학술논문
Characteristics associated with poor COVID-19 outcomes in people with psoriasis, psoriatic arthritis and axial spondyloarthritis: data from the COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries
Document Type
article
Author
Machado, Pedro M; Schäfer, Martin; Mahil, Satveer K; Liew, Jean; Gossec, Laure; Dand, Nick; Pfeil, Alexander; Strangfeld, Anja; Regierer, Anne Constanze; Fautrel, Bruno; Alonso, Carla Gimena; Saad, Carla GS; Griffiths, Christopher EM; Lomater, Claudia; Miceli-Richard, Corinne; Wendling, Daniel; Rodriguez, Deshire Alpizar; Wiek, Dieter; Mateus, Elsa F; Sirotich, Emily; Soriano, Enrique R; Ribeiro, Francinne Machado; Omura, Felipe; Martins, Frederico Rajão; Santos, Helena; Dau, Jonathan; Barker, Jonathan N; Hausmann, Jonathan; Hyrich, Kimme L; Gensler, Lianne; Silva, Ligia; Jacobsohn, Lindsay; Carmona, Loreto; Pinheiro, Marcelo M; Zelaya, Marcos David; de los Ángeles Severina, María; Yates, Mark; Dubreuil, Maureen; Gore-Massy, Monique; Romeo, Nicoletta; Haroon, Nigil; Sufka, Paul; Grainger, Rebecca; Hasseli, Rebecca; Lawson-Tovey, Saskia; Bhana, Suleman; Pham, Thao; Olofsson, Tor; Bautista-Molano, Wilson; Wallace, Zachary S; Yiu, Zenas ZN; Yazdany, Jinoos; Robinson, Philip C; Smith, Catherine H
Source
Annals of the Rheumatic Diseases. 82(5)
Subject
Language
Abstract
ObjectivesTo investigate factors associated with severe COVID-19 in people with psoriasis (PsO), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).MethodsDemographic data, clinical characteristics and COVID-19 outcome severity of adults with PsO, PsA and axSpA were obtained from two international physician-reported registries. A three-point ordinal COVID-19 severity scale was defined: no hospitalisation, hospitalisation (and no death) and death. ORs were estimated using multivariable ordinal logistic regression.ResultsOf 5045 cases, 18.3% had PsO, 45.5% PsA and 36.3% axSpA. Most (83.6%) were not hospitalised, 14.6% were hospitalised and 1.8% died. Older age was non-linearly associated with COVID-19 severity. Male sex (OR 1.54, 95% CI 1.30 to 1.83), cardiovascular, respiratory, renal, metabolic and cancer comorbidities (ORs 1.25-2.89), moderate/high disease activity and/or glucocorticoid use (ORs 1.39-2.23, vs remission/low disease activity and no glucocorticoids) were associated with increased odds of severe COVID-19. Later pandemic time periods (ORs 0.42-0.52, vs until 15 June 2020), PsO (OR 0.49, 95% CI 0.37 to 0.65, vs PsA) and baseline exposure to TNFi, IL17i and IL-23i/IL-12+23i (OR 0.57, 95% CI 0.44 to 0.73; OR 0.62, 95% CI 0.45 to 0.87; OR 0.67, 95% CI 0.45 to 0.98; respectively; vs no disease-modifying antirheumatic drug) were associated with reduced odds of severe COVID-19.ConclusionOlder age, male sex, comorbidity burden, higher disease activity and glucocorticoid intake were associated with more severe COVID-19. Later pandemic time periods, PsO and exposure to TNFi, IL17i and IL-23i/IL-12+23i were associated with less severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with PsO, PsA and axSpA during COVID-19 waves or similar future respiratory pandemics.