COVID-19 Hospitalization Outcomes Among Patients With Autoimmune Rheumatic Diseases in the United States.

Ahmad Khalaf, Garad Ibrahim, Spencer Goble, Marcela Kuijpers, Rawad Nasr
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Abstract

Objectives: To investigate the outcomes of COVID-19-related hospitalizations among patients with autoimmune rheumatic diseases (ARDs) in the United States in 2020. The primary outcome was in-hospital mortality, and secondary outcomes included intubation rate, length of hospital stay (LOS), and total hospital charges (THCs).

Methods: Data for the study were obtained from the National Inpatient Sample database and included patients who were hospitalized with a principal diagnosis of COVID-19. Univariable and multivariable logistic regression analyses were conducted to calculate odds ratios for the outcomes, adjusting for age, sex, and comorbidities.

Results: Out of the 1,050,720 COVID-19 admissions, 30,775 had an ARD diagnosis. The unadjusted analysis showed higher mortality (12.21%) and intubation (9.2%) rates in the ARD group compared with the non-ARD group (mortality rate: 11.14%, P = 0.013; intubation rate: 8.5%, P = 0.048). However, this difference was not significant after adjusting for confounding factors. The mean LOS and THCs did not differ significantly between the two groups. Among all ARD subgroups, the vasculitis group had significantly higher intubation rate, LOS, and THC.

Conclusion: The study suggests that ARD is not associated with an increased risk of mortality or worse outcomes among patients hospitalized with COVID-19 after adjusting for confounding factors. However, the vasculitis group had poorer outcomes during COVID-19 hospitalizations. Further studies are needed to evaluate the effect of ARD activity and immunosuppressants on outcomes. Additionally, more research is required to investigate the relationship between COVID-19 and vasculitis.

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美国自身免疫性风湿病患者的COVID-19住院结果
目的:了解2020年美国自身免疫性风湿性疾病(ARDs)患者与covid -19相关的住院治疗结果。主要结局是住院死亡率,次要结局包括插管率、住院时间(LOS)和总住院费用(THCs)。方法:本研究的数据来自国家住院患者样本数据库,包括主要诊断为COVID-19的住院患者。进行单变量和多变量logistic回归分析,计算结果的优势比,调整年龄、性别和合并症。结果:在1,050,720例COVID-19入院患者中,30,775例患有ARD诊断。未经校正的分析显示,与非ARD组相比,ARD组的死亡率(12.21%)和插管率(9.2%)更高(死亡率:11.14%,P = 0.013;插管率8.5%,P = 0.048)。然而,在调整混杂因素后,这种差异并不显著。两组间平均LOS和thc无显著差异。在所有ARD亚组中,血管炎组的插管率、LOS和THC均显著高于血管炎组。结论:该研究表明,在调整混杂因素后,ARD与COVID-19住院患者死亡风险增加或预后恶化无关。然而,血管炎组在COVID-19住院期间的预后较差。需要进一步的研究来评估ARD活性和免疫抑制剂对预后的影响。此外,还需要更多的研究来调查COVID-19与血管炎的关系。
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