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Identification of Risk Factors for COVID‐19 Hospitalization in Patients With Anti‐Rheumatic Drugs: Results From a Multicenter Nested Case Control Study
Author(s) -
Opdam Merel A. A.,
Benoy Sophie,
Verhoef Lise M.,
Van Bijnen Sandra,
LamersKarnebeek Femke,
Traksel René A. M.,
Vos Petra,
den Broeder Alfons A.,
Broen Jasper
Publication year - 2022
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.2551
Subject(s) - medicine , odds ratio , confidence interval , population , confounding , nested case control study , logistic regression , body mass index , case control study , environmental health
Patients with inflammatory rheumatic diseases (IRDs) do not have an increased risk for coronavirus disease 2019 (COVID‐19) compared with the general population. However, it remains uncertain whether subgroups of patients with IRD using different immunosuppressive antirheumatic drugs carry a higher risk for severe COVID‐19 compared with other patients with IRD. The aim of this study is to identify risk factors for severe COVID‐19, requiring hospitalization in patients with IRD. This is a multicenter nested case control study conducted in the Netherlands. Cases are hospital known patients with IRD requiring hospitalization for COVID‐19 between March 1, 2020, and May 31, 2020. Controls are hospital known patients with IRD not requiring hospitalization for COVID‐19 in this period, included at a 4:1 ratio. Patient, disease, and treatment characteristics were extracted from electronic medical records and a questionnaire. Potential risk factors were analyzed using unconditional logistic regression, corrected for confounders and multiple testing. Eighty‐one cases and 396 controls were included. General risk factors of older age and obesity apply to patients with IRD as well (odds ratio (OR) for age ≥ 75 3.5, 95% confidence interval (CI) 1.9–6.3, OR for body mass index ≥ 40 4.5, 95% CI 1.5–14). No significantly increased ORs for COVID‐19 hospitalization were found for any antirheumatic agent or IRD. A protective effect was found for use of methotrexate (OR 0.53, 95% CI 0.31–0.92). In conclusion, similar to the general population, elderly and obese patients with IRD have a higher risk for hospitalization for COVID‐19. We did not identify a specific antirheumatic agent or IRD to increase the risk of COVID‐19 hospitalization in patients with IRD, except for a possible protective effect of methotrexate.