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Patients with Rheumatic Disease Are at High Risk of COVID-19 Complications

In This Article

  • Kristin D'Silva, MD, rheumatology fellow at Massachusetts General Hospital, presented at the American College of Rheumatology Convergence 2020 on COVID-19 complications for patients with rheumatic disease
  • Dr. D'Silva and colleagues conducted a cohort study that showed that patients with systemic autoimmune rheumatic disease who contracted COVID-19 demonstrated higher rates of comorbidities than those without
  • These patients also had a higher risk for hospitalization, intensive care unit admission, mechanical ventilation, acute kidney injury and congestive heart failure (RR = 3.06)

According to researchers at Massachusetts General Hospital, patients with systemic autoimmune rheumatic diseases who contract COVID-19 may have a higher risk for end-organ failure than those without such diseases.

In a matched cohort study of patients with COVID-19, Kristin D'Silva, MD, former fellow in the Division of Rheumatology, Allergy and Immunology at Massachusetts General Hospital, and colleagues found that patients with systemic autoimmune rheumatic disease demonstrated higher rates of comorbidities—including hypertension, asthma, chronic kidney disease and heart failure—compared with those without.

Dr. D'Silva presented the study findings at the American College of Rheumatology Convergence 2020. In Healio, she said that patients with rheumatic diseases have concerns about COVID-19 outcomes due to underlying immunosuppression, a chronic inflammatory state and other factors.

The researchers assessed 716 patients with COVID-19 and systemic autoimmune rheumatic diseases, and 716 matched comparators without. After recording outcomes between two weeks and three months following COVID-19 infection, they calculated the risk difference and risk ratio for the association between systemic autoimmune rheumatic disease with each outcome.

In addition to higher rates of comorbidities, patients with systemic autoimmune rheumatic diseases were at higher risk for hospitalization, intensive care unit admission, mechanical ventilation, acute kidney injury and congestive heart failure.

Dr. D'Silva said that rheumatic disease may contribute to the risk for venous thromboembolism even beyond the mediating effects of comorbidities, emphasizing the importance of close monitoring of these patients for venous thromboembolism during COVID-19 infection.

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