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Temporal trends in COVID-19 outcomes among patients with systemic autoimmune rheumatic diseases: From the first wave to Omicron

OBJECTIVES: To investigate temporal trends in incidence and severity of COVID-19 among patients with systemic autoimmune rheumatic diseases (SARDs) from the first wave through the Omicron wave. METHODS: We conducted a retrospective cohort study investigating COVID-19 outcomes among SARD patients sys...

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Detalles Bibliográficos
Autores principales: Kawano, Yumeko, Patel, Naomi J., Wang, Xiaosong, Cook, Claire E., Vanni, Kathleen M.M., Kowalski, Emily N., Banasiak, Emily P., Qian, Grace, DiIorio, Michael, Hsu, Tiffany Y. T., Weinblatt, Michael E., Todd, Derrick J., Wallace, Zachary S., Sparks, Jeffrey A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cold Spring Harbor Laboratory 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238187/
https://www.ncbi.nlm.nih.gov/pubmed/35765565
http://dx.doi.org/10.1101/2022.06.19.22276599
Descripción
Sumario:OBJECTIVES: To investigate temporal trends in incidence and severity of COVID-19 among patients with systemic autoimmune rheumatic diseases (SARDs) from the first wave through the Omicron wave. METHODS: We conducted a retrospective cohort study investigating COVID-19 outcomes among SARD patients systematically identified to have confirmed COVID-19 from March 1, 2020 to January 31, 2022 at a large healthcare system in Massachusetts. We tabulated COVID-19 counts of total and severe cases (hospitalizations or deaths) and compared the proportion with severe COVID-19 by calendar period and by vaccination status. We used logistic regression to estimate the ORs for severe COVID-19 for each period compared to the early COVID-19 period (reference group). RESULTS: We identified 1449 SARD patients with COVID-19 (mean age 58.4 years, 75.2% female, 33.9% rheumatoid arthritis). There were 399 (27.5%) cases of severe COVID-19. The proportion of severe COVID-19 outcomes declined over calendar time (p for trend <0.001); 45.6% of cases were severe in the early COVID-19 period (March 1-June 30, 2020) vs. 14.7% in the Omicron wave (December 17, 2021-January 31, 2022; adjusted odds ratio 0.29, 95%CI 0.19–0.43). A higher proportion of those unvaccinated were severe compared to not severe cases (78.4% vs. 59.5%). CONCLUSIONS: The proportion of SARD patients with severe COVID-19 has diminished since early in the pandemic, particularly during the most recent time periods, including the Omicron wave. Advances in prevention, diagnosis, and treatment of COVID-19 may have improved outcomes among SARD patients.