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  • Response to: ‘Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors’ by Jovani et al

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Correspondence response
Response to: ‘Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors’ by Jovani et al
  1. Kristin M D’Silva1,
  2. Naomi Serling-Boyd1,
  3. Rachel Wallwork1,
  4. Tiffany Hsu2,
  5. Jeffrey A Sparks2,
  6. Zachary S Wallace1
  1. 1 Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA
  2. 2 Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Zachary S Wallace, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA 02114, USA; zswallace{at}partners.org

https://doi.org/10.1136/annrheumdis-2020-218179

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    We appreciate the comments by Jovani et al 1 in response to our manuscript evaluating the outcomes among a cohort of patients with rheumatic diseases and COVID-19.2 We commend the authors for sharing the experience of their patients during the COVID-19 pandemic and would like to reply to some of the queries they posed to us.

    First, Jovani et al wondered why we included age in our multivariable models if we matched on age. This was done because continuous age was matched over a range (±5 years). To further address any potential differences in ages between the study groups (which was minimal), we included age in our multivariable models. Notably, adjusting for age did not change our findings when comparing adjusted to unadjusted models.

    Second, the authors questioned why lymphopaenia and troponin levels were not included in the multivariable models. These laboratory changes may be a result of infection that occurred after the exposure of interest (COVID-19 infection). As such, they should not be adjusted for in models because they may be on the causal pathway between the exposure and outcome (eg, mechanical …

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    Footnotes

    • Handling editor Josef S Smolen

    • Twitter @jeffsparks

    • Contributors KMDS, NS-B, RW, TH, JAS and ZSW contributed to the conception and drafting of the article. All listed authors provided critical revision for important intellectual content and final approval.

    • Funding KMDS and NS-B are supported by the National Institutes of Health (NIH) Ruth L. Kirschstein Institutional National Research Service Award (T32-AR-007258). JAS reports grants from NIH/National Institute of Allergy and Infectious Diseases/Autoimmune Centers of Excellence, the Rheumatology Research Foundation, the Brigham Research Institute and the R. Bruce and Joan M. Mickey Research Scholar Fund, as well as personal fees from Bristol-Myers Squibb, Gilead, Inova, Janssen and Optum. ZSW reports research grants from NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23AR073334 and L30 AR070520) and Bristol Myers Squibb.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

    • Provenance and peer review Commissioned; internally peer reviewed.

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