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  • Prevalence, admission rates and hypoxia due to COVID-19 in patients with rheumatic disorders treated with targeted synthetic or biologic disease modifying antirheumatic drugs or methotrexate: a nationwide study from Iceland

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Prevalence, admission rates and hypoxia due to COVID-19 in patients with rheumatic disorders treated with targeted synthetic or biologic disease modifying antirheumatic drugs or methotrexate: a nationwide study from Iceland
  1. Aron Hjalti Bjornsson1,2,
  2. Gerdur Grondal3,
  3. Mar Kristjansson1,
  4. Thorunn Jonsdottir4,
  5. Thorvardur Jon Love2,
  6. Bjorn Gudbjornsson2,5
  7. ICEBIO
  1. 1 Medicine, National University Hospital of Iceland, Reykjavik, Iceland
  2. 2 Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
  3. 3 Rheumatology, National University Hospital of Iceland, Reykjavik, Capital, Iceland
  4. 4 Rheumatology, Landspítali University Hospital, Reykjavik, Iceland
  5. 5 Centre for Rheumatology Research, National University Hospital of Iceland, Reykjavik, Iceland
  1. Correspondence to Dr Aron Hjalti Bjornsson, Medicine, National University Hospital of Iceland, 101 Reykjavik, Iceland; aronh{at}landspitali.is

https://doi.org/10.1136/annrheumdis-2020-219564

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    Susceptibility and tolerance to COVID-19 of patients with rheumatic disorders remains poorly understood. A recent meta-analysis did not demonstrate any considerably worse outcomes.1 Sufferers from inflammatory rheumatic disorders are, however, known to be more prone to infections than the general population and this risk is increased by targeted biologic therapy.2 3 Therefore, we were interested in examining the risk of admission and respiratory failure in patients with rheumatic disorders with COVID-19 being treated with targeted synthetic or biologic disease-modifying anti-rheumatic drugs (ts/bDMARDs), comparing them to matched comparators and methotrexate (MTX) users within Iceland. Unique conditions exist in Iceland for this study, as the island nation is naturally isolated and performed extensive screening, tracing and systematic registration of all PCR-confirmed cases.4 5 All diagnosed individuals received regular follow-up by a COVID-19 outpatient clinic.6

    ICEBIO is a nationwide registry of patients with inflammatory arthritis treated with ts/bDMARDs. We included all patients in ICEBIO undergoing treatment at the start of the domestic outbreak. From the Icelandic Medicine Database we extracted all MTX prescriptions filled in the 9 months before Iceland’s first recorded case of COVID-19. Each individual from the ICEBIO and MTX groups was randomly matched …

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