Impact of the COVID-19 pandemic on morbidity and mortality in patients with inflammatory joint diseases and in the general population : A nationwide Swedish cohort study
(2021) In Annals of the Rheumatic Diseases 80(8). p.1086-1093- Abstract
Objectives To estimate absolute and relative risks for all-cause mortality and for severe COVID-19 in inflammatory joint diseases (IJDs) and with antirheumatic therapies. Methods Through Swedish nationwide multiregister linkages, we selected all adult patients with rheumatoid arthritis (RA, n=53 455 in March 2020), other IJDs (here: spondyloarthropathies, psoriatic arthritis and juvenile idiopathic arthritis, n=57 112), their antirheumatic drug use, and individually matched population referents. We compared annual all-cause mortality March-September 2015 through 2020 within and across cohorts, and assessed absolute and relative risks for hospitalisation, admission to intensive care and death due to COVID-19 March-September 2020, using... (More)
Objectives To estimate absolute and relative risks for all-cause mortality and for severe COVID-19 in inflammatory joint diseases (IJDs) and with antirheumatic therapies. Methods Through Swedish nationwide multiregister linkages, we selected all adult patients with rheumatoid arthritis (RA, n=53 455 in March 2020), other IJDs (here: spondyloarthropathies, psoriatic arthritis and juvenile idiopathic arthritis, n=57 112), their antirheumatic drug use, and individually matched population referents. We compared annual all-cause mortality March-September 2015 through 2020 within and across cohorts, and assessed absolute and relative risks for hospitalisation, admission to intensive care and death due to COVID-19 March-September 2020, using Cox regression. Results During March-September 2020, the absolute all-cause mortality in RA and in other IJDs was higher than 2015-2019, but relative risks versus the general population (around 2 and 1.5) remained similar during 2020 compared with 2015-2019. Among patients with IJD, the risks of hospitalisation (0.5% vs 0.3% in their population referents), admission to intensive care (0.04% vs 0.03%) and death (0.10% vs 0.07%) due to COVID-19 were low. Antirheumatic drugs were not associated with increased risk of serious COVID-19 outcomes, although for certain drugs, precision was limited. Conclusions Risks of severe COVID-19-related outcomes were increased among patients with IJDs, but risk increases were also seen for non-COVID-19 morbidity. Overall absolute and excess risks are low and the level of risk increases are largely proportionate to those in the general population, and explained by comorbidities. With possible exceptions, antirheumatic drugs do not have a major impact on these risks.
(Less)
- author
- Bower, Hannah
; Frisell, Thomas
; Di Giuseppe, Daniela
; Delcoigne, Bénédicte
; Ahlenius, Gerd Marie
; Baecklund, Eva
; Chatzidionysiou, Katerina
; Feltelius, Nils
; Forsblad-D'elia, Helena
; Kastbom, Alf
; Klareskog, Lars
; Lindqvist, Elisabet
LU
; Lindström, Ulf
; Turesson, Carl
LU
; Sjöwall, Christopher
and Askling, Johan
(Less) - author collaboration
- organization
- publishing date
- 2021-08-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- arthritis, biological therapy, Covid-19, epidemiology, health care, outcome assessment, rheumatoid
- in
- Annals of the Rheumatic Diseases
- volume
- 80
- issue
- 8
- pages
- 8 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:33622688
- scopus:85101578148
- ISSN
- 0003-4967
- DOI
- 10.1136/annrheumdis-2021-219845
- language
- English
- LU publication?
- yes
- id
- 66af8b9e-8984-46ed-b347-d61bd9841f82
- date added to LUP
- 2022-04-13 10:42:53
- date last changed
- 2025-04-04 14:12:14
@article{66af8b9e-8984-46ed-b347-d61bd9841f82,
abstract = {{<p>Objectives To estimate absolute and relative risks for all-cause mortality and for severe COVID-19 in inflammatory joint diseases (IJDs) and with antirheumatic therapies. Methods Through Swedish nationwide multiregister linkages, we selected all adult patients with rheumatoid arthritis (RA, n=53 455 in March 2020), other IJDs (here: spondyloarthropathies, psoriatic arthritis and juvenile idiopathic arthritis, n=57 112), their antirheumatic drug use, and individually matched population referents. We compared annual all-cause mortality March-September 2015 through 2020 within and across cohorts, and assessed absolute and relative risks for hospitalisation, admission to intensive care and death due to COVID-19 March-September 2020, using Cox regression. Results During March-September 2020, the absolute all-cause mortality in RA and in other IJDs was higher than 2015-2019, but relative risks versus the general population (around 2 and 1.5) remained similar during 2020 compared with 2015-2019. Among patients with IJD, the risks of hospitalisation (0.5% vs 0.3% in their population referents), admission to intensive care (0.04% vs 0.03%) and death (0.10% vs 0.07%) due to COVID-19 were low. Antirheumatic drugs were not associated with increased risk of serious COVID-19 outcomes, although for certain drugs, precision was limited. Conclusions Risks of severe COVID-19-related outcomes were increased among patients with IJDs, but risk increases were also seen for non-COVID-19 morbidity. Overall absolute and excess risks are low and the level of risk increases are largely proportionate to those in the general population, and explained by comorbidities. With possible exceptions, antirheumatic drugs do not have a major impact on these risks. </p>}},
author = {{Bower, Hannah and Frisell, Thomas and Di Giuseppe, Daniela and Delcoigne, Bénédicte and Ahlenius, Gerd Marie and Baecklund, Eva and Chatzidionysiou, Katerina and Feltelius, Nils and Forsblad-D'elia, Helena and Kastbom, Alf and Klareskog, Lars and Lindqvist, Elisabet and Lindström, Ulf and Turesson, Carl and Sjöwall, Christopher and Askling, Johan}},
issn = {{0003-4967}},
keywords = {{arthritis; biological therapy; Covid-19; epidemiology; health care; outcome assessment; rheumatoid}},
language = {{eng}},
month = {{08}},
number = {{8}},
pages = {{1086--1093}},
publisher = {{BMJ Publishing Group}},
series = {{Annals of the Rheumatic Diseases}},
title = {{Impact of the COVID-19 pandemic on morbidity and mortality in patients with inflammatory joint diseases and in the general population : A nationwide Swedish cohort study}},
url = {{http://dx.doi.org/10.1136/annrheumdis-2021-219845}},
doi = {{10.1136/annrheumdis-2021-219845}},
volume = {{80}},
year = {{2021}},
}