Risk factors for severe outcomes in patients with systemic vasculitis & COVID-19: a bi-national registry-based cohort study

Rutherford, M. A. et al. (2021) Risk factors for severe outcomes in patients with systemic vasculitis & COVID-19: a bi-national registry-based cohort study. Arthritis and Rheumatology, 73(9), pp. 1713-1719. (doi: 10.1002/art.41728) (PMID:33750043) (PMCID:PMC8251299)

[img] Text
234250.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

258kB

Abstract

Objective: COVID‐19 is a novel infectious disease with a broad spectrum of clinical severity. Patients with systemic vasculitis have an increased risk of serious infections and so may be at risk of severe outcomes following COVID‐19. It is important to establish the risk factors for severe COVID‐19 outcomes in these patients, including the impact of immunosuppressive therapies. Methods: A multi‐centre cohort was developed through the participation of centres affiliated with national UK and Ireland vasculitis registries. Clinical characteristics and outcomes were described. Logistic regression was used to evaluate associations between potential risk factors and severe COVID‐19 outcome, defined as a requirement for advanced oxygen therapy, invasive ventilation, or death. Results: Sixty‐five cases of patients with systemic vasculitis who developed COVID‐19 were reported (median age 70 years, 49% female) of whom 25 (38%) experienced a severe outcome. Most cases (55/65, 85%) had ANCA‐associated vasculitis (AAV). Almost all patients required hospitalization (59/65, 91%), 7 patients (11%) were admitted to intensive care and 18 patients (28%) died. Background glucocorticoid therapy was associated with severe outcome (adjusted odds ratio [aOR] 3.7 (1.1‐14.9, p=0.047)) as was comorbid respiratory disease (aOR 7.5 (1.9‐38.2, p=0.006)). Vasculitis disease activity and non‐glucocorticoid immunosuppression were not associated with severe outcome. Conclusion: In patients with systemic vasculitis, glucocorticoid use at presentation and comorbid respiratory disease were associated with severe outcomes in COVID‐19. These data can inform clinical decision making relating to risk of severe COVID‐19 in this vulnerable patient group.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Rutherford, Dr Matthew and Gopaluni, Dr Seerapani and Basu, Professor Neil and Geddes, Dr Colin
Authors: Rutherford, M. A., Scott, J., Karabayas, M., Antonelou, M., Gopaluni, S., Gray, D., Barrett, J., Brix, S. R., Dhaun, N., McAdoo, S. P., Smith, R., Geddes, C., Jayne, D., Luqmani, R., Salama, A. D., Little, M., and Basu, N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Arthritis and Rheumatology
Publisher:Wiley
ISSN:2326-5191
ISSN (Online):2326-5205
Published Online:22 March 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Arthritis and Rheumatology 73(9): 1713-1719
Publisher Policy:Reproduced under a Creative Commons licence

University Staff: Request a correction | Enlighten Editors: Update this record