Association between rheumatic disease treatments and severity of COVID-19
| All patients (n=694) | Patients with mild infection (n=438) | Patients with moderate infection (n=169) | Patients with severe infection (n=87) | OR (95% CI)* | P value | aOR (95% CI)*† | P value† | |
| Rheumatic or inflammatory disease treatments‡ | ||||||||
| Corticosteroid | 215 (31.1) | 88 (20.1) | 76 (45.2) | 51 (59.3) | 3.93 (2.46–6.26) | <0.001 | 2.25 (1.33–3.79) | 0.002 |
| Daily prednisone ≥10 mg or equivalent | 73 (34.3) | 28 (31.8) | 22 (29.3) | 23 (46.0) | 1.93 (1.01–3.68) | 0.048 | 1.69 (0.83–3.45) | 0.15 |
| NSAIDs§ | 73 (10.5) | 61 (13.9) | 10 (6.0) | 2 (2.3) | 0.22 (0.05–0.66) | 0.022 | 0.50 (0.10–1.58) | 0.31 |
| Colchicine | 24 (3.5) | 12 (2.7) | 8 (4.8) | 4 (4.7) | 1.56 (0.48–4.09) | 0.41 | 3.18 (0.77–11.24) | 0.090 |
| Hydroxychloroquine§ | 57 (8.2) | 40 (9.1) | 13 (7.7) | 4 (4.7) | 0.56 (0.18–1.37) | 0.26 | 1.06 (0.31–2.96) | 0.91 |
| Methotrexate | 252 (36.4) | 164 (37.4) | 62 (36.9) | 26 (30.2) | 0.73 (0.45–1.19) | 0.20 | 0.63 (0.37–1.08) | 0.096 |
| Leflunomide | 27 (3.9) | 19 (4.3) | 8 (4.8) | 0 | NA | NA | NA | NA |
| Sulfasalazine | 9 (1.3) | 5 (1.1) | 4 (2.4) | 0 | NA | NA | NA | NA |
| Mycophenolate mofetil/ mycophenolic acid§ | 16 (2.3) | 9 (2.1) | 4 (2.4) | 3 (3.5) | 1.84 (0.47–5.54) | 0.33 | 7.67 (1.73–28.04) | 0.004 |
| Azathioprine§ | 9 (1.3) | 5 (1.1) | 3 (1.8) | 1 (1.2) | NA | NA | NA | NA |
| IgIV§ | 7 (1.0) | 3 (0.7) | 2 (1.2) | 2 (2.3) | NA | NA | NA | NA |
| Biologics | ||||||||
| Anti-TNF | 202 (29.2) | 170 (38.8) | 25 (14.9) | 7 (8.1) | 0.19 (0.09–0.41) | <0.001 | 0.44 (0.19–1.04) | 0.060 |
| Anti-IL-6§ | 26 (3.8) | 19 (4.3) | 5 (3.0) | 2 (2.3) | 0.70 (0.14–2.21) | 0.61 | 0.63 (0.12–2.28) | 0.54 |
| Rituximab | 34 (4.9) | 16 (3.7) | 7 (4.2) | 11 (12.8) | 3.72 (1.74–7.93) | <0.001 | 4.34 (1.77–10.63) | 0.001 |
| Anti-IL-17a§ | 27 (3.9) | 19 (4.3) | 6 (3.6) | 2 (2.3) | 0.67 (0.14–2.12) | 0.57 | 2.34 (0.45–8.21) | 0.24 |
| Anti-IL-1§ | 8 (1.2) | 3 (0.7) | 3 (1.8) | 2 (2.3) | NA | NA | NA | NA |
| Abatacept§ | 18 (2.6) | 10 (2.3) | 7 (4.2) | 1 (1.2) | 0.59 (0.07–2.39) | 0.55 | 0.37 (0.04–1.80) | 0.31 |
| JAK inhibitor§ | 21 (3.0) | 13 (3.0) | 4 (2.4) | 4 (4.7) | 1.84 (0.56–4.91) | 0.27 | 1.94 (0.54–5.98) | 0.28 |
| Other biologic | 16 (2.3) | 11 (2.5) | 5 (3.0) | 0 | NA | NA | NA | NA |
Values are presented as frequency (percentage) unless otherwise indicated.
Not applicable (NA) when <10/694 patients or when 0 patients with severe infection.
*ORs were calculated for patients with severe infection, using patients with mild or moderate infection as reference.
†Adjusted for age and sex.
‡Two patients with missing information for treatments.
§Penalised logistic regression (Firth method) was used due to low number of patients (n<5) in an analysed group.
aOR, adjusted OR; IgIV, immunoglobulin intravenous; IL, interleukin; NSAIDs, non-steroidal anti-inflammatory drugs; TNF, tumour necrosis factor.