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SARS – CoV ‐2 Infection and COVID ‐19 Outcomes in Rheumatic Diseases: A Systematic Literature Review and Meta‐Analysis
Author(s) -
Conway Richard,
Grimshaw Alyssa A.,
Konig Maximilian F.,
Putman Michael,
DuarteGarcía Alí,
Tseng Leslie Yingzhijie,
Cabrera Diego M.,
Chock Yu Pei Eugenia,
Degirmenci Huseyin Berk,
Duff Eimear,
Egeli Bugra Han,
Graef Elizabeth R.,
Gupta Akash,
Harkins Patricia,
Hoyer Bimba F.,
Jayatilleke Arundathi,
Jin Shangyi,
Kasia Christopher,
Khilnani Aneka,
Kilian Adam,
Kim Alfred H. J.,
Lin Chung Mun Alice,
Low Candice,
Proulx Laurie,
Sattui Sebastian E.,
Singh Namrata,
Sparks Jeffrey A.,
Tam Herman,
UgarteGil Manuel F.,
Ung Natasha,
Wang Kaicheng,
Wise Leanna M.,
Yang Ziyi,
Young Kristen J.,
Liew Jean W.,
Grainger Rebecca,
Wallace Zachary S.,
Hsieh Evelyn
Publication year - 2022
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.42030
Subject(s) - medicine , meta analysis , odds ratio , confidence interval , observational study , mechanical ventilation , intensive care unit , population , relative risk , intensive care medicine , environmental health
Objective The relative risk of SARS–CoV‐2 infection and COVID‐19 disease severity among people with rheumatic and musculoskeletal diseases (RMDs) compared to those without RMDs is unclear. This study was undertaken to quantify the risk of SARS–CoV‐2 infection in those with RMDs and describe clinical outcomes of COVID‐19 in these patients. Methods We conducted a systematic literature review using 14 databases from January 1, 2019 to February 13, 2021. We included observational studies and experimental trials in RMD patients that described comparative rates of SARS–CoV‐2 infection, hospitalization, oxygen supplementation/intensive care unit (ICU) admission/mechanical ventilation, or death attributed to COVID‐19. Methodologic quality was evaluated using the Joanna Briggs Institute critical appraisal tools or the Newcastle‐Ottawa scale. Risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated, as applicable for each outcome, using the Mantel‐Haenszel formula with random effects models. Results Of the 5,799 abstracts screened, 100 studies met the criteria for inclusion in the systematic review, and 54 of 100 had a low risk of bias. Among the studies included in the meta‐analyses, we identified an increased prevalence of SARS–CoV‐2 infection in patients with an RMD (RR 1.53 [95% CI 1.16–2.01]) compared to the general population. The odds of hospitalization, ICU admission, and mechanical ventilation were similar in patients with and those without an RMD, whereas the mortality rate was increased in patients with RMDs (OR 1.74 [95% CI 1.08–2.80]). In a smaller number of studies, the adjusted risk of outcomes related to COVID‐19 was assessed, and the results varied; some studies demonstrated an increased risk while other studies showed no difference in risk in patients with an RMD compared to those without an RMD. Conclusion Patients with RMDs have higher rates of SARS–CoV‐2 infection and an increased mortality rate.