Volume 111, Issue 5 p. 1061-1065
Brief Report

Identification of Risk Factors for COVID-19 Hospitalization in Patients With Anti-Rheumatic Drugs: Results From a Multicenter Nested Case Control Study

Merel A. A. Opdam

Corresponding Author

Merel A. A. Opdam

Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands

Correspondence: Merel A. A. Opdam ([email protected])

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Sophie Benoy

Sophie Benoy

Regional Rheumatology Centre, Máxima Medical Centre, Eindhoven, The Netherlands

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Lise M. Verhoef

Lise M. Verhoef

Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands

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Sandra Van Bijnen

Sandra Van Bijnen

Department of Rheumatology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands

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Femke Lamers-Karnebeek

Femke Lamers-Karnebeek

Department of Rheumatology, Bernhoven, Uden, The Netherlands

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René A. M. Traksel

René A. M. Traksel

Regional Rheumatology Centre, Máxima Medical Centre, Eindhoven, The Netherlands

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Petra Vos

Petra Vos

Department of Rheumatology, Amphia Hospital, Breda, The Netherlands

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Alfons A. den Broeder

Alfons A. den Broeder

Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands

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Jasper Broen

Jasper Broen

Regional Rheumatology Centre, Máxima Medical Centre, Eindhoven, The Netherlands

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First published: 10 February 2022
Citations: 2

Abstract

Patients with inflammatory rheumatic diseases (IRDs) do not have an increased risk for coronavirus disease 2019 (COVID-19) compared with the general population. However, it remains uncertain whether subgroups of patients with IRD using different immunosuppressive antirheumatic drugs carry a higher risk for severe COVID-19 compared with other patients with IRD. The aim of this study is to identify risk factors for severe COVID-19, requiring hospitalization in patients with IRD. This is a multicenter nested case control study conducted in the Netherlands. Cases are hospital known patients with IRD requiring hospitalization for COVID-19 between March 1, 2020, and May 31, 2020. Controls are hospital known patients with IRD not requiring hospitalization for COVID-19 in this period, included at a 4:1 ratio. Patient, disease, and treatment characteristics were extracted from electronic medical records and a questionnaire. Potential risk factors were analyzed using unconditional logistic regression, corrected for confounders and multiple testing. Eighty-one cases and 396 controls were included. General risk factors of older age and obesity apply to patients with IRD as well (odds ratio (OR) for age ≥ 75 3.5, 95% confidence interval (CI) 1.9–6.3, OR for body mass index ≥ 40 4.5, 95% CI 1.5–14). No significantly increased ORs for COVID-19 hospitalization were found for any antirheumatic agent or IRD. A protective effect was found for use of methotrexate (OR 0.53, 95% CI 0.31–0.92). In conclusion, similar to the general population, elderly and obese patients with IRD have a higher risk for hospitalization for COVID-19. We did not identify a specific antirheumatic agent or IRD to increase the risk of COVID-19 hospitalization in patients with IRD, except for a possible protective effect of methotrexate.

CONFLICTS OF INTEREST

M.O. reports received grants (to the institution) from Gilead Sciences. A.d.B. has received consultancy honoraria, congress invitations, and research grants (to the institution) from Abbvie, Amgen, Cellgene, Roche, Biogen, Lilly, Novartis, Celltrion Sanofi, and Gilead. Is coinventor on a rituximab related patent (pending). J.B. has received consultancy fees from Novartis, UCB, Gilead, and Galapagos. All other authors declared no competing interests for this work.

DATA AVAILABILITY STATEMENT

De-identified data obtained, used, and/or analyzed during the current study are available from the corresponding author upon reasonable request.