Autoimmune disease and COVID-19: a multicentre observational study in the United Kingdom
Authors: Arachchillage Deepa J , Rajakaruna Indika , Pericleous Charis , Nicolson Philip L R , Makris Mike , Laffan Mike ,   the CA-COVID-19 Study Group, Dell Amanda , Hall Angela , Roynon Anna , Heron Anne , Price Cheri , Price Claire , Westacott Clare , Barnett Debra , Marshall Gail , Hodkinson Gemma , Mallison Georgia , Okoro Grace , Gwatkin Joshua , Davies Kirstin , Shipp Lucy , Nash Maxine , Hughes Rhian , Mardania Rina , Cutler Sarah Lewis Sean , Allan Caroline , Miah Atiqa , Okaygun Dide , Hart Dan , Dzumbunu Faith , Leveson James , Torre Karen , Taylor Louise , Raheja Priyanka , Mamsa Sara , Ferdousi Tasnima , Everden Angharad , Ngumo Alice , Ahmed Doaa , Venizelou Efstathia , Herdman James , Carpenter Janice , Bartkiewicz Konrad , Cash Rebecca , Riat Renu , Downing Abigail , Guerrero Ana , Etherington Astrid , Gamage Chapa , Gunasekara Dilupa , Morris Lee , Alikhan Raza , Cloudsdale Rebecca , Obaji Samya , Cunningham Stuart , Ndjombo Sylvain , Cowton Amanda , Wilkinson Ami , Kay Andrea , Sebakungu Anne , Thomson Anne , Brady Clare , Egginton Dawn , Brown Ellen , Wright Enid , Rogers Gill , Plaschkes Hannah , Jennings Jacqui , O'Brien Julie , Temple Julie , Potts Kathryn , Stamp Kimberly , Postlethwaite Kelly , Duncan Louise , Randall Margaret , Birt Mark , Kent Melanie , Mounter Philip , Wood Shelly , Hewitson Nicola , Kingston Noreen , Wadd Susan , McAuliffe Sarah , Hobson Stefanie , Riley Susan , Naylor Suzanne , Atkinson Vicki , Hancock Alysha , Deacon Bethan , Pothecary Carla , Hamilton Caroline , Lynch Ceri , Evenden Cerys , Jones Deborah , Davies Ellie , Page Felicity , Kennard-Holden Gareth , John Gavin , Pugh Joanne , Pike Joelle , Mikusek Justyna , Agravante Kevin , Hancock Kia , Geen Lauren , Rees Meryl , Stroud Natalie , Grahamslaw Amanda , Sanderson Amanda , McClelland Beverley , Barry Caitlin , Siddle Elaine , Pearce Lorraine , Blackwell Lucy , Bokhari Maria , Armstrong Maureen , Stoker Wendy , McCormick Wendy , Vlachou Caterina , Garfield Ben , Gaspar Mihaela , Passariello Maurizio , Bianchi Paolo , Ledot Stephane , Madlin Aileen , Everard Kerrianne , Panwar Khushboo , Beacher Natasha , Cole Niamh , Mangles Sarah , Everington Tamara , Reddy Udaya , Shah Alka , Weatherill Anna , Maropoulou Anthi , Herath Bhagya , Hopkins Billy , Vladescu Camelia , Ward Caroline , Copeland Christina Crossette-Thambiah Donna , Pickford Emily , Kapoor Gaurika , Lo Isabella , Kilner John , Boland Keith , Almonte Melanie , Simpson Neil , Bohnacker Niamh , Awomolo Omolade , Trikha Roochi , Hussain Samina , Duro Serah , Kathirgamanathan Sophie , Needham Yasmine , Hui Yee , Alashe Zainab , Abioye Adrienne , Miranda Aileen , Obiorah Christina , Dzienyo Cynthia , Mangal Hasina , Zorraquino Hernan , Roberts Lara N , Racz Mariusz , Johnson Maclaine Hipolito , Ryan Rachel , Swales Tamara , Taran Tatiana , Renshaw Zoe , Langridge Alexander , Evans Benjamin , Weller Callum , Judd Claire , Jerry Douglas , Haynes Euan , Jamil Fatima , McVittie Ian , Hanley John , Parker Julie , Smith Kayleigh , Pickard Keir , Kennedy Laura , Acres Meghan , Wiltshire Mikaela , Ramachandran Nitha , McAlinden Paul , Glancy Paula , Nair Smeera , Almugassabi Tarek , Jarvis Thomas , Coutts Amanda , Laurie Andrew , Owen Deborah , Scott Ian , Cooper Jamie , Kane Leia , Sim Lucy , Abdelrahman Mahmoud , Poulton Victoria , Griffin Jessica , Markwell Ria , Docherty Suzanne , Brown Alexander , Cooper Barbara , Wilkinson Beverley , Armstrong Diane , Fryer Grace , Gregory Jane , Davidson Katherine , Clapham Melanie , Kelsall Nicci , Nicholls Patricia , Hardy Rachel , Oakes Roderick , Harper Rosemary , Abdelhamid Sara , Cooper Theresa , Poultney Una , Saunders Zoe , Ramshaw Alex , Chilvers Alison , Campbell Barbara Jean , Adams Carol , Riley Claire , Wilson Deborah , Wardle Helen , Deane Jill , Skelton Jill , Quigley Julie , Pollard Leigh , Baker Liz , Poole Lynda , Weetman Maria , Clark Michele , Aung Nini , Taylor Rachel , Rowling Sarah , Purvis Sarah , Collins Vicky , Shenfine Amy , Ashbrook-Raby Catherine , Bomken Charlotte , Walker Claire , Cartner Faye , Campbell Helen , Luke Jane , Reynolds Jessica , Kilner Mari , Winder Laura , Patterson Linda , Gallagher Lisa , McLarty Nicola , Robinson Sandra , Dodds Steve , Hall Toni , Wright Victoria , Eordogh Agnes , Rampotas Alexandros , Sanigorska Anna Maria , Deane Christopher , Santos Kristine , Lecocq Olivia , Lay Rochelle , Fletcher Simon , Tarnakina Anna , Tasnim Aniqa , Drebes Anja , Garcia Cecilia , Aradom Elsa , Peralta Mariarita , Tomlin Michaella , Chowdary Pratima , Georgescu Ramona , Mohamed Suluma , Dissanayake Upuli , Powell Carol , Doolan James , Kenworthy Jessica , Bell Joanne , Jones Lewis , Wilkinson Mikiko , Shaw Rebecca , Robinson Ryan , Mukhtar Saman , D'Souza Shane , Dutt Tina , Stocks Tracy , Wade Joshua , Cagova Lenka , Kovzel Maksym , Jooste Rachel , Delaney Alison , Mapplebeck Claire , Walker Alycon , Watson Andrea , Vaux Andrew , Sawar Asia , Hannaway Carol , Jacobs Charlotte , Elliot Claire , Elliott Claire , Mower Craig , Ferro Daiana , Mahmoud Emanuela , Laidlaw Gill , Potts Julie , Harland Keith , Munglani Laura , Fall Lauren , Murray Leanne , Harris Lesley , Wayman Lisa , Westwood Lisa , Watson Louisa , Naylor Lynne , Siddaway Matthew , Robson Paula , Mohan Rita , Essex Sarah , Griffiths Sara , Liggett Steven , Valente Andreia , Kazmi Rashid , Kirby Ruth , Bowmer Sarah , Li Yanli , Longe Alice , Bamford Amy , Lokare Anand , McDarby Andrew , Drozd Aneta , Stretton Cathy , Mulvihill Catia , Ferris Charlotte , McGhee Christopher , McNeill Claire , Bergin Colin , Lynch Daniella , Lenehan Fionnuala , Gilleran Gerry , Lowe Gillian , McIlroy Graham , Jenner Helen , Shackleford Helen , Younis Isma , Gill Jaspret , Musngi Jimmy , Dasgin Joanne , Gresty Joanne , Nyaboko Joseph , Begum Juneka , Festejo Katerine , Lucas Katherine , Price Katie , Bhandal Khushpreet , Gallagher Kristina , Tsakiridou Kyriaki , Cooper Lauren , Wood Louise , Amutike Lulu , Thomas Marie , Kwok Marwan , Kelly Melanie , Bates Michelle , Haider Nafeesah Ahmad , Adams Nicholas , Topping Oliver , Smith Rachel , Joseph Rani Maria , Kadiri Salma , Caddick Samantha , Harrison Samuel , Elmoamly Shereef , Chante Stavroula , Gauhar Sumaiyyah , Ashraf Syed , Kharodia Tabinda , Peterkin Zhane , Graziella Isgro , Yusuff Hakeem , Sutton David , Massey Ian , Di-Silvestro Jade , Hiden Joanne , Johnson Mia , Buka Richard , Lentaigne Claire , Wooding Jackie , Crosbie Nicola , Alvaro Ana , Drasar Emma , Roblin Elen , Santiapillai Georgina , Simpson Kathryn , Gilbert Kayleigh , Jiang Yanrong , Sayar Zara , Al-Khafaji Zehraa 
Published: April 2022

