Milena A Gianfrancesco1, Liza A Leykina1, Zara Izadi1, Tiffany Taylor2, Jeffrey A Sparks3, Carly Harrison4, Laura Trupin1, Stephanie Rush1, Gabriela Schmajuk5, Patricia Katz1, Lindsay Jacobsohn1, Tiffany Y Hsu3, Kristin M D'Silva6, Naomi Serling-Boyd6, Rachel Wallwork6, Derrick J Todd3, Suleman Bhana7, Wendy Costello8, Rebecca Grainger9, Jonathan S Hausmann10, Jean W Liew11, Emily Sirotich12, Paul Sufka13, Zachary S Wallace6, Pedro M Machado14, Philip C Robinson15, Jinoos Yazdany1. 1. University of California, San Francisco. 2. University of California San Francisco, and University of California Berkeley. 3. Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. 4. LupusChat, New York, New York. 5. University of California and San Francisco VA Healthcare System, San Francisco. 6. Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 7. Crystal Run Health, Middletown, New York. 8. Irish Children's Arthritis Network (iCAN), Tipperary, Ireland. 9. University of Otago, Wellington, New Zealand. 10. Boston Children's Hospital, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts. 11. Boston University School of Medicine, Boston, Massachusetts. 12. McMaster University, Hamilton, Ontario, Canada, and Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada. 13. Healthpartners, St. Paul, Minnesota. 14. University College London, University College London Hospitals NHS Foundation Trust, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK. 15. University of Queensland, Brisbane, Queensland, Australia, and Royal Brisbane and Women's Hospital, Metro North Hospital & Health Service, Herston, Queensland, Australia.
Abstract
OBJECTIVE: Racial/ethnic minorities experience more severe outcomes of coronavirus disease 2019 (COVID-19) in the general US population. This study was undertaken to examine the association between race/ethnicity and COVID-19 hospitalization, ventilation status, and mortality in people with rheumatic disease. METHODS: US patients with rheumatic disease and COVID-19 were entered into the COVID-19 Global Rheumatology Alliance physician registry between March 24, 2020 and August 26, 2020 were included. Race/ethnicity was defined as White, African American, Latinx, Asian, or other/mixed race. Outcome measures included hospitalization, requirement for ventilatory support, and death. Multivariable regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for age, sex, smoking status, rheumatic disease diagnosis, comorbidities, medication use prior to infection, and rheumatic disease activity. RESULTS: A total of 1,324 patients were included, of whom 36% were hospitalized and 6% died; 26% of hospitalized patients required mechanical ventilation. In multivariable models, African American patients (OR 2.74 [95% CI 1.90-3.95]), Latinx patients (OR 1.71 [95% CI 1.18-2.49]), and Asian patients (OR 2.69 [95% CI 1.16-6.24]) had higher odds of hospitalization compared to White patients. Latinx patients also had 3-fold increased odds of requiring ventilatory support (OR 3.25 [95% CI 1.75-6.05]). No differences in mortality based on race/ethnicity were found, though power to detect associations may have been limited. CONCLUSION: Similar to findings in the general US population, racial/ethnic minorities with rheumatic disease and COVID-19 had increased odds of hospitalization and ventilatory support. These results illustrate significant health disparities related to COVID-19 in people with rheumatic diseases. The rheumatology community should proactively address the needs of patients currently experiencing inequitable health outcomes during the pandemic.
OBJECTIVE: Racial/ethnic minorities experience more severe outcomes of coronavirus disease 2019 (COVID-19) in the general US population. This study was undertaken to examine the association between race/ethnicity and COVID-19 hospitalization, ventilation status, and mortality in people with rheumatic disease. METHODS: US patients with rheumatic disease and COVID-19 were entered into the COVID-19 Global Rheumatology Alliance physician registry between March 24, 2020 and August 26, 2020 were included. Race/ethnicity was defined as White, African American, Latinx, Asian, or other/mixed race. Outcome measures included hospitalization, requirement for ventilatory support, and death. Multivariable regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for age, sex, smoking status, rheumatic disease diagnosis, comorbidities, medication use prior to infection, and rheumatic disease activity. RESULTS: A total of 1,324 patients were included, of whom 36% were hospitalized and 6% died; 26% of hospitalized patients required mechanical ventilation. In multivariable models, African American patients (OR 2.74 [95% CI 1.90-3.95]), Latinx patients (OR 1.71 [95% CI 1.18-2.49]), and Asian patients (OR 2.69 [95% CI 1.16-6.24]) had higher odds of hospitalization compared to White patients. Latinx patients also had 3-fold increased odds of requiring ventilatory support (OR 3.25 [95% CI 1.75-6.05]). No differences in mortality based on race/ethnicity were found, though power to detect associations may have been limited. CONCLUSION: Similar to findings in the general US population, racial/ethnic minorities with rheumatic disease and COVID-19 had increased odds of hospitalization and ventilatory support. These results illustrate significant health disparities related to COVID-19 in people with rheumatic diseases. The rheumatology community should proactively address the needs of patients currently experiencing inequitable health outcomes during the pandemic.
Authors: Jeffrey R Curtis; Sindhu R Johnson; Donald D Anthony; Reuben J Arasaratnam; Lindsey R Baden; Anne R Bass; Cassandra Calabrese; Ellen M Gravallese; Rafael Harpaz; Andrew Kroger; Rebecca E Sadun; Amy S Turner; Eleanor Anderson Williams; Ted R Mikuls Journal: Arthritis Rheumatol Date: 2022-05 Impact factor: 15.483
Authors: Bryant R England; Punyasha Roul; Yangyuna Yang; Andre C Kalil; Kaleb Michaud; Geoffrey M Thiele; Brian C Sauer; Joshua F Baker; Ted R Mikuls Journal: Arthritis Rheumatol Date: 2021-10-19 Impact factor: 15.483
Authors: Jonathan S Hausmann; Kevin Kennedy; Julia F Simard; Jean W Liew; Jeffrey A Sparks; Tarin T Moni; Carly Harrison; Maggie J Larché; Mitchell Levine; Sebastian E Sattui; Teresa Semalulu; Gary Foster; Salman Surangiwala; Lehana Thabane; Richard P Beesley; Karen L Durrant; Elsa F Mateus; Serena Mingolla; Michal Nudel; Candace A Palmerlee; Dawn P Richards; David F L Liew; Catherine L Hill; Suleman Bhana; Wendy Costello; Rebecca Grainger; Pedro M Machado; Philip C Robinson; Paul Sufka; Zachary S Wallace; Jinoos Yazdany; Emily Sirotich Journal: Lancet Rheumatol Date: 2021-07-22
Authors: D Sofia Villacis-Nunez; Christina A Rostad; Kelly Rouster-Stevens; Arezou Khosroshahi; Shanmuganathan Chandrakasan; Sampath Prahalad Journal: Pediatr Rheumatol Online J Date: 2021-06-21 Impact factor: 3.054