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Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a prospective cohort study

Jithin Mathew1, Siddharth Jain1, Terence Susngi2

  • 1Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Rheumatology Advances in Practice
|March 13, 2023
PubMed

Insights

In Indian rheumatic disease patients, comorbidities predicted severe COVID-19 and hospitalization. Ongoing disease activity, lupus, and SSc predicted mortality, highlighting key risk factors for adverse coronavirus disease 2019 outcomes.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Public Health

Background:

  • Limited data exists on coronavirus disease 2019 (COVID-19) outcomes in rheumatic and musculoskeletal disease (RMD) patients from Southeast Asia.
  • Understanding COVID-19's impact on RMD patients in India is crucial for clinical management and public health strategies.
  • This study addresses the gap by examining clinicodemographic profiles and predictors of COVID-19 outcomes in Indian RMD patients.

Purpose of the Study:

  • To determine the clinicodemographic profile of RMD patients with COVID-19 in India.
  • To identify independent predictors of severe COVID-19, hospitalization, and mortality in this cohort.
  • To assess the influence of comorbidities, disease activity, and specific RMD diagnoses on COVID-19 outcomes.

Main Methods:

  • Prospective cohort study conducted at a tertiary care center in India from April 2020 to October 2021.
  • Included 64 RMD patients diagnosed with COVID-19.
  • Demographic, clinical, laboratory, and RMD data were collected. Multivariable logistic regression was used to identify predictors of outcomes.

Main Results:

  • 18% of RMD patients experienced severe COVID-19, and 36% required hospitalization.
  • Comorbidities were independent predictors of COVID-19 severity (OR=4.5) and hospitalization (OR=10.7).
  • Ongoing rheumatic disease activity (OR=6.8), lupus (OR=7.1), and systemic sclerosis (SSc) (OR=9.5) independently predicted mortality.

Conclusions:

  • Comorbidities significantly increase the risk of severe COVID-19 and hospitalization in Indian RMD patients.
  • Active rheumatic disease, lupus, and SSc are critical predictors of mortality in this population.
  • Age, sex, immunosuppressive therapy, and RMD-associated interstitial lung disease did not significantly impact COVID-19 outcomes.
Abstract

Keywords:
COVID-19co-morbiditiesdisease activityhospitalizationmortalityrheumatic disease

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