P071 A case series of rheumatic disease patients diagnosed with COVID-19 Feb 2020 to March 2021 at the hospital that reported London’s index case of COVID-19
Authors: Pilcher James , Yanni Ghada , Lutalo Pamela , Pollard Louise 
Published: April 2022

Background/Aims

The aim of this study is to describe demographics features and outcomes of patients with rheumatic diseases diagnosed with COVID-19 in a single hospital.

Methods

Patients with rheumatic diseases and COVID-19 were identified via rheumatology outpatient and inpatient hospital admissions between February 2020 and March 2021. Data was collected retrospectively using the electronic medical records system and in-person and telephone consultations. The data was entered into the COVID-19 Global Rheumatology Alliance (GRA) Registry. Data collected included age, gender, ethnicity, smoker status, rheumatic disease, co-morbidities, drug history and vaccine status. Patient outcome was recorded as mortality, recovered (including days to recovery) or symptoms persisting over 90 days (&gt;90). Requirement for hospital admission was also recorded. Comparison was made to the published GRA Registry data.

Results

Forty-three patients were identified; 33 Female (77%),10 (23%) male. Median age 52. 22 Caucasian, 12 Black, 3 mixed race, 2 Asian, 2 Hispanic and 5 unknown. Rheumatoid arthritis (14 patients; 33%) was the most common disease. Other diagnoses included psoriatic arthritis (6; 14%), systemic lupus erythematosus (4: 9%), Sjogrens syndrome (4: 9%) and ankylosing spondylitis (4; 9%). The most common disease modifying antirheumatic drug (DMARD) was methotrexate (35%) followed by hydroxychloroquine (33%). Eight patients were taking steroids (19%). Factors associated with hospitalisation were older age (57% age ≥ 52 vs 40% &lt; 52), multiple co-morbidities (71% ≥ 2 co-morbidities vs 35% &lt; 2 co-morbidities) and black ethnicity (75% black vs 26% of caucasian). These risk factors for morbidity are similar to the UK background population and published COVID-19 GRA data. There was no increased risk of hospitalisation between different DMARDs (53% on methotrexate required admission vs 50% on hydroxychloroquine). 71% of patients on steroids required admission. The overall study cohort had a 49% hospital admission rate. Similar risk factors were identified for persistence of symptoms &gt; 90; 27% of black patients vs 5% of caucasian and 24% of patients with &gt; 2 co-morbidities vs 10% of patients with &lt; 2 co-morbidities. Age did not follow the same trend as hospitalisation; 10% of patients age ≥ 52 vs 20% of patients &lt; 52 had symptoms &gt; 90. 15% on methotrexate had a recovery time &gt; 90 vs 7% on hydroxychloroquine and 14% on steroids. The overall cohort had a 17% rate of patients having symptoms &gt; 90. Mortality rate within the cohort was 5% (2 patients).

Conclusion

A case-series of 43 patients with rheumatic diseases and COVID-19 was conducted. The risk factors for hospitalisation, mortality and persistence &gt;90 were similar to other studies. Most significantly the findings show a correlation between black ethnicity and increased risk of all mortality, hospitalisation and symptoms &gt; 90. There was no difference in hospitalisation and different DMARDs.

Disclosure

J. Pilcher: None. G. Yanni: None. P. Lutalo: None. L. Pollard: None.