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1Clinical Immunology, Bhagwan Mahaveer Jain Hospital, Bengaluru, Karnataka, India
2Department of Clinical Immunology and Rheumatology, St. John's Medical College Hospital, Bengaluru, Karnataka, India
3Department of Rheumatology, Optima Arthritis and Rheumatology Clinic, Bengaluru, Karnataka, India
4Division of Epidemiology and Biostatistics, St. John’s Research Institute, St. John's Medical College Hospital, Bengaluru, Karnataka, India
V Jain
, V Shobha, S Kumar, R Janardana, S Selvam
Background: The differential influence and outcome of various risk factors on occurrence of COVID-19 among patients with autoimmune rheumatic diseases (AIRD) during different COVID-19 peaks is underreported. Aim: To assess the impact and outcome of conventional risk factors, immunosuppressants, and comorbidities on the risk of COVID-19 among AIRD patients during the first two COVID-19 peaks. Design: Prospective, non-interventional longitudinal cohort study. Methods: This is a subset of the KRA COVID19 cohort undertaken during the initial wave of COVID-19 (W1) (Apr-Dec2021); and the 2nd-wave (W2) (Jan-Aug2021). Data collected included description of AIRD subsets, treatment characteristics, comorbidities, and COVID-19 occurrence. Risk factors associated with mortality were analysed. The incidence rate was compared with that of the general population in the same geographic region. Results: AIRD patients (n=2969) had a higher incidence of COVID-19 in the W2 (7.1%) than in the W1 (1.7%) as compared to the general population (Government bulletin). Age (p<0.01) and duration of AIRD (p<0.001) influenced COVID-19 occurrence in W2 while major disease subsets and immunosuppressants including glucocorticoids did not. The W2 had lower HCQ usage (Adjusted Odds Ratio [AOR]-0.81) and comorbidities like hypertension (AOR -0.54) and pre-existing lung disease (AOR -0.38;0.19-0.75) compared to W1. Older age (1.11) and coexistent diabetes mellitus (AOR 6.74) were independent risk factors associated with mortality in W2. Conclusions: We report 1.7 times higher occurrence, and no influence of major disease subsets or immunosuppressants including glucocorticoids on COVID-19. Age and diabetes were independent risk factors for mortality.
Cite this article as: Jain V, Shobha V, Kumar S, Janardana R, Selvam S. Comparison of Risk Factors During First and Second Wave of COVID-19 in Patients with Autoimmune Rheumatic Diseases (AIRD): Results from KRACC Subset. Mediterr J Rheumatol 2023;34(3):342-8
Article Submitted: 7 Sep 2022; Revised Form: 22 Nov 2022; Article Accepted: 29 Nov 2022; Available Online: 27 Aug 2023
https://doi.org/10.31138/mjr.20230827.co
This work is licensed under a Creative Commons Attribution 4.0 International License.
©2023 The Author(s).
