2023 Rheumatology at BMJ

Epidemiology

Table 1 Demographics and rheumatic disease characteristics of patients with history of COVID-19 infection

All rheumatic disease patients (N=280)

Breakthrough COVID-19 infection (N=116)

Non-breakthrough COVID-19 infection (N=164)

Characteristic

P value

Age at time of COVID-19 symptom onset in years, mean±SD Age at time of survey in years, mean±SD

52 (15)

53 (15)

51 (16)

0.48

53 (15) 223 (80)

53 (15) 93 (80)

52 (16) 130 (79)

0.68 0.88

Female, n (%)

Race, n (%) Asian

12 (4) 20 (7)

5 (4) 4 (3)

7 (4)

1.00 0.06 0.08 1.00 1.00 0.15 0.65

Black White Other

16 (10) 129 (79)

230 (82)

101 (87)

15 (5)

6 (5) 3 (3) 8 (7)

9 (5) 4 (2)

Unknown

7 (3)

Hispanic or Latinx ethnicity

27 (10)

19 (12)

Smoking status

Current Former

4 (1)

2 (2)

2 (1)

72 (26) 203 (73)

27 (23) 87 (75)

45 (27) 116 (71)

Never

SARD category*

0.33

Inflammatory arthritis Connective tissue disease

165 (59) 68 (24)

61 (53) 30 (26) 13 (11)

104 (63) 38 (23)

Vasculitis Multiple

26 (9)

13 (8)

9 (3)

5 (4) 7 (6)

4 (2) 5 (3)

Other

12 (4)

Immunomodulatory medications cs DMARDs Antimalarial (includes hydroxychloroquine and chloroquine)

64 (23)

34 (29)

30 (18)

0.04

Methotrexate

60 (21)

27 (23) 14 (12) 14 (12)

33 (20)

0.56 0.02 0.14 0.40 0.08 0.66 0.86 0.43 0.43 0.04 0.67 0.43 0.50 0.62 1.00 1.00 0.24 1.00 0.50 0.64

Mycophenolate mofetil/mycophenolic acid 21 (8)

7 (4)

Other csDMARD†

25 (9) 13 (5)

11 (7)

Targeted synthetic DMARD (JAK inhibitor)

7 (6)

6 (4)

Biologic DMARDs Anti-CD20 monoclonal antibody

23 (8)

14 (12) 28 (24) 15 (13) 24 (21) 8 (5–20)

9 (5)

TNF inhibitor

63 (22) 35 (13)

35 (21) 20 (12) 27 (16)

Other biologic DMARD‡

Baseline glucocorticoid use at COVID-19 onset 51 (18)

Dose (prednisone-equivalent, daily mg), median (IQR)

9 (5–15)

10 (5–15)

Comorbidities Obesity

58 (21) 64 (23) 49 (18)

17 (15) 28 (24) 23 (20)

41 (25) 36 (22) 26 (16)

Hypertension

Asthma

O bstructive sleep apnoea Coronary artery disease

21 (8) 18 (6) 16 (6)

7 (6) 6 (5) 7 (6) 2 (2) 7 (6) 2 (2) 5 (4) 1 (1)

14 (9) 12 (7)

Diabetes

9 (5) 4 (2) 5 (3) 2 (1) 4 (2) 3 (2)

Heart failure

6 (2)

Chronic kidney disease

12 (4)

Chronic obstructive pulmonary disease

4 (1)

Interstitial lung disease/pulmonary fibrosis 9 (3)

Solid tumour

4 (1)

Comorbidity count, median (IQR) 0.68 *For patients who reported multiple SARD diagnoses, those who reported inflammatory arthritis in addition to either lupus or myositis were classified as having a ‘connective tissue disease (CTD)’ given that inflammatory arthritis can be a component of CTD. Patients who listed both polymyalgia rheumatica and rheumatoid arthritis were classified as having ‘inflammatory arthritis’. Patients with multiple SARDs that can coexist (eg, psoriatic arthritis and lupus) were classified as having multiple SARDs. In the case of missing data or unanswered survey questions regarding rheumatic disease diagnosis or treatment, manual review of the EHR was performed to fill in this missing data. †Other conventional synthetic DMARD includes leflunomide, azathioprine, sulfasalazine, apremilast, cyclosporine and tacrolimus ‡Other biological DMARD includes IL-6 receptor inhibitor, B-cell activating factor inhibitor, IL-23 inhibitor, IL-17 inhibitor, IL-12/IL-23 inhibitor, IL-1 inhibitor and CTLA-4 immunoglobulin csDMARD, conventional synthetic disease-modifying antirheumatic drug; EHR, electronic health record; JAK, janus kinase; SARD, systemic autoimmune rheumatic disease. 1 (0–2) 1 (0–1) 1 (0–2)

Patel NJ, et al . Ann Rheum Dis 2023; 82 :565–573. doi:10.1136/ard-2022-223439

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