Characteristics, outcomes, and mortality amongst 133,589 patients with prevalent autoimmune diseases diagnosed with, and 48,418 hospitalised for COVID-19: a multinational distributed network cohort analysis
| Main Authors: | Eng Hooi Tan, Anthony G. Sena, Albert Prats-Uribe, Seng Chan You, Waheed-Ul-Rahman Ahmed, Kristin Kostka, Christian Reich, Scott L. Duvall, Kristine E. Lynch, Michael E. Matheny, Talita Duarte-Salles, Sergio Fernandez Bertolin, George Hripcsak, Karthik Natarajan, Thomas Falconer, Matthew Spotnitz, Anna Ostropolets, Clair Blacketer, Thamir M Alshammari, Heba Alghoul, Osaid Alser, Jennifer C.E. Lane, Dalia M Dawoud, Karishma Shah, Yue Yang, Lin Zhang, Carlos Areia, Asieh Golozar, Martina Relcade, Paula Casajust, Jitendra Jonnagaddala, Vignesh Subbian, David Vizcaya, Lana YH Lai, Fredrik Nyberg, Daniel R Morales, Jose D. Posada, Nigam H. Shah, Mengchun Gong, Arani Vivekanantham, Aaron Abend, Evan P Minty, Marc Suchard, Peter Rijnbeek, Patrick B Ryan, Daniel Prieto-Alhambra |
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| Format: | info publication-preprint Journal |
| Terbitan: |
, 2020
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| Subjects: | |
| Online Access: |
https://zenodo.org/record/4428402 |
Daftar Isi:
- Objective: Patients with autoimmune diseases were advised to shield to avoid COVID-19, but information on their prognosis is lacking. We characterised 30-day outcomes and mortality after hospitalisation with COVID-19 among patients with prevalent autoimmune diseases, and compared outcomes after hospital admissions among similar patients with seasonal influenza. Design: Multinational network cohort study Setting: Electronic health records data from Columbia University Irving Medical Center (CUIMC) (NYC, United States [US]), Optum [US], Department of Veterans Affairs (VA) (US), Information System for Research in Primary Care-Hospitalisation Linked Data (SIDIAP-H) (Spain), and claims data from IQVIA Open Claims (US) and Health Insurance and Review Assessment (HIRA) (South Korea). Participants: All patients with prevalent autoimmune diseases, diagnosed and/or hospitalised between January and June 2020 with COVID-19, and similar patients hospitalised with influenza in 2017-2018 were included. Main outcome measures: 30-day complications during hospitalisation and death Results: We studied 133,589 patients diagnosed and 48,418 hospitalised with COVID-19 with prevalent autoimmune diseases. The majority of participants were female (60.5% to 65.9%) and aged ≥50 years. The most prevalent autoimmune conditions were psoriasis (3.5 to 32.5%), rheumatoid arthritis (3.9 to 18.9%), and vasculitis (3.3 to 17.6%). Amongst hospitalised patients, Type 1 diabetes was the most common autoimmune condition (4.8% to 7.5%) in US databases, rheumatoid arthritis in HIRA (18.9%), and psoriasis in SIDIAP-H (26.4%). Compared to 70,660 hospitalised with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2% to 4.3% versus 6.3% to 24.6%). Conclusions: Patients with autoimmune diseases had high rates of respiratory complications and 30-day mortality following a hospitalization with COVID-19. Compared to influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality. Future studies should investigate predictors of poor outcomes in COVID-19 patients with autoimmune diseases.