A study has highlighted which factors put people with rheumatic diseases – such as arthritis and lupus – at higher risk of death from Covid-19.
The study, led by Dr Pedro Machado of UCL and UCLH, found people with moderate or high rheumatic disease activity were more likely to die from Covid-19 compared with those with low disease activity or in remission – demonstrating the importance of adequate disease control.
Male sex, increasing age and having comorbidities were also factors, along with certain medications, including rituximab and moderate to high doses of glucocorticoids (steroids) – more than 10mg per day.
However the research team said most anti-rheumatic medications were not associated with Covid-19 related death, and that people with rheumatic disease should continue taking their medication unless told otherwise by those managing their care.
Rheumatic diseases typically affect joints, muscle, or connective tissue. Many are autoimmune conditions which cause inflammation in the body, and make the body more prone to infection.
There has been limited information around the risk factors for Covid-19-related death in people with rheumatic diseases. The research team aimed to fill this gap, by analysing data on 3,729 people with rheumatic disease who had either a confirmed or highly likely case of COVID-19, or had symptoms of this infection.
In total, 390 people died – just over 10%. The authors looked to see if there were any common factors in the people who died compared to those who recovered from the COVID-19 infection.
In common with the general population, older age was more closely linked to Covid-19-related death. Of those who died, over two-thirds were over 65. And the risk was higher for men compared to women.
Comorbidities were also more common in people who died from Covid-19. The most common were high blood pressure, chronic lung disease and obesity. 21% of people in the overall group of people looked at had three or more comorbidities. For those that died, 43% had three or more comorbidities.
The research team said: "The large majority of anti-rheumatic medications were not associated with Covid-19 related death. Study results highlight the importance of achieving a balance between protecting the patients and staff and reducing the risk of spread of viral transmission whilst providing safe continuous clinical care of people with rheumatic disease, aiming to maintain their disease control. People with rheumatic disease should continue taking their medication unless told otherwise by the clinicians managing their care."
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