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  • Correspondence on ‘Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry’ by Gianfrancesco et al. Disease activity, rather than gluco…

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Correspondence
Correspondence on ‘Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry’ by Gianfrancesco et al. Disease activity, rather than glucocorticoid therapy, may be associated with COVID-19 severity in patients with rheumatic musculoskeletal diseases
  1. Alessandro Giollo1,
  2. Eugenia Bertoldo1,
  3. Giovanni Adami1,
  4. Adam J Cybulski2,
  5. Angelo Fassio1,
  6. Giovanni Orsolini1,
  7. Luca Idolazzi1,
  8. Davide Gatti1,
  9. Ombretta viapiana1,
  10. Maurizio Rossini1
  1. 1 Department of Medicine, Rheumatology Unit, Universita degli Studi di Verona, Verona, Italy
  2. 2 Department of Radiology, University of Verona, Verona, Veneto, Italy
  1. Correspondence to Dr Alessandro Giollo, Department of Medicine, Rheumatology Unit, Universita degli Studi di Verona, Verona 37134, Italy; alessandrogiollo{at}gmail.com

https://doi.org/10.1136/annrheumdis-2020-218845

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    The COVID-19 Global Rheumatology Alliance physician-reported registry has provided data on 600 individuals with rheumatic musculoskeletal disease (RMD) and COVID-19,1 277 (46%) of whom were hospitalised. The study was not powered to explore the association between disease activity and hospitalisation status; still, it was deemed to be non-significant (p=0.49). However, only 18% of patients had moderate and just 2% high disease activity. Therefore, the relationship between disease activity and COVID-19 severity deserves further investigation.

    We collected clinical data of patients with RMD older than 18 years who reported a hospital admission for COVID-19 between 15 April and 15 June 2020. We retrieved 11 out of 1974 patients with RMD followed up in our rheumatology unit (0.55%) who tested positive for SARS-CoV-2 with real-time reverse transcription PCR analysis in the nasopharyngeal swab. We compared five patients with active versus six with remission disease status defined according to (1) persistency of signs or symptoms due to RMD for >50% of the time in the 3 months’ prior hospital admission plus (2) laboratory or imaging abnormalities typical of disease activity or (3) escalation of treatment for the RMD (increase in the dose of immunosuppressive treatment, adding a drug or …

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    Footnotes

    • Collaborators Not applicable.

    • Contributors AG provided the conception of the study, literature search and interpretation of data, drafted the article and revised it critically for important intellectual content; EB provided data search, interpretation of data, drafted the article and revised it critically for important intellectual content; AJ reviewed and commented on radiology images, provided interpretation of data, drafted the article and revised it critically for important intellectual content; GA, AF, GO, LI, OV, DG and MR revised the article critically for important intellectual content. All authors gave the final approval of the version to be submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, conduct, reporting or dissemination plans of this research.

    • Provenance and peer review Commissioned; externally peer reviewed.

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