Risk of severe SARS-CoV-2 infection in patients with autoimmune rheumatic diseases in Qatar : a cohort matched study

Abstract EN

Background: It remains unclear whether patients with autoimmune rheumatic diseases (ARDs) are at a higher risk of poor outcomes from a SARS-CoV-2 infection.

We evaluated whether patients with an ARDs infected with SARS-CoV-2 were at a higher risk of a poorer outcome than those without an ARDs.

Methods: Patients with an ARDs infected with SARS-CoV-2 were matched to control patients without a known ARDs.

Matching was performed according to age ( ± 6 years) and sex at a case-to-control ratio of 1:3.

Demographic and clinical data were extracted from the databases and were compared between the two groups.

Severe SARS-CoV-2 infection was the primary outcome and was defined as the requirement for oxygen therapy support, the need for invasive or noninvasive mechanical ventilation, or the use of glucocorticoids.

Results: A total of 141 patients with an ARDs were matched to 398 patients who formed the control group.

The mean ages (SD) of the ARDs and non-ARDs groups were 44.4 years (11.4) and 43.4 years (12.2).

Women accounted for 58.8% of the ARDs group and 56.3% of the control group (p = 0.59).

Demographics and comorbidities were balanced between the groups.

ARDs included connective tissue disease in 43 (30.3%) patients, inflammatory arthritis in 92 (65.2%), and other ARDs in 8 (5.7%).

ARDs medications included biological/targeted synthetic disease-modifying antirheumatic drugs (b/ts-DMARDs) in 28 (15.6%) patients, conventional synthetic DMARDs in 95 (67.4%), and immunosuppressive antimetabolites in 13 (9.2%).

The ARDs group had more respiratory and gastrointestinal symptoms related to SARS-CoV-2 infection than the control group (24.8% and 20.6% vs.

10% and 5.3%, respectively; p < 0.001 for both).

Severe SARS-CoV-2 infection was more common in the ARDs group than in the control group (14.9% vs.

5.8%; p < 0.001).

Conclusions: In this single-center matched cohort study, patients with an ARDs experienced more respiratory and gastrointestinal symptoms related to SARS-CoV-2 infection and had more severe infection than those from the control group.

Therefore, patients with an ARDs require close observation during the coronavirus disease 2019 pandemic.