Ab1296 equated hospitalization rate of patients with inflammatory rheumatic diseases as compared to general population – data from the second wave of the covid-19 pandemic

Background The outbreak of COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (called SARS-CoV-2), has quickly became a global health emergency with over 660 million confirmed cases and over 6 million deaths worldwide. Over the last two years, several registries and cohort studies have collected data about the course and possible predictors of outcomes of COVID-19 infection in of inflammatory rheumatic and musculoskeletal disease (iRMD) patients. However, whether iRMD patients perform differently from the general is not clear, as most studies miss an adequate control group [1]. Objectives To investigate the clinical manifestations and outcome of coronavirus disease (COVID-19 second wave) in patients with iRMD compared to the general population. Methods This is a case-control study of patients with and without an iRMD affected by COVID-19. Patients were selected in South Tyrol health trust, Italy, retrieving data from a single central database. We included patients ≥18 years of age and with a positive SARS-CoV-2 PCR test result between October 1sts 2020 and March 1st, 2021. During the study period, a whole population screening was conducted in South Tyrol with central registration of all results. Cases were identified by linking the diagnosis of a rheumatic disease with the result of the PCR test. Cases were subsequently matched in a 1:2 ratio for age, sex, and date of COVID-19 diagnosis with non iRMD patients (controls). Differences in demographics, clinical features, and outcomes of COVID-19 infection were compared between the two groups. The outcomes analyzed were hospitalization, severe course (ICU, mechanical ventilation/ECMO) and mortality. Results The study population consisted of 201 iRMD patients (mean age 60.4 years±14.9; 65.2 % female) and 360 controls (mean age 59.8 years ± 5.6; 64.7 % female). Asthenia and malaise were the most common symptoms, reported more frequently in the iRMD as compared to the control group (61.7% vs 43.1%, respectively, p<0.001). The majority of iRMD patients (88.6%) received an immunosuppressive drug at time of COVID-19 diagnosis, 36.3% were under glucocorticoids therapy. iRMD patients more frequently had three or more comorbidities than controls (34.8% vs. 6.1%, p<0.001). iRMD patients received more commonly glucocorticoids to treat COVID-19 disease [n=42 (20.9%) vs n=23 (6.4%), p=<0.001] than controls. The rate of COVID-19 related hospitalization (12.4% vs. 10.6%, p=0.49), severe course (40.0% vs. 44.7%, p=0.80) and mortality (3.5% vs. 4.2%, p=0.82) in iRMD and control group respectively, did not show significant differences. Among hospitalized patients, mechanic ventilation was significantly more common among iRMD than control group [n=5 (20.0%) vs. n=1 (2.6%), p=0.035]. Conclusion Our study indicates similar rates of admission, severe course and mortality among iRMD and non-iRMD patients affected by COVID-19. However, iRMD patients displayed a higher number of comorbidities and were more frequently treated with glucocorticoids. Among hospitalized patients, mechanical ventilation was more frequently required among iRMD group. Reference [1]R. Conway et al., «SARS–CoV-2 Infection and COVID-19 Outcomes in Rheumatic Diseases: A Systematic Literature Review and Meta-Analysis», Arthritis & Rheumatology, vol. 74, n. 5, pag. 766–775, 2022. Acknowledgements: NIL. Disclosure of Interests gloria dallagiacoma Paid instructor for: Galapagos, Christian Weichenberger: None declared, Bernd Raffeiner: None declared, Sara Zandonella Callegher: None declared, Peter Matzneller: None declared, ARMIN MAIER: None declared, Lena Karadar: None declared, AARON MASL: None declared, IRIS KUPPELWIESER: None declared, Essi Hantikainen: None declared, Christian Dejaco Speakers bureau: Novartis, Janssen, AbbVie, Roche, Sanofi, Pfizer, Galapagos, Lilly, Consultant of: Sparrow, Novartis, Janssen, AbbVie, Roche, Sanofi, Galapagos, Grant/research support from: AbbVie.