Effects of the COVID-19 pandemic on patients with inflammatory joint diseases in Sweden: from infection severity to impact on care provision. Issue 3 (8th December 2021)

• Record Type: Journal Article
• Authors: Bower, Hannah; Frisell, Thomas; di Giuseppe, Daniela; Delcoigne, Bénédicte; Alenius, Gerd-Marie; Baecklund, Eva; Chatzidionysiou, Katerina; Feltelius, Nils; Forsblad-d'Elia, Helena; Kastbom, Alf; Klareskog, Lars; Lindqvist, Elisabet; Lindström, Ulf; Turesson, Carl; Sjöwall, Christopher; Askling, Johan
• Other Names: author non-byline.; Ahlenius Gerd-Marie author non-byline.; Baecklund Eva author non-byline.; Chatzidionysiou Katerina author non-byline.; Feltelius Nils author non-byline.; Forsblad-d'Elia Helena author non-byline.; Kastbom Alf author non-byline.; Klareskog Lars author non-byline.; Lindqvist Elisabet author non-byline.; Lindström Ulf author non-byline.; Turesson Carl author non-byline.; Sjöwall Christopher author non-byline.; Askling Johan author non-byline.
• Is Part Of: RMD open. Volume 7:Issue 3(2021)
• Publication Date: 2021-12-08
• Subjects: rheumatoid arthritis -- COVID-19 -- treatment -- antirheumatic agents; Musculoskeletal system -- Diseases -- Periodicals; Rheumatism -- Periodicals; 616.7005
• DOI: 10.1136/rmdopen-2021-001987
• Languages: English
• ISSNs: 2056-5933

Abstract

Abstract : Objectives: To compare risks for COVID-19-related outcomes in inflammatory joint diseases (IJDs) and across disease-modifying antirheumatic drugs (DMARDs) during the first two waves of the pandemic and to assess effects of the pandemic on rheumatology care provision. Methods: Through nationwide multiregister linkages and cohort study design, we defined IJD and DMARD use annually in 2015–2020. We assessed absolute and relative risks of hospitalisation or death listing COVID-19. We also assessed the incidence of IJD and among individuals with IJD, rheumatologist visits, DMARD use and incidence of selected comorbidities. Results: Based on 115 317 patients with IJD in 2020, crude risks of hospitalisation and death listing COVID-19 (0.94% and 0.33% across both waves, respectively) were similar during both waves (adjusted HR versus the general population 1.33, 95% CI 1.23 to 1.43, for hospitalisation listing COVID-19; 1.23, 95% CI 1.08 to 1.40 for death listing COVID-19). Overall, biological disease-modifying antirheumatic drugs (bDMARDs)/targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) did not increase risks of COVID-19 related hospitalisation (with the exception of a potential signal for JAK inhibitors) or death. During the pandemic, decreases were observed for IJD incidence (−7%), visits to rheumatology units (−16%), DMARD dispensations (+6.5% for bDMARD/tsDMARDs and −8.5% for conventional synthetic DMARDs compared with previous years) and for new comorbid conditions, but several of these changes were part of underlying secular trends. Conclusions: Patients with IJD are at increased risk of serious COVID-19 outcomes, which may partially be explained by medical conditions other than IJD per se. The SARS-CoV-2 pandemic has exerted measurable effects on aspects of rheumatology care provision demonstrated, the future impact of which will need to be assessed.