Gout and Excess Risk of Severe SARS-CoV-2 Infection Among Vaccinated Individuals: A General Population Study.

Abstract

ObjectivesGout patients often have multiple comorbidities, making them susceptible to SARS‐CoV‐2 infection and its severe outcomes; however, few studies have examined the association between gout and the risk of SARS‐CoV‐2 infection and its severe sequelae, especially after COVID‐19 vaccination.MethodsWe conducted two cohort studies using The Health Improvement Network. Individuals with gout and those without gout from the general population were followed from December 8th, 2020, to October 31st, 2021. We estimated the rate difference (RD) and hazard ratio (HR) of SARS‐CoV‐2 infection and its severe outcomes (i.e., hospitalization and death over 30 days after SARS‐CoV‐2 infection) for individuals with gout versus those without gout using Cox proportional hazard model according to COVID‐19 vaccination status. We adjusted potential confounders using overlap weighting of exposure score.ResultsAmong the vaccinated cohort, 1,955 cases of breakthrough infection occurred in 54,576 individuals with gout (4.68/1000 person‐months) and 52,468 cases in 1,336,377 individuals without gout (3.76/1000 person‐months). The adjusted RD of breakthrough infection was 0.91 (95%CI: 0.62‐1.20)/1000 person‐months, and the adjusted HR was 1.24 (95%CI: 1.19‐1.30). Gout was also associated with an increased risk of hospitalization (adjusted HR=1.30, 95%CI: 1.10‐1.53) and death (adjusted HR=1.36, 95%CI: 0.87‐2.13). Women with gout showed an increased risk of hospitalization (adjusted HR 1.55, 95%CI: 1.15‐2.10) and death (adjusted HR=2.46, 95%CI: 1.12‐5.41). Similar associations with gout were observed in the unvaccinated cohort.ConclusionsThese general population data suggest that individuals with gout, especially women, have higher risks of both SARS‐CoV‐2 infection and severe sequelae, even with vaccinations.This article is protected by copyright. All rights reserved.