Risk of death among people with rare autoimmune diseases during COVID-19 pandemic

A study was done to quantify the risk of death among people with rare autoimmune rheumatic diseases (RAIRD) during the UK 2020 COVID-19 pandemic compared with the general population, and compared with their pre-COVID risk.  In this article, we explain the importance of this research.

Rare autoimmune rheumatic diseases (RAIRD) can be split in two groups: 

1. Connective tissue disorders: Lupus, scleroderma, myositis, primary Sjögren’s syndrome. 

2. Systemic vasculitis: ANCA-associated vasculitis, giant cell arteritis, Takaysu’s Arteritis and Behcet’s disease. 

Researchers from the University of Nottingham, Division of Epidemiology and the National Disease Registration Service at Public Health, England, conducted a study to quantify the risk for death in people with RAIRD during the COVID-19 pandemic. 

Data from 168,691 people was collected. These people had a diagnosis of RAIRD and were alive on March 1, 2020. The general population mortality rates were accessed from the Office of National Statistics.

The research showed that in March and April 2020 in the UK the risk of death among people with RAIRD :

•  increased more than it did among the general population. 
•  increased from the age of 35, rather than 55
•  was not reduced by being female, as it does in the general population with COVID (see image below)

Dr Fiona Pearce, study co-author, said: “People with rare diseases often have poorer health outcomes generally, so we wanted to find out what impact the pandemic had. We now know that during the early months of the pandemic, people with these diseases were more likely to die than the general population.”

“Women with rare autoimmune rheumatic diseases had a similar risk of death to men during COVID-19, whereas usually their risk of death is lower. The risk of working age people with rare autoimmune rheumatic diseases dying during COVID-19 was similar to that of someone 20 years older in the general population.” Pearce said.

Other important findings, of this research include, the fact that, ‘COVID-age’ a tool used by workplaces to assess someone’s vulnerability to COVID-19, would “underestimate the risks particularly to young and/or female people with RAIRDs”. 

Another planned COVID-19 risk prediction model commissioned by Office of the Chief Medical Officer for England to help GPs and clinicians give patients better advice about their risk from COVID-19 would also underestimate risk to people with RAIRDs. This is because the risk for people with RAIRDs is higher than people with other chronic conditions which these conditions have been grouped with. ~ RAIRDA

Study Conclusion: The risk of all-cause death is more prominently raised during COVID-19 among people with RAIRD than among the general population. 

We urgently need to quantify how much risk is due to COVID-19 infection and how much is due to disruption to healthcare services.        

SOURCES: 

Risk of death among people with rare autoimmune diseases compared to the general population in England during the 2020 COVID-19 pandemic. 

PMID: 33271595

 

DOI: 10.1093/rheumatology/keaa855

The Rare Autoimmune Rheumatic Disease Alliance (RAIRDA)

Healio Rheumatology