Table 2.
Rheumatic disease characteristics of patients with SARD with COVID-19 over calendar time
| Time period | ||||||
|---|---|---|---|---|---|---|
| Overall (n=1449) | Early COVID-19 | Early treatment | Early vaccination | Additional vaccination and Delta wave | Omicron wave | |
| 1 March 2020–30 June 2020 (n=261) | 1 July 2020–31 January 2021 (n=492) | 1 February 2021–30 June 2021 (n=123) | 1 July 2021–16 December 2021 (n=172) | 17 December 2021–31 January 2022 (n=401) | ||
| Rheumatic disease diagnosis, n () | ||||||
| Rheumatoid arthritis | 491 (33.9) | 90 (34.5) | 174 (35.4) | 48 (39.0) | 45 (26.2) | 134 (33.4) |
| Psoriatic arthritis and spondyloarthritis | 213 (14.7) | 31 (11.9) | 75 (15.2) | 17 (13.8) | 32 (18.6) | 58 (14.5) |
| Systemic lupus erythematosus | 190 (13.1) | 39 (14.9) | 64 (13.0) | 16 (13.0) | 21 (12.2) | 50 (12.5) |
| Other inflammatory arthritis* | 106 (7.3) | 19 (7.3) | 38 (7.7) | 4 (3.3) | 13 (7.6) | 32 (8.0) |
| PMR and/or GCA | 101 (7.0) | 23 (8.8) | 31 (6.3) | 7 (5.7) | 14 (8.1) | 26 (6.5) |
| ANCA-associated vasculitis | 68 (4.7) | 11 (4.2) | 21 (4.3) | 7 (5.7) | 12 (7.0) | 17 (4.2) |
| Other vasculitis† | 33 (2.3) | 8 (3.1) | 7 (1.4) | 4 (3.3) | 2 (1.2) | 12 (3.0) |
| Sjogren’s syndrome | 36 (2.5) | 2 (0.8) | 13 (2.6) | 3 (2.4) | 5 (2.9) | 13 (3.2) |
| Systemic sclerosis | 35 (2.4) | 6 (2.3) | 11 (2.2) | 5 (4.1) | 3 (1.7) | 10 (2.5) |
| Inflammatory myopathy | 33 (2.3) | 6 (2.3) | 13 (2.6) | 1 (0.8) | 6 (3.5) | 7 (1.8) |
| Other connective tissue diseases‡ | 37 (2.6) | 9 (3.4) | 8 (1.6) | 3 (2.4) | 3 (1.7) | 14 (3.5) |
| Sarcoidosis | 43 (3.0) | 9 (3.4) | 22 (4.5) | 1 (0.8) | 4 (2.3) | 7 (1.8) |
| Multiple rheumatic diagnoses | 35 (2.4) | 6 (2.3) | 9 (1.8) | 4 (3.3) | 4 (2.3) | 12 (3.0) |
| Other diagnoses§ | 28 (1.9) | 2 (0.8) | 6 (1.2) | 3 (2.4) | 8 (4.7) | 9 (2.2) |
| Disease activity, n (%) | ||||||
| Remission or low activity | 1074 (74.1) | 181 (69.3) | 365 (74.2) | 91 (74.0) | 131 (76.2) | 306 (76.3) |
| Moderate or severe activity | 259 (17.9) | 50 (19.2) | 100 (20.3) | 23 (18.7) | 27 (15.7) | 59 (14.7) |
| Unknown | 116 (8.0) | 30 (11.5) | 27 (5.5) | 9 (7.3) | 14 (8.1) | 36 (9.0) |
| Rheumatic disease medications at time of infection, n (%) | ||||||
| Glucocorticoids | 377 (26.0) | 80 (30.7) | 125 (25.4) | 29 (23.6) | 42 (24.4) | 101 (25.2) |
| None | 1072 (74.0) | 181 (69.3) | 367 (74.6) | 94 (76.4) | 130 (75.6) | 300 (74.8) |
| Low dose (1–10 mg) | 317 (21.9) | 70 (26.8) | 106 (21.5) | 26 (21.1) | 36 (20.9) | 79 (19.7) |
