TY - JOUR
T1 - Characteristics associated with poor COVID-19 outcomes in people with psoriasis, psoriatic arthritis and axial spondyloarthritis
T2 - data from the COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries
AU - Machado, Pedro M
AU - Schäfer, Martin
AU - Mahil, Satveer K
AU - Liew, Jean
AU - Gossec, Laure
AU - Dand, Nick
AU - Pfeil, Alexander
AU - Strangfeld, Anja
AU - Regierer, Anne Constanze
AU - Fautrel, Bruno
AU - Alonso, Carla Gimena
AU - Saad, Carla G S
AU - Griffiths, Christopher E M
AU - Lomater, Claudia
AU - Miceli-Richard, Corinne
AU - Wendling, Daniel
AU - Alpizar Rodriguez, Deshire
AU - Wiek, Dieter
AU - Mateus, Elsa F
AU - Sirotich, Emily
AU - Soriano, Enrique R
AU - Ribeiro, Francinne Machado
AU - Omura, Felipe
AU - Rajão Martins, Frederico
AU - Santos, Helena
AU - Dau, Jonathan
AU - Barker, Jonathan N
AU - Hausmann, Jonathan
AU - Hyrich, Kimme L
AU - Gensler, Lianne
AU - Silva, Ligia
AU - Jacobsohn, Lindsay
AU - Carmona, Loreto
AU - Pinheiro, Marcelo M
AU - Zelaya, Marcos David
AU - Severina, María de Los Ángeles
AU - Yates, Mark
AU - Dubreuil, Maureen
AU - Gore-Massy, Monique
AU - Romeo, Nicoletta
AU - Haroon, Nigil
AU - Sufka, Paul
AU - Grainger, Rebecca
AU - Hasseli, Rebecca
AU - Lawson-Tovey, Saskia
AU - Bhana, Suleman
AU - Pham, Thao
AU - Olofsson, Tor
AU - Bautista-Molano, Wilson
AU - Wallace, Zachary S
AU - Yiu, Zenas Z N
AU - Yazdany, Jinoos
AU - Robinson, Philip C
AU - Smith, Catherine H
N1 - Funding The study received support from the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR).
PY - 2023/5/1
Y1 - 2023/5/1
N2 - 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.
AB - 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.
KW - Arthritis
KW - Arthritis, Psoriatic
KW - Autoimmunity
KW - Covid-19
KW - Spondylitis, Ankylosing
U2 - 10.1136/ard-2022-223499
DO - 10.1136/ard-2022-223499
M3 - Article
C2 - 36787993
SN - 0003-4967
VL - 82
SP - 698
EP - 709
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 5
M1 - 223499
ER -
