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Meta-Analysis
. 2021 May;41(5):851-861.
doi: 10.1007/s00296-021-04803-9. Epub 2021 Mar 9.

Risk and clinical outcomes of COVID-19 in patients with rheumatic diseases compared with the general population: a systematic review and meta-analysis

Qingxiu Wang  1 , Jianbo Liu  2 , Runxia Shao  1 , Xiaopeng Han  1 , Chenhao Su  3 , Wenjia Lu  1
Affiliations
Meta-Analysis

Risk and clinical outcomes of COVID-19 in patients with rheumatic diseases compared with the general population: a systematic review and meta-analysis

Qingxiu Wang et al. Rheumatol Int. 2021 May.

Abstract

Patients with rheumatic diseases are often more susceptible to different bacteria and viruses because of immune impairment, but it is not clear whether there is a higher risk of infection and a more serious course of disease for novel coronavirus (SARS-CoV-2). We performed this systematic review and meta analysis to assess the risk and clinical outcomes of COVID-19 in patients with rheumatic diseases compared with the general population. We searched PubMed, EMBASE, Scopus and Web of Science databases from January 1, 2020 to October 20, 2020 to determine epidemiological information related to patients with rheumatic diseases and COVID-19, including clear risk estimate or data that could be converted and extracted. We included 26 observational studies, totaling about 2000 patients with rheumatic diseases of whom were infected with COVID-19. Meta-analysis showed that the risk of COVID-19 infection in rheumatic patients was significantly higher than that in the general population (OR = 1.53, 95% CI 1.24-1.88, P = 0.000). In terms of hospitalization and severe clinical outcomes associated with COVID-19, we found that rheumatic patients showed similar results to the reference population (hospitalization OR = 1.36, 95% CI 0.81-2.29, P = 0.247; admitted to ICU OR = 1.94, 95% CI 0.88-4.27, P = 0.098; death OR = 1.29, 95% CI 0.84-1.97, P = 0.248). The presence of comorbidities, hypertension, lung diseases were significantly associated with the increased risk of COVID-19-related hospitalization in rheumatic patients and anti-TNF drugs were associated with lower hospitalization risk. Older age was related to severe COVID-19. Our meta-analysis indicated that rheumatic patients were at a higher risk of COVID-19 infection but might not lead to a more serious disease process.

Keywords: COVID-19; Meta analysis; Rheumatic diseases; Risk; Systematic review.

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Conflict of interest statement

Authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of literature search and screening
Fig. 2
Fig. 2
Forest plot of the risk of COVID-19 infection in rheumatic patients
Fig. 3
Fig. 3
Forest plot of the COVID-19-related hospitalization risk in rheumatic patients
Fig. 4
Fig. 4
Forest plot of ICU admission risk related to COVID-19 in patients with rheumatic diseases
Fig. 5
Fig. 5
Forest plot of the risk of death from COVID-19 in rheumatic patients
See this image and copyright information in PMC

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References

    1. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet (London, England) 2020;395(10223):470–473. doi: 10.1016/S0140-6736(20)30185-9. - DOI - PMC - PubMed
    1. Sun J, Chen X, Zhang Z, et al. Forecasting the long-term trend of COVID-19 epidemic using a dynamic model. Sci Rep. 2020;10(1):21122. doi: 10.1038/s41598-020-78084-w. - DOI - PMC - PubMed
    1. Goyal R, Bulua AC, Nikolov NP, Schwartzberg PL, Siegel RM. Rheumatologic and autoimmune manifestations of primary immunodeficiency disorders. Curr Opin Rheumatol. 2009;21(1):78–84. doi: 10.1097/BOR.0b013e32831cb939. - DOI - PMC - PubMed
    1. D'Antiga L. Coronaviruses and immunosuppressed patients: the facts during the third epidemic. Liver Transplant. 2020;26(6):832–834. doi: 10.1002/lt.25756. - DOI - PubMed
    1. Au K, Reed G, Curtis JR, et al. High disease activity is associated with an increased risk of infection in patients with rheumatoid arthritis. Ann Rheum Dis. 2011;70(5):785–791. doi: 10.1136/ard.2010.128637. - DOI - PubMed