| Moderate/high dose (>10 mg) | 53 (3.7) | 10 (3.8) | 18 (3.7) | 3 (2.4) | 4 (2.3) | 18 (4.5) |
| Unknown dose | 7 (0.5) | 0 (0.0) | 1 (0.2) | 0 (0.0) | 2 (1.2) | 4 (1.0) |
| Conventional synthetic DMARDs and immunosuppressants | ||||||
| Methotrexate | 319 (22.0) | 49 (18.8) | 108 (22.0) | 21 (17.1) | 38 (22.1) | 103 (25.7) |
| Antimalarials | 314 (21.7) | 58 (22.2) | 102 (20.7) | 20 (16.3) | 36 (20.9) | 98 (24.4) |
| Sulfasalazine | 31 (2.1) | 5 (1.9) | 8 (1.6) | 2 (1.6) | 3 (1.7) | 13 (3.2) |
| Leflunomide | 54 (3.7) | 12 (4.6) | 23 (4.7) | 1 (0.8) | 5 (2.9) | 13 (3.2) |
| Mycophenolate mofetil | 101 (7.0) | 13 (5.0) | 27 (5.5) | 13 (10.6) | 17 (9.9) | 31 (7.7) |
| Azathioprine | 27 (1.9) | 9 (3.4) | 6 (1.2) | 4 (3.3) | 2 (1.2) | 6 (1.5) |
| Calcineurin inhibitor | 19 (1.3) | 4 (1.5) | 5 (1.0) | 5 (4.1) | 3 (1.7) | 2 (0.5) |
| Cyclophosphamide | 4 (0.3) | 3 (1.2) | 0 (0) | 0 (0) | 1 (0.6) | 0 (0) |
| Biologic DMARDs | ||||||
| TNF inhibitors | 292 (20.2) | 32 (12.3) | 90 (18.3) | 26 (21.1) | 40 (23.3) | 104 (25.9) |
| Rituximab | 133 (9.2) | 17 (6.5) | 33 (6.7) | 18 (14.6) | 25 (14.5) | 40 (10.0) |
| Belimumab | 20 (1.4) | 4 (1.5) | 1 (0.2) | 1 (0.8) | 3 (1.7) | 11 (2.7) |
| Abatacept | 31 (2.1) | 4 (1.5) | 6 (1.2) | 3 (2.4) | 3 (1.7) | 15 (3.7) |
| IL-6 inhibitors | 45 (3.1) | 3 (1.2) | 18 (3.7) | 3 (2.4) | 5 (2.9) | 16 (4.0) |
| IL-17, IL-12/23, and IL-23 inhibitors | 36 (2.5) | 8 (3.1) | 16 (3.3) | 2 (1.6) | 3 (1.7) | 7 (1.7) |
| IL-1 inhibitors | 6 (0.4) | 0 (0) | 0 (0) | 0 (0%) | 3 (1.7) | 3 (0.8) |
| Targeted synthetic DMARDs | ||||||
| JAK inhibitors | 55 (3.8) | 8 (3.1) | 21 (4.3) | 4 (3.3) | 7 (4.1) | 15 (3.7) |
| Apremilast | 5 (0.4) | 0 (0) | 2 (0.4) | 0 (0) | 0 (0) | 3 (0.8) |
| IVIG | 19 (1.3) | 2 (0.8) | 7 (1.4) | 2 (1.6) | 4 (2.3) | 4 (1.0) |
Includes juvenile idiopathic arthritis, other unspecified inflammatory arthritis.
Includes Takayasu’s arteritis, Kawasaki disease, Behcet’s disease, polyarteritis nodosa, other vasculitis.
Includes undifferentiated connective tissue disease, mixed connective tissue disease, antiphospholipid syndrome (without concurrent systemic lupus erythematosus).
Includes relapsing polychondritis, IgG4-related disease, sclerosing mediastinitis, periodic fever syndromes, adult-onset Still’s disease.
ANCA, antineutrophil cytoplasmic antibody; DMARD, disease-modifying antirheumatic drug; GCA, giant cell arteritis; IL, interleukin; IVIG, intravenous immune globulin; JAK, Janus kinase; PMR, polymyalgia rheumatica; SARD, systemic autoimmune rheumatic disease; TNF, tumour necrosis factor.