• Jose L Pablos, Lydia Abasolo, Jose M Alvaro-Gracia, Francisco J Blanco, Ricardo Blanco, Isabel Castrejón, David Fernandez-Fernandez, Benjamín Fernandez-Gutierrez, María Galindo-Izquierdo, Miguel A Gonzalez-Gay, Sara Manrique-Arija, Natalia Mena Vázquez, Antonio Mera Varela, Miriam Retuerto, Alvaro Seijas-Lopez, and RIER investigators group.
• Servicio de Reumatología, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain jlpablos@h12o.es.
• Ann. Rheum. Dis. 2020 Sep 1; 79 (9): 1170-1173.

BackgroundThe susceptibility of patients with rheumatic diseases and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown.MethodsWe performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with severe acute respiratory syndrome coronavirus 2-positive PCR tests performed in the hospital to the same reference populations. Rates of PCR+ confirmed COVID-19 were compared among groups.ResultsPatients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Patients with systemic autoimmune or immune-mediated disease (AI/IMID) showed a significant increase, whereas patients with inflammatory arthritis (IA) or systemic lupus erythematosus did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. Patients with IA on targeted-synthetic or biological disease-modifying antirheumatic drugs (DMARDs), but not those on conventional-synthetic DMARDs, had a greater prevalence despite a similar age distribution.ConclusionPatients with AI/IMID show a variable risk of hospital-diagnosed COVID-19. Interplay of ageing, therapies and disease-specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyse the specific factors involved in COVID-19 susceptibility.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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