Department of Rheumatology, Center for Rheumatology and Spine Diseases, Rigshospitalet HovedOrtoCentret, Kobenhavn, Denmark
Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Kobenhavn, Denmark.
Ann Rheum Dis. 2023 Oct;82(10):1359-1367. doi: 10.1136/ard-2023-223974. Epub 2023 Jul 6.
In a setting with an extensive SARS-CoV-2 test strategy and availability of effective vaccines, we aimed to investigate if patients with inflammatory rheumatic diseases (IRD) face greater risk of contracting SARS-CoV-2 and have a worse prognosis of increased risk of hospitalisation, assisted ventilation and death compared with the general population.
This was a nationwide, population-based register study that compared outcomes of SARS-CoV-2 infection in Danish patients with IRD (n=66 840) with matched population controls (n=668 400). The study period was from March 2020 to January 2023. Cox regression analyses were used to calculate incidence rate ratios (IRRs) for SARS-CoV-2-related outcomes.
We observed a difference in time to first and second positive SARS-CoV-2 test in patients with IRD compared with the general population (IRR 1.06, 95% CI 1.05 to 1.07) and (IRR 1.21, 95% CI 1.15 to 1.27). The risks of hospital contact with COVID-19 and severe COVID-19 were increased in patients with IRD compared with population controls (IRR 2.11, 95% CI 1.99 to 2.23) and (IRR 2.18, 95% CI 1.94 to 2.45). The risks of assisted ventilation (IRR 2.33, 95% CI 1.89 to 2.87) and COVID-19 leading to death were increased (IRR 1.98, 95% CI 1.69 to 2.33). Patients with IRD had more comorbidities compared with the general population. A third SARS-CoV-2 vaccination was associated with a reduced need for hospitalisation with COVID-19 and reduced the risk of death.
Patients with IRD have a risk of SARS-CoV-2, which nearly corresponds to the general population but had a substantial increased risk of hospitalisation with COVID-19, severe COVID-19, requiring assisted ventilation and COVID-19 leading to death, especially in patients with comorbidities.
在广泛应用 SARS-CoV-2 检测策略和有效疫苗的环境下，我们旨在研究炎症性风湿病 (IRD) 患者是否面临更高的感染 SARS-CoV-2 的风险，以及与普通人群相比，住院、辅助通气和死亡风险增加的预后是否更差。
这是一项全国性的基于人群的登记研究，比较了丹麦 IRD 患者（n=66840）和匹配的人群对照（n=668400）的 SARS-CoV-2 感染结局。研究期间为 2020 年 3 月至 2023 年 1 月。使用 Cox 回归分析计算 SARS-CoV-2 相关结局的发病率比值 (IRR)。
与普通人群相比，IRD 患者首次和第二次 SARS-CoV-2 检测呈阳性的时间存在差异（IRR 1.06，95%CI 1.05 至 1.07）和（IRR 1.21，95%CI 1.15 至 1.27）。IRD 患者与人群对照相比，COVID-19 住院接触和严重 COVID-19 的风险增加（IRR 2.11，95%CI 1.99 至 2.23）和（IRR 2.18，95%CI 1.94 至 2.45）。辅助通气（IRR 2.33，95%CI 1.89 至 2.87）和 COVID-19 导致死亡的风险增加（IRR 1.98，95%CI 1.69 至 2.33）。与普通人群相比，IRD 患者合并症更多。第三次 SARS-CoV-2 疫苗接种与 COVID-19 住院需求减少相关，并降低死亡风险。
IRD 患者感染 SARS-CoV-2 的风险与普通人群相当，但 COVID-19、严重 COVID-19、需要辅助通气和 COVID-19 导致死亡的住院风险显著增加，尤其是在合并症患者中。
