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Incidence and clinical course of COVID-19 in patients with rheumatologic diseases: A population-based study
Ho So1, Joyce Wing-Yan Mak2, Jacqueline So1
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
Insights
Patients with rheumatologic diseases did not show increased COVID-19 risk or severity in Hong Kong. The study found no alarming signals, with all five identified cases recovering well without complications.
Area of Science:
- Rheumatology
- Infectious Diseases
- Epidemiology
Background:
- Patients with rheumatologic diseases may be at higher risk for COVID-19.
- Understanding COVID-19 incidence and outcomes in this population is crucial.
Purpose of the Study:
- To determine the incidence of COVID-19 among patients with rheumatologic conditions in Hong Kong.
- To analyze the clinical outcomes of COVID-19 in this patient group.
Main Methods:
- Population-based retrospective study.
- Reviewed PCR-confirmed SARS-CoV-2 cases with prior rheumatologic disease diagnosis.
- Calculated COVID-19 incidence and compared it to the general population.
Main Results:
- Five COVID-19 cases were identified among 39,835 patients with rheumatologic diseases (0.0126% incidence).
- All cases had inflammatory arthropathies; none on b/tsDMARDs were infected.
- All patients recovered uneventfully without disease flare.
Conclusions:
- No increased frequency or severity of COVID-19 was observed in rheumatologic disease patients.
- Results suggest caution when extrapolating to populations with different infection control measures.
Objectives:
Patients with rheumatologic diseases might be more susceptible to COVID-19 and carry a poorer prognosis. The aim of this study is to examine the incidence and outcomes of all COVID-19 patients with rheumatologic conditions in Hong Kong.
Methods:
This is a population-based retrospective study. All patients tested positive for SARS-CoV-2 by PCR with a previous diagnosis of rheumatologic diseases were reviewed. The incidence of COVID-19 in patients with rheumatologic conditions was calculated and compared to the general population in Hong Kong. Descriptive data of those rheumatologic patients with COVID-19 and the clinical course of the index infection were presented.
Results:
Up till 27 May 2020, there were 1067 cases of COVID-19 diagnosed in Hong Kong which had a population of 7.5 million. Out of the 39,835 patients with underlying rheumatologic diseases, we identified 5 PCR confirmed COVID-19 cases. The estimated incidence of COVID-19 was 0.0126% patients with rheumatologic diseases, compared to 0.0142% in the general population. All 5 patients had inflammatory arthropathies. One patient was on hydroxychloroquine and sulphasalazine, and one was on methotrexate. None of the 3534 patients on b/tsDMARDs was infected. Four patients had leucopenia/lymphopenia and stool viral PCR was positive in 3 patients. All patients made uneventful recovery without complications or flare of underlying diseases.
Conclusions:
We found no alarming signals of increased frequency or severity of COVID-19 in patients with rheumatologic diseases, although extrapolation of the results to other populations with different infection control strategies should be made with caution.
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