Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data

Objective Individuals with autoimmune rheumatic disease (RD) are considered to be at increased risk for infection. However, few US population‐based studies have assessed whether these patients are at increased risk of hospitalization or death due to COVID‐19 compared with those without RD. Methods W...

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Autores principales:	Gabriela Schmajuk, Anna D. Montgomery, Samuel Leonard, Jing Li, Milena Gianfrancesco, Andrea Seet, Zara Izadi, Jinoos Yazdany, Salomeh Keyhani
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/888753374c85464cb0a7b871bf0b9465
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spelling	oai:doaj.org-article:888753374c85464cb0a7b871bf0b94652021-11-16T09:54:20ZFactors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data2578-574510.1002/acr2.11328https://doaj.org/article/888753374c85464cb0a7b871bf0b94652021-11-01T00:00:00Zhttps://doi.org/10.1002/acr2.11328https://doaj.org/toc/2578-5745Objective Individuals with autoimmune rheumatic disease (RD) are considered to be at increased risk for infection. However, few US population‐based studies have assessed whether these patients are at increased risk of hospitalization or death due to COVID‐19 compared with those without RD. Methods We performed a retrospective cohort study using national Veterans Affairs Health Care System data for individuals who tested positive for SARS‐CoV‐2. Outcomes of interest were hospitalization or death due to any cause within 30 days of COVID‐19 diagnosis. Outcomes were compared among veterans with RD and those without RD by using propensity score matching (PSM) and mixed‐effects multivariate logistic regression. Results Of 26,116 veterans with COVID‐19, 501 (1.9%) had an underlying RD. Prior to matching, patients with RD were more likely to have poor outcomes compared with controls (37.7% vs. 28.5% hospitalized; 6.4% vs. 4.5% died). In the PSM analysis, RD was not a significant predictor for poor outcomes; however, patients with prescriptions for glucocorticoids had increased odds of poor outcomes in a dose‐dependent manner (odds ratio [95% confidence interval] for hospitalization or death: 1.33 [1.20‐1.48] for doses >0 and ≤10 mg/day; 1.29 [1.09‐1.52] for doses >10 mg/day). Conclusion Among US veterans with COVID‐19, we did not find a significant association between RD and hospitalization or death. Poor outcomes appear to be mostly driven by age and other comorbidities, similar to the general veteran population. However, we observed an increased risk for poor outcomes among patients who received glucocorticoids, even at daily doses less than or equal to 10 mg.Gabriela SchmajukAnna D. MontgomerySamuel LeonardJing LiMilena GianfrancescoAndrea SeetZara IzadiJinoos YazdanySalomeh KeyhaniWileyarticleDiseases of the musculoskeletal systemRC925-935ENACR Open Rheumatology, Vol 3, Iss 11, Pp 796-803 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Gabriela Schmajuk Anna D. Montgomery Samuel Leonard Jing Li Milena Gianfrancesco Andrea Seet Zara Izadi Jinoos Yazdany Salomeh Keyhani Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data
description	Objective Individuals with autoimmune rheumatic disease (RD) are considered to be at increased risk for infection. However, few US population‐based studies have assessed whether these patients are at increased risk of hospitalization or death due to COVID‐19 compared with those without RD. Methods We performed a retrospective cohort study using national Veterans Affairs Health Care System data for individuals who tested positive for SARS‐CoV‐2. Outcomes of interest were hospitalization or death due to any cause within 30 days of COVID‐19 diagnosis. Outcomes were compared among veterans with RD and those without RD by using propensity score matching (PSM) and mixed‐effects multivariate logistic regression. Results Of 26,116 veterans with COVID‐19, 501 (1.9%) had an underlying RD. Prior to matching, patients with RD were more likely to have poor outcomes compared with controls (37.7% vs. 28.5% hospitalized; 6.4% vs. 4.5% died). In the PSM analysis, RD was not a significant predictor for poor outcomes; however, patients with prescriptions for glucocorticoids had increased odds of poor outcomes in a dose‐dependent manner (odds ratio [95% confidence interval] for hospitalization or death: 1.33 [1.20‐1.48] for doses >0 and ≤10 mg/day; 1.29 [1.09‐1.52] for doses >10 mg/day). Conclusion Among US veterans with COVID‐19, we did not find a significant association between RD and hospitalization or death. Poor outcomes appear to be mostly driven by age and other comorbidities, similar to the general veteran population. However, we observed an increased risk for poor outcomes among patients who received glucocorticoids, even at daily doses less than or equal to 10 mg.
format	article
author	Gabriela Schmajuk Anna D. Montgomery Samuel Leonard Jing Li Milena Gianfrancesco Andrea Seet Zara Izadi Jinoos Yazdany Salomeh Keyhani
author_facet	Gabriela Schmajuk Anna D. Montgomery Samuel Leonard Jing Li Milena Gianfrancesco Andrea Seet Zara Izadi Jinoos Yazdany Salomeh Keyhani
author_sort	Gabriela Schmajuk
title	Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data
title_short	Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data
title_full	Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data
title_fullStr	Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data
title_full_unstemmed	Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data
title_sort	factors associated with hospitalization and death after covid‐19 diagnosis among patients with rheumatic disease: an analysis of veterans affairs data
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/888753374c85464cb0a7b871bf0b9465
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Factors Associated With Hospitalization and Death After COVID‐19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data

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