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
(2023) In Annals of the Rheumatic Diseases 82(5). p.698-709- 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... (More)
- 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. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. (Less)
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https://lup.lub.lu.se/record/3aeb0fa3-7367-40fa-aa1e-7eb7e930a9ee
- author
- Machado, P.M. ; Olofsson, T. LU and Smith, C.H.
- author collaboration
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arthritis, Arthritis, Psoriatic, Autoimmunity, Covid-19, Spondylitis, Ankylosing, glucocorticoid, interleukin 12, adult, complication, human, male, physician, psoriasis, psoriatic arthritis, register, rheumatology, spondylarthritis, Adult, Axial Spondyloarthritis, COVID-19, Glucocorticoids, Humans, Interleukin-12, Male, Physicians, Psoriasis, Registries, Rheumatology
- in
- Annals of the Rheumatic Diseases
- volume
- 82
- issue
- 5
- pages
- 12 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85152490395
- pmid:36787993
- ISSN
- 0003-4967
- DOI
- 10.1136/ard-2022-223499
- language
- English
- LU publication?
- yes
- id
- 3aeb0fa3-7367-40fa-aa1e-7eb7e930a9ee
- date added to LUP
- 2023-11-06 13:22:35
- date last changed
- 2023-11-07 03:00:06
@article{3aeb0fa3-7367-40fa-aa1e-7eb7e930a9ee,
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. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.}},
author = {{Machado, P.M. and Olofsson, T. and Smith, C.H.}},
issn = {{0003-4967}},
keywords = {{Arthritis; Arthritis, Psoriatic; Autoimmunity; Covid-19; Spondylitis, Ankylosing; glucocorticoid; interleukin 12; adult; complication; human; male; physician; psoriasis; psoriatic arthritis; register; rheumatology; spondylarthritis; Adult; Axial Spondyloarthritis; COVID-19; Glucocorticoids; Humans; Interleukin-12; Male; Physicians; Psoriasis; Registries; Rheumatology}},
language = {{eng}},
number = {{5}},
pages = {{698--709}},
publisher = {{BMJ Publishing Group}},
series = {{Annals of the Rheumatic Diseases}},
title = {{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}},
url = {{http://dx.doi.org/10.1136/ard-2022-223499}},
doi = {{10.1136/ard-2022-223499}},
volume = {{82}},
year = {{2023}},
}