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. 2022 Dec;81(12):1742-1749.
doi: 10.1136/ard-2022-222954. Epub 2022 Aug 9.

Temporal trends in COVID-19 outcomes among patients with systemic autoimmune rheumatic diseases: from the first wave through the initial Omicron wave

Yumeko Kawano  1   2 , Naomi J Patel  2   3 , Xiaosong Wang  1 , Claire E Cook  3 , Kathleen Mm Vanni  1 , Emily N Kowalski  1 , Emily P Banasiak  1 , Grace Qian  1 , Michael DiIorio  1   4 , Tiffany Y-T Hsu  1   2 , Michael E Weinblatt  1   2 , Derrick J Todd  1   2 , Zachary S Wallace #  2   3 , Jeffrey A Sparks #  5   2
Affiliations

Temporal trends in COVID-19 outcomes among patients with systemic autoimmune rheumatic diseases: from the first wave through the initial Omicron wave

Yumeko Kawano et al. Ann Rheum Dis. 2022 Dec.

Abstract

Objectives: To investigate temporal trends in incidence and severity of COVID-19 among patients with systemic autoimmune rheumatic diseases (SARDs) from the first wave through the initial Omicron wave.

Methods: We conducted a retrospective cohort study investigating COVID-19 outcomes among patientswith SARD systematically identified to have confirmed COVID-19 from 1 March 2020 to 31 January 2022 at Mass General Brigham. We tabulated COVID-19 counts of total and severe cases (hospitalisations or deaths) and compared the proportion with severe COVID-19 by calendar period and by vaccination status. We used logistic regression to estimate the ORs for severe COVID-19 for each period compared with the early COVID-19 period (reference group).

Results: We identified 1449 patients with SARD with COVID-19 (mean age 58.4 years, 75.2% female, 33.9% rheumatoid arthritis). There were 399 (28%) cases of severe COVID-19. The proportion of severe COVID-19 outcomes declined over calendar time (p for trend <0.001); 46% of cases were severe in the early COVID-19 period (1 March 2020-30 June 2020) vs 15% in the initial Omicron wave (17 December 2021-31 January 2022; adjusted OR 0.29, 95% CI 0.19 to 0.43). A higher proportion of those unvaccinated were severe compared with not severe cases (78% vs 60%).

Conclusions: The proportion of patients with SARD with severe COVID-19 has diminished since early in the pandemic, particularly during the most recent time periods, including the initial Omicron wave. Advances in prevention, diagnosis and treatment of COVID-19 may have improved outcomes among patients with SARD.

Keywords: Autoimmune Diseases; Covid-19; Vaccination.

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Conflict of interest statement

Competing interests: NJP reports consulting fees from FVC Health unrelated to this work. MEW reports research support from Bristol Meyers Squibb, Sanofi, Eli Lilly, Amgen, and consulting fees from Abbvie, Aclaris, Amgen Bristol Myers Squibb, Corevitas, EQRx, Genosco, GlaxoSmithKline, Gilead, Horizon, Johnson & Johnson, Eli Lilly, Pfizer, Roche, Sanofi, Scipher, Set Point, and Tremeau, and stock options in Can-Fite, Inmediz, and Scipher unrelated to this work. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Viela Bio, Zenas BioPharma, and MedPace. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum and Pfizer unrelated to this work. All other authors report no competing interests.

Figures

Figure 1
Figure 1
Total and severe COVID-19 case counts over time. Case counts of SARS-CoV-2 infections over calendar time with total infections shown in blue and infections with severe outcomes in red.
Figure 2
Figure 2
Proportion of cases with severe and non-severe COVID-19 in each time period. P value is for the trend across categories.
Figure 3
Figure 3
Vaccination status stratified by severe or not severe COVID-19. J&J, Johnson & Johnson-Janssen.
See this image and copyright information in PMC

Update of

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