Outcomes of coronavirus disease 19 patients with a history of rheumatoid arthritis: A retrospective registry-based study in Iran

Abstract

Background: We aimed to study the outcomes of coronavirus disease 2019 (COVID-19) in patients with a history of rheumatoid arthritis (RA) in Iran, where most patients receive corticosteroids and are at high risk for COVID-19 infection.

Method: We collected the demographic, diagnostic, and treatment data of all COVID-19 patients by the clinical COVID-19 registry system. We recruited 38 RA patients and 2216 non-RA patients from the COVID-19 registry. The primary outcome was mortality due to COVID-19. We also studied the risk of intensive care unit admission and intubation in RA patients compared to non-RA patients. We used multiple logistic regression analysis to study the association between RA and the risk of COVID-19 outcomes.

Result: We recruited 38 RA patients and 2216 non-RA patients from the COVID-19 registry. The RA patients had a higher mean age (59.9 years) than the non-RA patients (57.7 years). The group of RA patients had a larger proportion of women (76.3%) than the non-RA patients (40.8%). The death rate due to COVID-19 was significantly higher in RA patients than non-RA patients (odds ratio [OR] = 2.69, 95% confidence interval [CI] = 1.24-5.81). The OR was higher among those who received prednisolone than among those who did not (OR = 3.59, 95% CI = 1.54-7.81). The odds of intubation were statistically significant among patients who received corticosteroid therapy (OR = 2.58, 95% CI = 1.07-6.18).

Conclusion: The risk of COVID-19 outcomes was higher in RA patients than non-RA patients, especially for RA patients who received a low dose of prednisolone. The results of this study can be used to triage RA patients who get infected by COVID-19. Further studies with larger sample sizes are required to more precisely define the high-risk groups.

Keywords: COVID-19; outcome; pandemic; rheumatoid arthritis.