Abstract
Objective
To determine whether the patients with rheumatoid arthritis (RA) are at higher risks for SARS‐CoV‐2 infection and its severe outcomes before and after COVID‐19 vaccination.
Methods
Using United Kingdom primary care database, we conducted two cohort studies to compare the risks of SARS‐CoV‐2 infection, hospitalization and death from COVID‐19 between the patients with RA and the general population according to their COVID‐19 vaccination status. We used exposure score overlap weighting to balance baseline characteristics between two comparison cohorts.
Results
Among the unvaccinated individuals, the weighted incidence rates of SARS‐CoV‐2 infection (9.21 vs. 8.16/1000 person‐months), hospitalization (3.46 vs. 2.14/1000 person‐months) and death (1.19 vs. 0.62/1000 person‐months) were higher among the patients with RA than the general population over three months of follow‐up; the corresponding adjusted HRs were 1.10 (95%CI: 1.00‐1.24), 1.62 (95%CI: 1.34‐1.96) and 1.88 (95%CI: 1.37‐2.60), respectively. Among the vaccinated individuals, the weighted rates of breakthrough infection (4.17 vs. 3.96/1000 person‐months; HR=1.10, 95%CI: 1.00‐1.20) and hospitalization (0.42 vs. 0.32/1000 person‐months; HR=1.29, 95%CI: 0.96‐1.75) were higher among the patients with RA than the general population over nine months of follow‐up; however, no apparent difference in the risk of these outcomes was observed over three and six months of follow‐up between two comparison cohorts.
Conclusion
Patients with RA are still at higher risks of SARS‐CoV‐2 infection and COVID‐19 hospitalization than the general population after receiving COVID‐19 vaccines. These findings support booster COVID‐19 vaccinations and adherence of other preventive strategies among patients with RA.