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COVID-19 Infection and Clinical Outcomes in Hospitalized Patients With Rheumatoid Arthritis: Insights From the
Monique G Davis1, Anum Akhlaq2, Sameen Aamer3
1Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Journal of Community Hospital Internal Medicine Perspectives
|March 14, 2024
Summary
Patients with rheumatoid arthritis (RA) face higher in-hospital mortality from COVID-19. This study highlights increased risks for RA patients, emphasizing the need for targeted research and improved care strategies for this vulnerable group.
Area of Science:
- Infectious Diseases
- Rheumatology
- Critical Care Medicine
Background:
- Coronavirus-19 (COVID-19) primarily affects the respiratory system but can impact multiple organs and exacerbate autoimmune conditions.
- Patients with autoimmune diseases, particularly rheumatoid arthritis (RA), are at increased risk for severe COVID-19 infection and complications.
- Limited large-scale studies exist on COVID-19 outcomes specifically within the rheumatoid arthritis patient population.
Purpose of the Study:
- To compare in-hospital mortality and other critical outcomes between COVID-19 patients with and without rheumatoid arthritis.
- To evaluate the impact of rheumatoid arthritis on the severity and complications of COVID-19 hospitalization.
- To identify specific risk factors and outcomes for rheumatoid arthritis patients diagnosed with COVID-19.
Main Methods:
- A retrospective analysis of the National Inpatient Sample database from January 1 to December 31, 2020.
- Inclusion of 1,050,040 adult hospitalizations: 21,545 with COVID-19 and RA, and 1,028,495 with COVID-19 but without RA.
- Primary outcome: in-hospital mortality. Secondary outcomes included mechanical ventilation, vasopressor use, cardiac arrest, cardiogenic shock, acute kidney injury, and length of stay.
Main Results:
- COVID-19 patients with RA exhibited significantly higher in-hospital mortality (12.9%) compared to those without RA (11.1%) (aOR: 1.2; p < 0.001).
- The RA cohort experienced significantly increased rates of mechanical ventilation, vasopressor use, and cardiogenic shock.
- Secondary analysis indicated a correlation between age and in-hospital mortality and mechanical ventilation rates in COVID-19 patients.
Conclusions:
- Rheumatoid arthritis is associated with significantly worse outcomes, including increased mortality, among hospitalized COVID-19 patients.
- The findings underscore the vulnerability of RA patients to severe COVID-19 complications.
- Further large-scale research is crucial to develop targeted strategies for improving outcomes in this high-risk patient subset.
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