COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries

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Objective

Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization 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 [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017–18 were included. Outcomes were death and complications within 30 days of hospitalization.

Results

We studied 133 589 patients diagnosed and 48 418 hospitalized 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 hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2–4.3% vs 6.32–24.6%).

Conclusion

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



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Authors: Eng Hooi Tan, Anthony G Sena, Albert Prats-Uribe, Seng Chan You, Waheed-Ul-Rahman Ahmed, Kristin Kostka, Christian Reich, Scott L Duvall, Kristine E Lynch, Michael E Matheny, Talita Duarte-Salles, Sergio Fernandez Bertolin, George Hripcsak, Karthik Natarajan, Thomas Falconer, Matthew Spotnitz, Anna Ostropolets, Clair Blacketer, Thamir M Alshammari, Heba Alghoul, Osaid Alser, Jennifer C E Lane, Dalia M Dawoud, Karishma Shah, Yue Yang, Lin Zhang, Carlos Areia, Asieh Golozar, Martina Recalde, Paula Casajust, Jitendra Jonnagaddala, Vignesh Subbian, David Vizcaya, Lana Y H Lai, Fredrik Nyberg, Daniel R Morales, Jose D Posada, Nigam H Shah, Mengchun Gong, Arani Vivekanantham, Aaron Abend, Evan P Minty, Marc Suchard, Peter Rijnbeek, Patrick B Ryan, Daniel Prieto-Alhambra

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