Author:
Kristensen S.,Cordtz R. L.,Duch K.,Lindhardsen J.,Torp-Pedersen C.,Dreyer L.
Abstract
BackgroundPatients with small vessel vasculitis (SVV) and large vessel vasculitis (LVV, including giant cell arteritis (GCA)) are considered at higher risk of infections compared to the general population, owing to their underlying condition and the use of immunosuppressive drugs. Thus, the risk of COVID-19 infection and related outcomes during the global pandemic is of immediate concern to rheumatologists worldwide.ObjectivesTo estimate the incidence of COVID-19 hospitalisation in patients with vasculitis, and to evaluate the impact of glucocorticoid treatment on the outcome between March 2020 and February 2021.MethodsWith use of the Danish nationwide registers, a cohort of patients with LVV and SVV, respectively, and general population controls (GPCs) matched on age and gender was established. Hazard ratios (HR) for COVID-19 hospitalisation was estimated. National COVID-19 surveillance data was used to calculate the odds ratio (OR) of having had a positive SARS-CoV2 PCR test. Lastly, a nested case-control design and conditional logistic regression was used to estimate the impact of glucocorticoids on the risk of hospitalisation.ResultsPatients with SVV (n=1090) had an increased incidence of COVID-19 hospitalisation compared with GPCs (comorbidity-adjusted HR 2·73; 95% CI 1·64-4·55), whereas no increased risk was seen in patients with LVV. Patients with vasculitis had similar likelihoods of having had a positive PCR test as GPCs. Glucocorticoids did not increase the HR of hospitalisation among patients with LVV or SVV.ConclusionPatients with SVV were more likely to be admitted with COVID-19 than the GPCs. The impact of glucocorticoid treatment on the risk of hospitalisation needs further investigation.References[1]Cordtz R, Lindhardsen J, Soussi BG, et al. Incidence and severeness of COVID-19 hospitalization in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark. Rheumatology. Published online 2020. doi:10.1093/rheumatology/keaa897[2]Rutherford MA, Scott J, Karabayas M, et al. Risk factors for severe outcomes in patients with systemic vasculitis & COVID-19: a bi-national registry-based cohort study. Arthritis Rheumatol. Published online 2021. doi:10.1002/art.41728[3]Tomelleri A, Sartorelli S, Campochiaro C, Baldissera EM, Dagna L. Impact of COVID-19 pandemic on patients with large-vessel vasculitis in Italy: A monocentric survey. Ann Rheum Dis. Published online 2020. doi:10.1136/annrheumdis-2020-217600Disclosure of InterestsSalome Kristensen: None declared, René Lindholm Cordtz: None declared, Kirsten Duch: None declared, Jesper Lindhardsen: None declared, Christian Torp-Pedersen Grant/research support from: Recieved grants from Bayer and Novo Nordisk outside the present work, Lene Dreyer Grant/research support from: Received research grant/research support from BMS, and speakers bureau from EliLilly and Galderma outside the present work.
Subject
General Biochemistry, Genetics and Molecular Biology,Immunology,Immunology and Allergy,Rheumatology