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The authors disclosed receipt of the following financial support for the research, authorship,and/or publication of this article: This work was supported by the Instituto de Salud Carlos III (ISCIII), Ministry of Health, Spain (CP16/00916; PI18/01188; and RD16/0012/0014), and cofunded by el Fondo Europeo de Desarrollo Regional (FEDER). The funders had no role in study design, data collection, analysis, article preparation, or decision to publish.

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Mortality related to COVID-19 in patients with rheumatic and musculoskeletal diseases, first wave of the outbreak: a single-center study

Publicado en:Therapeutic Advances In Musculoskeletal Disease. 14 NULL- - 2022-04-01 14(), DOI: 10.1177/1759720X221090296

Autores: Freites Nunez, Dalifer; Leon, Leticia; Madrid Garcia, Alfredo; Colomer Arce, Jose Ignacio; Mucientes, Arkaitz; Gutierrez-Fernandez, Benjamin; Rodriguez, Luis; Perez San Cristobal, Ines; Alvarez, Paula; Martinez Prada, Cristina; Abasolo, Lydia;

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Objectives: The aim of this study was to assess the cause-specific mortality rate related to COVID-19 (CMR) in patients with rheumatic and musculoskeletal diseases (RMDs) and COVID-19 and to analyze the role of the different RMDs in their mortality risk.Methods: An observational longitudinal study was conducted during the first pandemic wave in our center. Patients with the diagnosis of RMDs and COVID-19 were included. Main outcome is the death related to COVID-19. Independent variable - type of RMDs: autoimmune rheumatic diseases LARD), such as chronic inflammatory arthritis (CIA) and connective tissue diseases (CTD) and non-autoimmune Rheumatic Diseases (non-ARD). Survival techniques were used to estimate the CMR per 1000 patients-month with a 95% confidence interval (CIL and Cox multivariate regression analysis was run to examine the effect of ARD compared to non-ARD on mortality risk adjusted by confounders.Results were expressed by Hazard Ratio (HR) and CI. Results: Overall, 405 patients were included (642.5 patients-month). During the study period, 44 (10.86%) deaths were recorded. CMR was 68.48 (50.96-92.01). After adjusting for confounders, HR of mortality in ARD compared to non-ARD did not achieve statistical significance [HR: 1.15 (0.64-2.071], neither CTD versus CIA nor CTD versus non-ARD. Age and certain comorbidities which are being diagnosed in March compared to April or May [HR: 2.43 (1.1-5.55)] increased the mortality risk. Glucocorticoids and disease-modifying antirheumatic drugs (DMARDs) dropped from the final model.Conclusion: In patients with RMDs and COVID-19, CMR was 6.8% patients-month. This study shows that mortality risk is higher in males, older patients, and similar between CTD, CIA, and non-ARD. COVID-19 management improved after the first month of pandemic.

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