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Correspondence on ‘Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis’
  1. Haiyan Yang1,
  2. Jie Xu1,
  3. Li Shi1,
  4. Guangcai Duan1,
  5. Yadong Wang2
  1. 1 Department of Epidemiology, Zhengzhou University, Zhengzhou, Henan, China
  2. 2 Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou, Henan, China
  1. Correspondence to Dr Haiyan Yang, Department of Epidemiology, Zhengzhou University, Zhengzhou 450001, China; yhy{at}; Dr Yadong Wang, Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China; wangyd76{at}

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With great interest, we have read the recent article entitled ‘Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis’, which is published online in Annals of the Rheumatic Diseases.1 In this paper, Akiyama et al performed a meta-analysis to investigate the prevalence and clinical outcomes of coronavirus disease 2019 (COVID-19) in patients with autoimmune diseases.1 The authors observed that there was no significant difference in death between COVID-19 patients with autoimmune diseases and those without (odds ratio (OR)=0.545, 95% confidence interval (CI): 0.081 to 3.682).1 It is an extremely interesting study. But, their findings were based on only five published studies. Up to now, a considerable number of studies on this topic are emerging. Therefore, the association between autoimmune diseases and COVID-19 mortality is needed to be clarified on the basis of updated data by a quantitative meta-analysis.

We performed this meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.2 A comprehensive literature search was performed in electronic databases including PubMed, Web of Science and EMBASE to identify eligible studies from 1 January 2020 to 23 December 2020 using the following keywords: ‘coronavirus disease 2019’ or ‘COVID-19’ or ‘severe acute respiratory syndrome coronavirus-2’ or ‘SARS-CoV-2’ and ‘autoimmune diseases’ or ‘rheumatic diseases’ or ‘inflammatory bowel disease’ or ‘psoriasis’ or ‘systemic lupus erythematosus’ and ‘mortality’ or ‘death’ or ‘fatality’ or ‘non-survivor’ or ‘deceased’. The reference lists of relevant literatures were also reviewed to identify missing studies. We included articles …

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  • Contributors YW and HY designed the study. JX and LS performed literature search. HY and JX performed data extraction. JX, HY, LS and GD performed statistical analyses. HY, JX and YW wrote and reviewed the manuscript. All the authors approved the final version of the manuscript.

  • Funding This study was supported by grants from the National Natural Science Foundation of China (grant number 81973105), Key Scientific Research Project of Henan Institution of Higher Education (grant number 21A330008), the National Science and Technology Major Projects of China (grant number 2018ZX10301407) and Joint Construction Project of Henan Medical Science and Technology Research Plan (grant number LHGJ20190679).

  • Disclaimer The funders have no role in the data collection, data analysis, preparation of manuscript and decision to submission.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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