Coronavirus disease 2019 outcomes among patients with rheumatic diseases 6 months into the pandemic

Naomi Serling-Boyd, Kristin M. D'Silva, Tiffany Y.T. Hsu, Rachel Wallwork, Xiaoqing Fu, Ellen M. Gravallese, April M. Jorge, Yuqing Zhang, Hyon Choi, Jeffrey A. Sparks, Zachary S. Wallace

Research output: Contribution to journalArticlepeer-review


Objective In earlier studies, patients with rheumatic and musculoskeletal disease (RMD) who got infected with COVID-19 had a higher risk of mechanical ventilation than comparators. We sought todetermine COVID-19 outcomes among patients with RMD 6 months into the pandemic. Methods We conducted a cohort study at Mass General Brigham in Boston, Massachusetts, of patients with RMD matched to up to five comparators by age, sex and COVID-19 diagnosis date (between 30 January 2020 and 16 July2020) and followed until last encounter or 18 August 2020. COVID-19 outcomes were compared using Cox regression. Risk of mechanical ventilation was compared in an early versus a recent cohort of patients with RMD. Results We identified 143 patients with RMD and with COVID-19 (mean age 60 years; 76% female individuals) and 688 comparators (mean age 59 years; 76% female individuals). There were no significantly higher adjusted risks of hospitalisation (HR: 0.87, 95% CI: 0.68-1.11), intensive care unit admission (HR: 1.27, 95% CI: 0.86-1.86), or mortality (HR: 1.02, 95% CI: 0.53-1.95) in patients with RMD versus comparators. There was a trend towards a higher risk of mechanical ventilation in the RMD cohort versus comparators, although not statistically significant (adjusted HR: 1.51,95% CI: 0.93-2.44). There was a trend towards improvement in mechanical ventilation risk in the recent versus early RMD cohort (10% vs 19%, adjusted HR: 0.44, 95% CI: 0.17-1.12). Conclusions Patients with RMD and comparators had similar risks of poor COVID-19 outcomes after adjusting for race, smoking and comorbidities. The higher risk of mechanical ventilation in the early RMD cohort was no longer detected in a recent cohort, suggesting improved management over time.

Original languageEnglish (US)
Pages (from-to)660-666
Number of pages7
JournalAnnals of the rheumatic diseases
Issue number5
StatePublished - May 1 2021
Externally publishedYes


  • autoimmune diseases
  • epidemiology
  • health care
  • outcome assessment

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology
  • General Biochemistry, Genetics and Molecular Biology


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