COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries

Authors：Tan, Eng Hooi; Sena, Anthony G.; Prats-Uribe, Albert; You, Seng Chan; Ahmed, Waheed-Ul-Rahman; Kostka, Kristin; Reich, Christian; Duvall, Scott L.; Lynch, Kristine E.; Matheny, Michael E.; Duarte-Salles, Talita; Bertolin, Sergio Fernandez; Hripcsak, George; Natarajan, Karthik; Falconer, Thomas; Spotnitz, Matthew; Ostropolets, Anna; Blacketer, Clair; Alshammari, Thamir M.; Alghoul, Heba; Alser, Osaid; Lane, Jennifer C. E.; Dawoud, Dalia M.; Shah, Karishma; Yang, Yue; Zhang, Lin; Areia, Carlos

Source：RHEUMATOLOGY, 2021, 60: SI37-SI50.

DOI：10.1093/rheumatology/keab250

• COVID-19
• autoimmune condition
• mortality
• hospitalization
• open science
• Observational Health Data Sciences and Informatics (OHDSI)
• Observational Medical Outcomes Partnership (OMOP)

Objective. Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization with COVID-19 among patients with prevalent autoimmune diseases, and compared outcomes after hospital admissions among similar patients with seasonal influenza. @@@ Methods. A multinational network cohort study was conducted using electronic health records data from Columbia University Irving Medical Center [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017-18 were included. Outcomes were death and complications within 30days of hospitalization. @@@ Results. We studied 133589 patients diagnosed and 48418 hospitalized with COVID-19 with prevalent autoimmune diseases. Most patients were female, aged >= 50years with previous comorbidities. The prevalence of hypertension (45.5-93.2%), chronic kidney disease (14.0-52.7%) and heart disease (29.0-83.8%) was higher in hospitalized vs diagnosed patients with COVID-19. Compared with 70660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2-4.3% vs 6.32-24.6%). @@@ Conclusion. Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.

• Institution
  南方医科大学; 河北医科大学; 1; 中国医学科学院; 中国医学科学院北京协和医院