COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries

Eng Hooi Tan, Anthony G. Sena, Albert Prats-Uribe, Seng Chan You, Waheed-Ul-Rahman Ahmed, Kristin Kostka, Christian Reich, Scott L. Duvall, Kristine E. Lynch, Michael E. Matheny, Talita Duarte-Salles, Sergio Fernandez Bertolin, George Hripcsak, Karthik Natarajan, Thomas Falconer, Matthew Spotnitz, Anna Ostropolets, Clair Blacketer, Thamir M. Alshammari, Heba AlghoulOsaid Alser, Jennifer C. E. Lane, Dalia M. Dawoud, Karishma Shah, Yue Yang, Lin Zhang, Carlos Areia, Asieh Golozar, Martina Recalde, Paula Casajust, Jitendra Jonnagaddala, Vignesh Subbian, David Vizcaya, Lana Y. H. Lai, Fredrik Nyberg, Daniel R. Morales, Jose D. Posada, Nigam H. Shah, Mengchun Gong, Arani Vivekanantham, Aaron Abend, Evan P. Minty, Marc Suchard, Peter Rijnbeek, Patrick B. Ryan, Daniel Prieto-Alhambra

Research output: Contribution to journalArticlepeer-review


Objective: Patients with autoimmune diseases were advised to shield to avoid COVID-19, but information on their prognosis is lacking. We characterised 30-day outcomes and mortality after hospitalisation with COVID-19 among patients with prevalent autoimmune diseases, and compared outcomes after hospital admissions among similar patients with seasonal influenza.

Methods: A multinational network cohort study was conducted using electronic health records data from Columbia University Irving Medical Center (CUIMC) (United States [US]), Optum [US], Department of Veterans Affairs (VA) (US), Information System for Research in Primary Care-Hospitalisation Linked Data (SIDIAP-H) (Spain), and claims data from IQVIA Open Claims (US) and Health Insurance and Review Assessment (HIRA) (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalised between January and June 2020 with COVID-19, and similar patients hospitalised with influenza in 2017-2018 were included. Outcomes were death and complications within 30 days of hospitalisation.

Results: We studied 133 589 patients diagnosed and 48 418 hospitalised with COVID-19 with prevalent autoimmune diseases. Most patients were female, aged ≥50 years with previous comorbidities. The prevalence of hypertension (45.5-93.2%), chronic kidney disease (14.0-52.7%) and heart disease (29.0-83.8%) was higher in hospitalised vs diagnosed patients with COVID-19. Compared with 70 660 hospitalised with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2% to 4.3% vs 6.3% to 24.6%).

Conclusions: Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.

Original languageEnglish
Early online date16 Mar 2021
Publication statusE-pub ahead of print - 16 Mar 2021


  • COVID-19
  • autoimmune condition
  • mortality
  • hospitalisation
  • open science
  • Observational Health Data Sciences and Informatics (OHDSI)
  • Observational Medical Outcomes Partnership (OMOP)

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