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Axial spondyloarthritis might
safeguard against poor outcomes in SARS-CoV-2 infection.
In a propensity score matched analysis of 9766 people from a nationwide multi-centric research network, people having axial spondyloarthritis exhibited reduced morbidity and mortality during coronavirus disease when compared to propensity score matched controls. This study was carried out to determine the impact of coronavirus disease in people with axial spondyloarthritis and also to examine tumor necrosis factor inhibitors (TNFi) effects.
People suffering from axial spondyloarthritis, including ankylosing spondylitis and non-radiographic spondyloarthritis who had developed SARS-CoV-2 infection were queried. A similar number of propensity score matched controls were extracted from the database among coronavirus-infected people who didn't have any inflammatory arthritis. The outcomes included ventilation need, mortality, hospitalization, sepsis, cerebral infarction, acute kidney injury, renal replacement therapy, acute respiratory distress syndrome, venous thromboembolism, and intensive care unit admission.
Overall, 9766 people with axial spondyloarthritis (8842 non-radiographic spondyloarthritis, 924 ankylosing spondylitis ) and 691,862 people without spondyloarthritis who suffered from coronavirus disease were recognized. In the unmatched comparison, people with axial spondyloarthritis had elevated risk ratios (RR) for all the outcomes. Following matching for comorbidities and demographics, axial spondyloarthritis people exhibited reduced RR for mortality [RR: 0.707], acute kidney injury [RR: 0.902], severe coronavirus disease [RR: 0.791], and hospital admission [RR: 0.872].
Only venous thromboembolism risk was reported to be greater in axial spondyloarthritis people [RR: 1.219]. In the axial spondyloarthritis group, males exhibited worse outcomes in nine out of the eleven domains except for cerebral infarction and venous thromboembolism. As found, blacks illustrated poor outcomes in all except for the requirement for renal replacement treatment and mortality. For all the outcomes, ankylosing spondylitis had similar risk ratios in comparison with non-radiographic spondyloarthritis except hospitalization [RR: 1.457].
No difference in the results was noted in people who were given TNFi in the year prior to coronavirus disease. Axial spondyloarthritis people who had been prescribed non-steroidal anti-inflammatory agents in the three months prior to SARS-CoV-2 infection exhibited poorer outcomes.
Thus, coronavirus outcomes were
superior in people having axial spondyloarthritis in comparison with propensity
score matched controls except for elevated risk for venous thromboembolism. TNFi
usage is not linked with worse or better outcomes. These apparently protective
effects must be validated and investigated further, concluded the study
authors.
Clinical Rheumatology
Axial spondyloarthritis may protect against poor outcomes in COVID-19: propensity score matched analysis of 9766 patients from a nationwide multi-centric research network
Rahul Raiker et al.
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