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Observational Study
. 2022 Nov 28;61(12):4643-4655.
doi: 10.1093/rheumatology/keac209.

Autoimmune disease and COVID-19: a multicentre observational study in the United Kingdom

Deepa J Arachchillage  1   2 , Indika Rajakaruna  3 , Charis Pericleous  4 , Philip L R Nicolson  5 , Mike Makris  6 , Mike Laffan  1   2 ; CA-COVID-19 Study Group
Collaborators, Affiliations
Observational Study

Autoimmune disease and COVID-19: a multicentre observational study in the United Kingdom

Deepa J Arachchillage et al. Rheumatology (Oxford). .

Abstract

Objective: To establish the demographic characteristics, laboratory findings and clinical outcomes in patients with autoimmune disease (AD) compared with a propensity-matched cohort of patients without AD admitted with COVID-19 to hospitals in the UK.

Methods: This is a multicentre observational study across 26 NHS Trusts. Data were collected both retrospectively and prospectively using a predesigned standardized case record form. Adult patients (≥18 years) admitted between 1 April 2020 and 31 July 2020 were included.

Results: Overall, 6288 patients were included to the study. Of these, 394 patients had AD prior to admission with COVID-19. Of 394 patients, 80 patients with SLE, RA or aPL syndrome were classified as severe rheumatologic AD. A higher proportion of those with AD had anaemia [240 (60.91%) vs 206 (52.28%), P = 0.015], elevated LDH [150 (38.08%) vs 43 (10.92%), P < 0.001] and raised creatinine [122 (30.96%) vs 86 (21.83%), P = 0.01], respectively. A significantly higher proportion of patients with severe rheumatologic AD had elevated CRP [77 (96.25%) vs 70 (87.5%), P = 0.044] and LDH [20 (25%) vs 6 (7.5%), P = 0.021]. Patients with severe rheumatologic AD had significantly higher mortality [32/80 (40%)] compared with propensity matched cohort of patients without AD [20/80 (25%), P = 0.043]. However, there was no difference in 180-day mortality between propensity-matched cohorts of patients with or without AD in general (P = 0.47).

Conclusions: Patients with severe rheumatologic AD had significantly higher mortality. Anaemia, renal impairment and elevated LDH were more frequent in patients with any AD while elevated CRP and LDH were more frequent in patients with severe rheumatologic AD both of which have been shown to associate with increased mortality in patients with COVID-19.

Keywords: APS; COVID-19; RA; SLE; autoimmune rheumatologic disease; bleeding; mortality; thrombosis.

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Figures

<sc>Fig</sc>. 1
Fig. 1
Inclusion of patients into the study and analysis plan
<sc>Fig</sc>. 2
Fig. 2
Probability of 180 day survival in patients with and without AD (A) Probability of 180 day survival in patients with AD vs no AD admitted with COVID-19. (B) Probability of 180 day survival in patients classified as severe AD vs no AD admitted with COVID-19.
See this image and copyright information in PMC

References

    1. Akiyama S, Hamdeh S, Micic D. et al. Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis. Ann Rheum Dis 2020;80:384–91. - PubMed
    1. Spihlman AP, Gadi N, Wu SC. et al. COVID-19 and systemic lupus erythematosus: focus on immune response and therapeutics. Front Immunol 2020;11:589474. - PMC - PubMed
    1. Raiker R, Pakhchanian H, DeYoung C. et al. Short term outcomes of COVID-19 in lupus: propensity score matched analysis from a nationwide multi-centric research network. J Autoimmun 2021;125:102730. - PMC - PubMed
    1. Taha M, Samavati L.. Antiphospholipid antibodies in COVID-19: a meta-analysis and systematic review. RMD Open 2021;7:e001580. - PMC - PubMed
    1. Uthman IW, Gharavi AE.. Viral infections and antiphospholipid antibodies. Semin Arthritis Rheum 2002;31:256–63. - PubMed

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