Objective: Patients with autoimmune diseases were advised to shield to avoid COVID-19, but information on their prognosis is lacking. We characterised 30-day outcomes and mortality after hospitalisation with COVID-19 among patients with prevalent autoimmune diseases, and compared outcomes after hospital admissions among similar patients with seasonal influenza.

Methods: A multinational network cohort study was conducted using electronic health records data from Columbia University Irving Medical Center (CUIMC) (United States [US]), Optum [US], Department of Veterans Affairs (VA) (US), Information System for Research in Primary Care-Hospitalisation Linked Data (SIDIAP-H) (Spain), and claims data from IQVIA Open Claims (US) and Health Insurance and Review Assessment (HIRA) (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalised between January and June 2020 with COVID-19, and similar patients hospitalised with influenza in 2017-2018 were included. Outcomes were death and complications within 30 days of hospitalisation.

Results: We studied 133 589 patients diagnosed and 48 418 hospitalised with COVID-19 with prevalent autoimmune diseases. Most patients were female, aged ≥50 years with previous comorbidities. The prevalence of hypertension (45.5-93.2%), chronic kidney disease (14.0-52.7%) and heart disease (29.0-83.8%) was higher in hospitalised vs diagnosed patients with COVID-19. Compared with 70 660 hospitalised with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2% to 4.3% vs 6.3% to 24.6%).

Conclusions: Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.


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Cite as

Tan, E., Sena, A., Prats-Uribe, A., You, S., Ahmed, W., Kostka, K., Reich, C., DuVall, S., Lynch, K., Matheny, M., Duarte-Salles, T., Fernández-Bertolín, S., Hripcsak, G., Natarajan, K., Falconer, T., Spotnitz, M., Ostropolets, A., Blacketer, C., Alshammari, T., Alghoul, H., Alser, O., Lane, J., Dawoud, D., Shah, K., Yang, Y., Zhang, L., Areia, C., Golozar, A., Recalde, M., Casajust, P., Jonnagaddala, J., Subbian, V., Vizcaya, D., Lai, L., Nyberg, F., Morales, D., Posada, J., Shah, N., Gong, M., Vivekanantham, A., Abend, A., Minty, E., Suchard, M., Rijnbeek, P., Ryan, P. & Prieto-Alhambra, D. 2021, 'COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries', Rheumatology, article no: keab250. https://doi.org/10.1093/rheumatology/keab250

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Last updated: 14 September 2022
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