- Overall COVID-19 rate was 0.43% in patients with rheumatic diseases.
- Patients with rheumatic diseases had a higher risk of COVID-19 compared to their non-rheumatic family members (OR 2.68).
- Hydroxychloroquine use was linked to a lower risk of COVID-19 (OR 0.09), while increasing age was associated with higher risk (OR 1.04).
Conclusions:
- Patients with autoimmune rheumatic diseases may be more susceptible to COVID-19.
- Hydroxychloroquine may offer some protection against COVID-19 in this group.
- Age is a significant risk factor for COVID-19 in patients with rheumatic diseases.
Background:
In the ongoing COVID-19 pandemic, the susceptibility of patients with rheumatic diseases to COVID-19 remains unclear. We aimed to investigate susceptibility to COVID-19 in patients with autoimmune rheumatic diseases during the ongoing COVID-19 pandemic.
Methods:
We did a multicentre retrospective study of patients with autoimmune rheumatic diseases in Hubei province, the epicentre of the COVID-19 outbreak in China. Patients with rheumatic diseases were contacted through an automated telephone-based survey to investigate their susceptibility to COVID-19. Data about COVID-19 exposure or diagnosis were collected. Families with a documented history of COVID-19 exposure, as defined by having at least one family member diagnosed with COVID-19, were followed up by medical professionals to obtain detailed information, including sex, age, smoking history, past medical history, use of medications, and information related to COVID-19.
Findings:
Between March 20 and March 30, 2020, 6228 patients with autoimmune rheumatic diseases were included in the study. The overall rate of COVID-19 in patients with an autoimmune rheumatic disease in our study population was 0·43% (27 of 6228 patients). We identified 42 families in which COVID-19 was diagnosed between Dec 20, 2019, and March 20, 2020, in either patients with a rheumatic disease or in a family member residing at the same physical address during the outbreak. Within these 42 families, COVID-19 was diagnosed in 27 (63%) of 43 patients with a rheumatic disease and in 28 (34%) of 83 of their family members with no rheumatic disease (adjusted odds ratio [OR] 2·68 [95% CI 1·14-6·27]; p=0·023). Patients with rheumatic disease who were taking hydroxychloroquine had a lower risk of COVID-19 infection than patients taking other disease-modifying anti-rheumatic drugs (OR 0·09 [95% CI 0·01-0·94]; p=0·044). Additionally, the risk of COVID-19 was increased with age (adjusted OR 1·04 [95%CI 1·01-1·06]; p=0·0081).
Interpretation:
Patients with autoimmune rheumatic disease might be more susceptible to COVID-19 infection than the general population.
Funding:
National Natural Science Foundation of China and the Tongji Hospital Clinical Research Flagship Program.
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