COVID-19 Hospitalization Up With Prednisone in Rheumatic Disease

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For patients with rheumatic disease with COVID-19, glucocorticoids are associated with increased odds of hospitalization, according to a study published in the July issue of the Annals of Rheumatic Diseases.

Milena Gianfrancesco, Ph.D., M.P.H., from the University of California San Francisco, and colleagues examined demographic and clinical factors associated with COVID-19 hospitalization status in individuals with rheumatic disease using data from March 24 to April 20, 2020. Six hundred cases from 40 countries were included.

The researchers found that 46 percent of cases were hospitalized and 9 percent died. Prednisone dose ≥10 mg/day was associated with increased odds of hospitalization in multivariable adjusted models (odds ratio, 2.05; 95 percent confidence interval [CI], 1.06 to 3.96). There was no association seen for use of conventional disease-modifying antirheumatic drugs alone or in combination with biologics/Janus Kinase inhibitors (odds ratios, 1.23 [95 percent CI, 0.70 to 2.17] and 0.74 [95 percent CI, 0.37 to 1.46], respectively). There was no association noted for nonsteroidal anti-inflammatory drug use with hospitalization status (odds ratio, 0.64; 95 percent CI, 0.39 to 1.06). Reduced odds of hospitalization were seen in association with tumor necrosis factor inhibitor use (odds ratio, 0.40; 95 percent CI, 0.19 to 0.81), while no link was seen with antimalarial use (odds ratio, 0.94; 95 percent CI, 0.57 to 1.57).

"With additional cases, we will be able to examine more detailed outcomes associated with specific rheumatic diseases and COVID-19 treatments, as well as the outcomes of COVID-19 in people with rheumatic diseases," the authors write.

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