COVID-19 OUTCOMES in PATIENTS with DERMATOMYOSITIS: A REGISTRY-BASED COHORT ANALYSIS
Annals of the Rheumatic Diseases
; 81:332, 2022.
Article
in English
| EMBASE | ID: covidwho-2009139
ABSTRACT
Background:
Dermatomyositis (DM) patients have fewer risks of COVID-19 infection compared to the general population, however, certain subgroups with DM have worse outcomes. Men. African Americans, those with interstitial lung disease, exhibited higher risks of severe COVID-19. DMARD and glucocorticoid use was associated with frequent hospitalisations and severe sepsis.Objectives:
Rheumatic diseases (RDs) like DM, are previously known to be vulnerable towards various types of infections due to its aggressive activity mandating high dose immunosuppressive therapy. The severity of COVID-19 in RDs is limited in literature due to the heterogeneous nature of the condition. Therefore, specifc details on mortality is essential to navigate any precautions required in the treatment.Methods:
Retrospective data of individuals with DM and COVID-19 and the general population with COVID-19 between January 2020 to August 2020 was retrieved from the TriNetX database. A one-to-one matched COVID-19 positive control was selected using propensity score (PS) matching. We assessed COVID-19 outcomes such as mortality, hospitalisation, ICU admission, severe COVID-19, mechanical ventilation (MV), acute kidney injury (AKI), venous thromboembo-lism (VTE), ischemic stroke, acute respiratory distress syndrome (ARDS), renal replacement therapy (RRT) and sepsis. Subgroup analyses included gender, race, ILD, cancer patients, disease-modifying rheumatic drugs (DMARDs) use, and glucocorticoids (GC) use (Figure 1).Results:
We identifed 5,574 DM patients with COVID-19, and 5,574 general population with COVID-19 (controls). DM with COVID-19 had a lower risk of mortality in comparison to controls [RR 0.76], hospitalisation [RR 0.8], severe COVID-19 [RR 0.76], AKI [RR 0.83], and sepsis [RR 0.73]. Males and African Americans were more likely to develop AKI [RR 1.35, 1.65], while African Americans had higher odds for severe COVID-19 [RR 1.62] and VTE [RR 1.54]. DM with ILD group also experienced higher odds for severe COVID-19 infection [RR 1.64], and VTE [RR 2.06] (Figure 1). DM patients receiving DMARDs and glucocorticoids had higher odds for hospitalisation [RR 1.46, 2.12], and sepsis [RR 3.25] Subgroup analysis of neoplasms amongst DM patients with COVID-19 was inadequate for meaningful comparison (Figure 1).Conclusion:
DM patients are protected for certain aspects of COVID-19 disease, including severe COVID-19, hospitalization, and mortality. The African American race, male gender, ILD, DMARDS and glucocorticoid users, are associated with poor outcomes.
disease modifying antirheumatic drug; glucocorticoid; acute kidney failure; adult; adult respiratory distress syndrome; African American; artificial ventilation; cancer patient; clinical assessment; cohort analysis; conference abstract; controlled study; coronavirus disease 2019; dermatomyositis; drug combination; drug megadose; drug therapy; female; gender; hospitalization; human; immunosuppressive treatment; ischemic stroke; major clinical study; male; mortality; mortality risk; neoplasm; outcome assessment; propensity score; race; renal replacement therapy; retrospective study; rheumatic disease; sepsis
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Language:
English
Journal:
Annals of the Rheumatic Diseases
Year:
2022
Document Type:
Article
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