Outcomes of coronavirus disease 19 patients with a history of rheumatoid arthritis: A retrospective registry-based study in Iran.

Abstract

BackgroundWe aimed to study the outcomes of coronavirus disease 2019 (COVID‐19) in patients with a history of rheumatoid arthritis (RA) in Iran, where most patients receive corticosteroids and are at high risk for COVID‐19 infection.MethodWe collected the demographic, diagnostic, and treatment data of all COVID‐19 patients by the clinical COVID‐19 registry system. We recruited 38 RA patients and 2216 non‐RA patients from the COVID‐19 registry. The primary outcome was mortality due to COVID‐19. We also studied the risk of intensive care unit admission and intubation in RA patients compared to non‐RA patients. We used multiple logistic regression analysis to study the association between RA and the risk of COVID‐19 outcomes.ResultWe recruited 38 RA patients and 2216 non‐RA patients from the COVID‐19 registry. The RA patients had a higher mean age (59.9 years) than the non‐RA patients (57.7 years). The group of RA patients had a larger proportion of women (76.3%) than the non‐RA patients (40.8%). The death rate due to COVID‐19 was significantly higher in RA patients than non‐RA patients (odds ratio [OR] = 2.69, 95% confidence interval [CI] = 1.24‐5.81). The OR was higher among those who received prednisolone than among those who did not (OR = 3.59, 95% CI = 1.54‐7.81). The odds of intubation were statistically significant among patients who received corticosteroid therapy (OR = 2.58, 95% CI = 1.07‐6.18).ConclusionThe risk of COVID‐19 outcomes was higher in RA patients than non‐RA patients, especially for RA patients who received a low dose of prednisolone. The results of this study can be used to triage RA patients who get infected by COVID‐19. Further studies with larger sample sizes are required to more precisely define the high‐risk groups.