• Milena A Gianfrancesco, Liza A Leykina, Zara Izadi, Tiffany Taylor, Jeffrey A Sparks, Carly Harrison, Laura Trupin, Stephanie Rush, Gabriela Schmajuk, Patricia Katz, Lindsay Jacobsohn, Tiffany Y Hsu, Kristin M D'Silva, Naomi Serling-Boyd, Rachel Wallwork, Derrick J Todd, Suleman Bhana, Wendy Costello, Rebecca Grainger, Jonathan S Hausmann, Jean W Liew, Emily Sirotich, Paul Sufka, Zachary S Wallace, Pedro M Machado, Philip C Robinson, Jinoos Yazdany, and COVID-19 Global Rheumatology Alliance.
• University of California, San Francisco.
• Arthritis Rheumatol. 2021 Mar 1; 73 (3): 374-380.

ObjectiveRacial/ethnic minorities experience more severe outcomes of coronavirus disease 2019 (COVID-19) in the general US population. This study was undertaken to examine the association between race/ethnicity and COVID-19 hospitalization, ventilation status, and mortality in people with rheumatic disease.MethodsUS patients with rheumatic disease and COVID-19 were entered into the COVID-19 Global Rheumatology Alliance physician registry between March 24, 2020 and August 26, 2020 were included. Race/ethnicity was defined as White, African American, Latinx, Asian, or other/mixed race. Outcome measures included hospitalization, requirement for ventilatory support, and death. Multivariable regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for age, sex, smoking status, rheumatic disease diagnosis, comorbidities, medication use prior to infection, and rheumatic disease activity.ResultsA total of 1,324 patients were included, of whom 36% were hospitalized and 6% died; 26% of hospitalized patients required mechanical ventilation. In multivariable models, African American patients (OR 2.74 [95% CI 1.90-3.95]), Latinx patients (OR 1.71 [95% CI 1.18-2.49]), and Asian patients (OR 2.69 [95% CI 1.16-6.24]) had higher odds of hospitalization compared to White patients. Latinx patients also had 3-fold increased odds of requiring ventilatory support (OR 3.25 [95% CI 1.75-6.05]). No differences in mortality based on race/ethnicity were found, though power to detect associations may have been limited.ConclusionSimilar to findings in the general US population, racial/ethnic minorities with rheumatic disease and COVID-19 had increased odds of hospitalization and ventilatory support. These results illustrate significant health disparities related to COVID-19 in people with rheumatic diseases. The rheumatology community should proactively address the needs of patients currently experiencing inequitable health outcomes during the pandemic.© 2020, American College of Rheumatology.

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