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

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Title: Autoimmune disease and COVID-19- a multicentre observational study in the United Kingdom
Authors: Jayakody Arachchillage, D
Rajakaruna, I
Pericleous, C
Nicolson, PLR
Makris, M
Laffan, M
The CA-COVID-19 Study Group
Item Type: Journal Article
Abstract: Objective To establish the demographic characteristics, laboratory findings and clinical outcomes in patients with autoimmune disease (AD) in comparison to 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 pre-designed standardised case record form. Adult patients (≥18 years) admitted between 1st of 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 systemic lupus erythematosus, rheumatoid arthritis or antiphospholipid 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, raised 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 raised 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 raised LDH were more frequent in patients with any AD whilst raised 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.
Issue Date: 1-Dec-2022
Date of Acceptance: 26-Mar-2022
URI: http://hdl.handle.net/10044/1/96178
DOI: 10.1093/rheumatology/keac209
ISSN: 1462-0324
Publisher: British Society for Rheumatology
Start Page: 4643
End Page: 4655
Journal / Book Title: Rheumatology
Volume: 61
Issue: 12
Copyright Statement: © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: Medical Research Council (MRC)
Versus Arthritis
Wellcome Trust
Funder's Grant Number: MR/V037633/1
Keywords: Science & Technology
Life Sciences & Biomedicine
autoimmune rheumatologic disease
autoimmune rheumatologic disease
CA-COVID-19 study group
Arthritis & Rheumatology
1103 Clinical Sciences
1107 Immunology
1117 Public Health and Health Services
Publication Status: Published
Online Publication Date: 2022-04-04
Appears in Collections:Department of Immunology and Inflammation
National Heart and Lung Institute
Faculty of Medicine
Imperial College London COVID-19

This item is licensed under a Creative Commons License Creative Commons