Infectious Disease

Average, excessive exercise for rheumatic ailments related to a better threat of COVID-related deaths

February 22, 2021

2 min read

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Machado reports on consulting / speaking fees from Abbvie, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB. In the study you will find all relevant financial information from all other authors.

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Moderate and high disease activity and the use of immunosuppressants were associated with a higher risk of COVID-related deaths in patients with rheumatic diseases, according to information in the Annals of the Rheumatic Diseases.

Researchers found that while most disease-modifying anti-inflammatory drugs were not associated with a higher risk of death from COVID-19, there were “notable exceptions” with rituximab and sulfasalazine.

“It is important that people with rheumatic disease continue to control their disease activity with anti-rheumatic drugs, preferably without increasing the dose of glucocorticoids if possible,” said Dr. Pedro M. Machado of University College London and Northwick Park Hospital, said Healio Rheumatology.

“As in the general population, age, male gender, cardiovascular and chronic lung diseases have been linked to death-related COVID-19.” Pedro M.. Machado, MD, of University College London and Northwick Park Hospital, said Healio Rheumatology. “Some rheumatic disease-specific factors have also been linked to death from COVID-19. In particular, moderate or high disease activity was associated with a two-fold increased risk of death. Fortunately, most of the drugs taken by people with rheumatic diseases were not associated with higher death rates. “

To examine what factors are linked to death-related COVID-19 in patients with rheumatic diseases, Strangfeld and colleagues analyzed data from the COVID-19 Global Rheumatology Alliance, a doctor-reported observational registry. The register, which was set up on March 24, 2020, contains international data on patients with COVID-19 and an existing rheumatic disease. As of July 1, 2020, it contained information on 3,830 patients.

Pedro M.. Machado

The researchers focused on the period from March 24, 2020 to July 1, 2020 and analyzed age, gender, smoking status, comorbidities, diagnosis of rheumatic diseases, disease activity, and drugs – all as covariates in multivariable logistic regression models. The analyzes were further stratified according to the categories of rheumatic diseases. The primary outcome was death related to COVID-19. In total, the registry included 3,729 patients with complete information on death, age, gender, and DMARD therapy. 390 died among these patients.

The most common rheumatic diseases among the patients included were rheumatoid arthritis with 37.4%, connective tissue diseases other than systemic lupus erythematosus with 14.3%, SLE with 10.5%, psoriatic arthritis with 11.8% and other spondyloarthritis with 11, 6%.

According to the researchers, independent factors related to death related to COVID-19 were age – 66 to 75 years (OR = 3; 95% CI, 2.13-4.22) and older than 75 years (OR = 6 , 18; 95% CI), 4.47-8.53), both compared to 65 years of age or younger – male sex (OR = 1.46; 95% CI, 1.11-1.91), hypertension combined with Cardiovascular diseases (OR = 1.89; 95% CI, 1.31-2.73); chronic lung disease (OR = 1.68; 95% CI, 1.26-2.25) and a prednisolone-equivalent dose of more than 10 mg per day compared to no glucocorticoid intake (OR = 1.69; 95% CI, 1.18-2.41).

In addition, moderate and high disease activity compared to remission and low disease activity were associated with a higher probability of death associated with COVID-19 (OR = 1.87; 1.27-2.77). Treatment with rituximab (Rituxan; Genentech, Biogen) (OR = 4.04; 95% CI, 2.32-7.03), sulfasalazine (OR = 3.6; 95% CI, 1.66-7.78) , Immunosuppressants – azathioprine, cyclophosphamide, ciclosporin, mycophenolate, or tacrolimus – (OR = 2.22; 95% CI, 1.43-3.46) and not receiving DMARDs (OR = 2.11; 95% CI, 1, 48-3.01) were also associated with a higher probability of death compared to methotrexate monotherapy.

“Overall, this article highlights that the risk of dying from COVID-19 varies depending on people’s underlying disease activity and the medicine they take,” Machado said. “It is important that people with rheumatic disease continue to control disease activity with anti-rheumatic drugs, preferably without increasing the dose of glucocorticoids if possible.”

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