Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea

Objectives The prevalence of rheumatoid arthritis (RA) among patients with COVID-19 and the association between RA and the outcome of COVID-19 remain unclear. We aimed to compare the prevalence of RA between participants with and without COVID-19; we then analysed the association between the presenc...

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Main Authors: Hyo Geun Choi, Younghee Jung, Mihye Kwon
Format: Article
Language:English
Published: BMJ Publishing Group 2021-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/10/e054753.full
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author Hyo Geun Choi
Younghee Jung
Mihye Kwon
author_facet Hyo Geun Choi
Younghee Jung
Mihye Kwon
author_sort Hyo Geun Choi
collection DOAJ
description Objectives The prevalence of rheumatoid arthritis (RA) among patients with COVID-19 and the association between RA and the outcome of COVID-19 remain unclear. We aimed to compare the prevalence of RA between participants with and without COVID-19; we then analysed the association between the presence of RA and the severity of COVID-19.Design A cross-sectional study.Setting Data from a nationwide COVID-19 cohort database by the Korea National Health Insurance Corporation were used.Participants and interventions A total of 8070 patients with COVID-19 (1 January 2020 through 4 June 2020) were matched with 32 280 control participants with regard to age, sex and income. Patients with COVID-19 were confirmed by SARS-CoV-2 PCR and controls were collected from the database. RA was confirmed using the diagnostic code (International Classification of Disease, Tenth Revision) and medication claim codes. Conditional/unconditional logistic regression was applied to analyse the association between RA and COVID-19.Primary outcome and secondary outcome Laboratory confirmation of SARS-CoV-2 infection was defined as the primary outcome. The secondary outcome was severe COVID-19 defined as a history of intensive care unit admission, invasive ventilation or death.Results The prevalence of RA in the COVID-19 (0.4%, 35/8070) and control (0.4%, 121/32,280) groups did not differ (p=0.446). After adjusting for underlying diseases, no association between RA and COVID-19 was observed (adjusted OR=1.14, 95% CI: 0.78 to 1.67) and COVID-19 severity was not associated with RA (adjusted OR=0.62, 95% CI: 0.14 to 7.29). The overall mortality rate was 2.9% (237/8070) and RA was not significantly associated with mortality (adjusted OR=1.64, 95% CI: 0.33 to 8.15).Conclusion We did not find an association between the presence of RA and COVID-19. In addition, RA was not associated with the severity of COVID-19.
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spelling doaj-art-a09c9de7e1f643c1a3d5b6f837c06e442025-08-20T02:21:20ZengBMJ Publishing GroupBMJ Open2044-60552021-10-01111010.1136/bmjopen-2021-054753Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South KoreaHyo Geun Choi0Younghee Jung1Mihye Kwon2Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University, Anyang-si, Republic of Korea1 Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea3College of Medicine, Konyanguniversity, Daejeon, Korea, Rep. of (South Korea)Objectives The prevalence of rheumatoid arthritis (RA) among patients with COVID-19 and the association between RA and the outcome of COVID-19 remain unclear. We aimed to compare the prevalence of RA between participants with and without COVID-19; we then analysed the association between the presence of RA and the severity of COVID-19.Design A cross-sectional study.Setting Data from a nationwide COVID-19 cohort database by the Korea National Health Insurance Corporation were used.Participants and interventions A total of 8070 patients with COVID-19 (1 January 2020 through 4 June 2020) were matched with 32 280 control participants with regard to age, sex and income. Patients with COVID-19 were confirmed by SARS-CoV-2 PCR and controls were collected from the database. RA was confirmed using the diagnostic code (International Classification of Disease, Tenth Revision) and medication claim codes. Conditional/unconditional logistic regression was applied to analyse the association between RA and COVID-19.Primary outcome and secondary outcome Laboratory confirmation of SARS-CoV-2 infection was defined as the primary outcome. The secondary outcome was severe COVID-19 defined as a history of intensive care unit admission, invasive ventilation or death.Results The prevalence of RA in the COVID-19 (0.4%, 35/8070) and control (0.4%, 121/32,280) groups did not differ (p=0.446). After adjusting for underlying diseases, no association between RA and COVID-19 was observed (adjusted OR=1.14, 95% CI: 0.78 to 1.67) and COVID-19 severity was not associated with RA (adjusted OR=0.62, 95% CI: 0.14 to 7.29). The overall mortality rate was 2.9% (237/8070) and RA was not significantly associated with mortality (adjusted OR=1.64, 95% CI: 0.33 to 8.15).Conclusion We did not find an association between the presence of RA and COVID-19. In addition, RA was not associated with the severity of COVID-19.https://bmjopen.bmj.com/content/11/10/e054753.full
spellingShingle Hyo Geun Choi
Younghee Jung
Mihye Kwon
Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea
BMJ Open
title Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea
title_full Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea
title_fullStr Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea
title_full_unstemmed Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea
title_short Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea
title_sort association between previous rheumatoid arthritis and covid 19 and its severity a nationwide cohort study in south korea
url https://bmjopen.bmj.com/content/11/10/e054753.full
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