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. 2022 Nov;40(11):2038-2043.
doi: 10.55563/clinexprheumatol/fmyozh. Epub 2022 Mar 8.

Increased COVID-19 mortality in patients with rheumatic diseases: results from the CONTROL-19 study by the Italian Society for Rheumatology

Anna Zanetti  1 , Greta Carrara  2 , Gianpiero Landolfi  2 , Davide Rozza  2 , Cecilia Beatrice Chighizola  3 , Alessia Alunno  4 , Laura Andreoli  5 , Roberto Caporali  6 , Roberto Gerli  4 , Gian Domenico Sebastiani  7 , Guido Valesini  8 , Luigi Sinigaglia  9 , Bernd Raffeiner  10 , Claudia Lomater  11 , Marta Caprioli  12 , Micaela Fredi  5 , Nicoletta Romeo  13 , Giovanna Cuomo  14 , Marta Vadacca  15 , Carlo Alberto Scirè  16 ; CONTROL-19 study by the Italian Society for Rheumatology
Collaborators, Affiliations
Free article

Increased COVID-19 mortality in patients with rheumatic diseases: results from the CONTROL-19 study by the Italian Society for Rheumatology

Anna Zanetti et al. Clin Exp Rheumatol. 2022 Nov.
Free article

Abstract

Objectives: To investigate differences in coronavirus disease 2019 (COVID-19) mortality between patients with rheumatic musculoskeletal diseases (RMD) and the general population in Italy.

Methods: We analysed the data from the national surveillance study promoted by the Italian Society for Rheumatology (CONTROL-19 database) including patients with RMD and COVID-19 between 26 March 2020 and 29 November 2020, compared with official data from the Italian population (within the same period) adjusted for age, sex and geographic location. The main outcome of the analyses was mortality. The relationship between RMD and mortality was analysed using adjusted logistic models and sensitivity analyses were conducted to support the robustness of our results.

Results: We included 668 RMD patients (62.7% with inflammatory arthritis, 28.6% with systemic autoimmune diseases), who had a mean age of 58.4 years and of which 66% were female. Compared to the general population, the RMD population showed an increased risk of death (OR 3.10 (95% CI 2.29-4.12)), independently from the differences in age and sex distribution. Even after considering the potential influence of surveillance bias, the OR was 2.08 (95% CI: 1.55-2.73). Such excess of risk was more evident in the subgroup of younger patients, and more consistent in women. Subjects with systemic autoimmune diseases showed a higher risk of death than patients with any other RMDs.

Conclusions: Patients with RMD and COVID-19 infection evidenced a significant increase in mortality during the first pandemic phases in Italy. These findings support the need for strong SARS-CoV-2 prevention in patients with rheumatic diseases.

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