COVID-19 infection, admission and death and the impact of corticosteroids among people with rare autoimmune rheumatic disease during the second wave of COVID-19 in England: results from the RECORDER Project

Megan Rutter, Peter C. Lanyon, Matthew J. Grainge, Richard Hubbard, Mary Bythell, Peter Stilwell, Jeanette Aston, Sean McPhail, Sarah Stevens, Fiona A. Pearce

Research output: Journal PublicationArticlepeer-review

3 Citations (Scopus)

Abstract

Objectives: To calculate the rates of COVID-19 infection and COVID-19-related death among people with rare autoimmune rheumatic diseases (RAIRD) during the second wave of the COVID-19 pandemic in England, and describe the impact of corticosteroids on outcomes. Methods: Hospital Episode Statistics data were used to identify people alive on 1 August 2020 with ICD-10 codes for RAIRD from the whole population of England. Linked national health records were used to calculate rates and rate ratios of COVID-19 infection and death up to 30 April 2021. Primary definition of COVID-19-related death was mention of COVID-19 on the death certificate. NHS Digital and Office for National Statistics general population data were used for comparison. The association between 30-day corticosteroid usage and COVID-19-related death, COVID-19-related hospital admissions and all-cause deaths was also described. Results: Of 168 330 people with RAIRD, 9961 (5.92%) had a positive COVID-19 PCR test. The age-standardized infection rate ratio between RAIRD and the general population was 0.99 (95% CI: 0.97, 1.00). 1342 (0.80%) people with RAIRD died with COVID-19 on their death certificate and the age–sex-standardized mortality rate for COVID-19-related death was 2.76 (95% CI: 2.63, 2.89) times higher than in the general population. There was a dose-dependent relationship between 30-day corticosteroid usage and COVID-19-related death. There was no increase in deaths due to other causes. Conclusions: During the second wave of COVID-19 in England, people with RAIRD had the same risk of COVID-19 infection but a 2.76-fold increased risk of COVID-19-related death compared with the general population, with corticosteroids associated with increased risk.

Original languageEnglish
Pages (from-to)3828-3837
Number of pages10
JournalRheumatology
Volume62
Issue number12
DOIs
Publication statusPublished - 1 Dec 2023
Externally publishedYes

Keywords

  • COVID-19
  • coronavirus
  • epidemiology
  • infection
  • mortality
  • rare autoimmune rheumatic diseases
  • shielding

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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