Objective

To establish the demographic characteristics, laboratory findings and clinical outcomes in patients with autoimmune disease (AD) compared with a propensity-matched cohort of patients without AD admitted with COVID-19 to hospitals in the UK.

Methods

This is a multicentre observational study across 26 NHS Trusts. Data were collected both retrospectively and prospectively using a predesigned standardized case record form. Adult patients (≥18 years) admitted between 1 April 2020 and 31 July 2020 were included.

Results

Overall, 6288 patients were included to the study. Of these, 394 patients had AD prior to admission with COVID-19. Of 394 patients, 80 patients with SLE, RA or aPL syndrome were classified as severe rheumatologic AD. A higher proportion of those with AD had anaemia [240 (60.91%) vs 206 (52.28%), P = 0.015], elevated LDH [150 (38.08%) vs 43 (10.92%), P &lt; 0.001] and raised creatinine [122 (30.96%) vs 86 (21.83%), P = 0.01], respectively. A significantly higher proportion of patients with severe rheumatologic AD had elevated CRP [77 (96.25%) vs 70 (87.5%), P = 0.044] and LDH [20 (25%) vs 6 (7.5%), P = 0.021]. Patients with severe rheumatologic AD had significantly higher mortality [32/80 (40%)] compared with propensity matched cohort of patients without AD [20/80 (25%), P = 0.043]. However, there was no difference in 180-day mortality between propensity-matched cohorts of patients with or without AD in general (P = 0.47).

Conclusions

Patients with severe rheumatologic AD had significantly higher mortality. Anaemia, renal impairment and elevated LDH were more frequent in patients with any AD while elevated CRP and LDH were more frequent in patients with severe rheumatologic AD both of which have been shown to associate with increased mortality in patients with COVID-19.