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Characteristics associated with poor COVID-19 outcomes in people with psoriasis, psoriatic arthritis and axial spondyloarthritis: data from the COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries.
Machado, Pedro M; Schäfer, Martin; Mahil, Satveer K; Liew, Jean; Gossec, Laure; Dand, Nick; Pfeil, Alexander; Strangfeld, Anja; Regierer, Anne Constanze; Fautrel, Bruno; Alonso, Carla Gimena; Saad, Carla G S; Griffiths, Christopher E M; Lomater, Claudia; Miceli-Richard, Corinne; Wendling, Daniel; Alpizar Rodriguez, Deshire; Wiek, Dieter; Mateus, Elsa F; Sirotich, Emily; Soriano, Enrique R; Ribeiro, Francinne Machado; Omura, Felipe; Rajão Martins, Frederico; Santos, Helena; Dau, Jonathan; Barker, Jonathan N; Hausmann, Jonathan; Hyrich, Kimme L; Gensler, Lianne; Silva, Ligia; Jacobsohn, Lindsay; Carmona, Loreto; Pinheiro, Marcelo M; Zelaya, Marcos David; Severina, María de Los Ángeles; Yates, Mark; Dubreuil, Maureen; Gore-Massy, Monique; Romeo, Nicoletta; Haroon, Nigil; Sufka, Paul; Grainger, Rebecca; Hasseli, Rebecca; Lawson-Tovey, Saskia; Bhana, Suleman; Pham, Thao; Olofsson, Tor; Bautista-Molano, Wilson; Wallace, Zachary S.
  • Machado PM; Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK p.machado@ucl.ac.uk.
  • Schäfer M; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
  • Mahil SK; Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK.
  • Liew J; Epidemiology and Health Services Research, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany.
  • Gossec L; St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.
  • Dand N; Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
  • Pfeil A; INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universite, Paris, France.
  • Strangfeld A; AP-HP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France.
  • Regierer AC; Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
  • Fautrel B; Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University, Jena, Germany.
  • Alonso CG; Epidemiology and Health Services Research, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany.
  • Saad CGS; Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany.
  • Griffiths CEM; Epidemiology and Health Services Research, German Rheumatism Research Center Berlin, Berlin, Germany.
  • Lomater C; Rheumatology, Pitié-Salpêtrière hospital, AP - HP, Paris, France.
  • Miceli-Richard C; Hospital Italiano de Córdoba, Córdoba, Argentina.
  • Wendling D; Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
  • Alpizar Rodriguez D; Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
  • Wiek D; National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
  • Mateus EF; Academic Rheumatology Centre, Università degli Studi di Torino, Torino, Italy.
  • Sirotich E; Assistance Publique, Hôpital Cochin, Hôpitaux de Paris & Université de Paris, Paris, France.
  • Soriano ER; Unité Mixte AP-HP/ Institut Pasteur, Institut Pasteur, Paris, France.
  • Ribeiro FM; Rheumatology, Franche-Comté University and University Teaching Hospital (CHRU), Besançon, France.
  • Omura F; Research Unit, Colegio Mexicano de Reumatologia, Mexico City, Mexico.
  • Rajão Martins F; People with Arthritis and Rheumatism (PARE), EULAR, Zurich, Switzerland.
  • Santos H; Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal.
  • Dau J; European Alliance of Associations for Rheumatology (EULAR), Kilchberg, Switzerland.
  • Barker JN; Yale School of Medicine, Yale University, New Haven, Connecticut, USA.
  • Hausmann J; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
  • Hyrich KL; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada.
  • Gensler L; Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Silva L; Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Jacobsohn L; Rheumatology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
  • Carmona L; Clínica Omura Medicina Diagnóstica, São Paulo, Brazil.
  • Pinheiro MM; Rheumatology, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
  • Zelaya MD; Instituto Português de Reumatologia, Lisbon, Portugal.
  • Severina MLÁ; EpiDoC Unit, CEDOC, Nova Medical School, Lisbon, Portugal.
  • Yates M; University of Colorado School of Medicine, Denver, Colorado, USA.
  • Dubreuil M; St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
  • Gore-Massy M; Program in Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Romeo N; Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Haroon N; National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
  • Sufka P; Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
  • Grainger R; University of California, San Francisco, California, USA.
  • Hasseli R; Rheumatology, Centro Hospitalar de Trás-os-montes e Alto Douro (CHTMAD), Vila Real, Portugal.
  • Lawson-Tovey S; Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA.
  • Bhana S; Instituto de Salud Musculoesquelética (INMUSC), Madrid, Spain.
  • Pham T; Rheumatology, Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
  • Olofsson T; Hospital de Agudos Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina.
  • Bautista-Molano W; Centro Privado de Medicina Nuclear and Clinica Villa Dalcar, Córdoba, Argentina.
  • Wallace ZS; Clinica Villa Dalcar, Río Cuarto, Córdoba, Argentina.
Ann Rheum Dis ; 82(5): 698-709, 2023 05.
Article in English | MEDLINE | ID: covidwho-2311299
ABSTRACT

OBJECTIVES:

To investigate factors associated with severe COVID-19 in people with psoriasis (PsO), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).

METHODS:

Demographic data, clinical characteristics and COVID-19 outcome severity of adults with PsO, PsA and axSpA were obtained from two international physician-reported registries. A three-point ordinal COVID-19 severity scale was defined no hospitalisation, hospitalisation (and no death) and death. ORs were estimated using multivariable ordinal logistic regression.

RESULTS:

Of 5045 cases, 18.3% had PsO, 45.5% PsA and 36.3% axSpA. Most (83.6%) were not hospitalised, 14.6% were hospitalised and 1.8% died. Older age was non-linearly associated with COVID-19 severity. Male sex (OR 1.54, 95% CI 1.30 to 1.83), cardiovascular, respiratory, renal, metabolic and cancer comorbidities (ORs 1.25-2.89), moderate/high disease activity and/or glucocorticoid use (ORs 1.39-2.23, vs remission/low disease activity and no glucocorticoids) were associated with increased odds of severe COVID-19. Later pandemic time periods (ORs 0.42-0.52, vs until 15 June 2020), PsO (OR 0.49, 95% CI 0.37 to 0.65, vs PsA) and baseline exposure to TNFi, IL17i and IL-23i/IL-12+23i (OR 0.57, 95% CI 0.44 to 0.73; OR 0.62, 95% CI 0.45 to 0.87; OR 0.67, 95% CI 0.45 to 0.98; respectively; vs no disease-modifying antirheumatic drug) were associated with reduced odds of severe COVID-19.

CONCLUSION:

Older age, male sex, comorbidity burden, higher disease activity and glucocorticoid intake were associated with more severe COVID-19. Later pandemic time periods, PsO and exposure to TNFi, IL17i and IL-23i/IL-12+23i were associated with less severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with PsO, PsA and axSpA during COVID-19 waves or similar future respiratory pandemics.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Physicians / Psoriasis / Rheumatology / Arthritis, Psoriatic / COVID-19 / Axial Spondyloarthritis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans / Male Language: English Journal: Ann Rheum Dis Year: 2023 Document Type: Article Affiliation country: Ard-2022-223499

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Physicians / Psoriasis / Rheumatology / Arthritis, Psoriatic / COVID-19 / Axial Spondyloarthritis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans / Male Language: English Journal: Ann Rheum Dis Year: 2023 Document Type: Article Affiliation country: Ard-2022-223499