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Correspondence on ‘Impact of the COVID-19 pandemic on morbidity and mortality in patients with inflammatory joint diseases and in the general population: a nationwide Swedish cohort study’
  1. Liang En Wee1,
  2. Edwin Philip Conceicao2,
  3. Jing Yuan Tan3,
  4. Julian Thumboo4,
  5. Indumathi Venkatachalam1,2
  1. 1Infectious Diseases, Singapore General Hospital, Singapore
  2. 2Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
  3. 3Internal Medicine, Singapore General Hospital, Singapore
  4. 4Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
  1. Correspondence to Dr Liang En Wee, Infectious Diseases, Singapore General Hospital, Singapore, Singapore; ian.wee{at}

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We read with interest the article by Bower et al detailing the impact of the COVID-19 pandemic on mortality and morbidity among patients with rheumatic diseases (RDs).1 Though Bower et al reported that the risks of severe COVID-19-related outcomes among patients with RD, such as increased risk of hospitalisation and death, were largely proportionate to those in the general population and explained by comorbidities, risks of severe COVID-19-related outcomes were still increased among patients with RD.1 Indeed, in a separate cohort of inpatients with systemic lupus erythematosus and concomitant SARS-CoV-2 infection, almost one-fifth required intensive care unit admission.2 Outside the pandemic setting, however, common respiratory viral infections (RVIs), including influenza, still remain a significant cause of morbidity and mortality among patients with RD. Increased influenza incidence has been reported among patients with RD,3 and various anti-RD therapies are associated with increased frequency of RVIs.4 Public health measures, such as influenza vaccination, are hence recommended for RVI prevention in patients with RD,5 though most RVIs are not vaccine-preventable. The COVID-19 pandemic …

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  • Contributors Concept and design: IW: analysis of data: IW and EPC; drafting of manuscript: IW, JYT, JT and IV; supervision: IV

  • 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 not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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