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 Alghoul; Osaid 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

doi:10.1093/rheumatology/keab250

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 (Lead / Corresponding author)

Population Health and Genomics

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Abstract

Objective: Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization 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 [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017-18 were included. Outcomes were death and complications within 30 days of hospitalization.

Results: We studied 133 589 patients diagnosed and 48 418 hospitalized 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 hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2-4.3% vs 6.32-24.6%).

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

Original language	English
Pages (from-to)	SI37-SI50
Number of pages	14
Journal	Rheumatology
Volume	60
Issue number	SI
Early online date	16 Mar 2021
DOIs	https://doi.org/10.1093/rheumatology/keab250
Publication status	Published - 6 Oct 2021

Keywords

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

ASJC Scopus subject areas

Rheumatology
Pharmacology (medical)

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10.1093/rheumatology/keab250Licence: CC BY

Final published versionFinal published version, 615 KBLicence: CC BY

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Tan, E. H., Sena, A. G., Prats-Uribe, A., You, S. C., Ahmed, W.-U.-R., Kostka, K., Reich, C., Duvall, S. L., Lynch, K. E., Matheny, M. E., Duarte-Salles, T., Bertolin, S. F., Hripcsak, G., Natarajan, K., Falconer, T., Spotnitz, M., Ostropolets, A., Blacketer, C., Alshammari, T. M., ... Prieto-Alhambra, D. (2021). COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries. Rheumatology, 60(SI), SI37-SI50. https://doi.org/10.1093/rheumatology/keab250

@article{3cdd91b27f864bf1b44ec7a13ee29b6a,

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

abstract = "Objective: Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization 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 [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017-18 were included. Outcomes were death and complications within 30 days of hospitalization.Results: We studied 133 589 patients diagnosed and 48 418 hospitalized 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 hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2-4.3% vs 6.32-24.6%).Conclusion: Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.",

keywords = "COVID-19, Observational Health Data Sciences and Informatics (OHDSI), Observational Medical Outcomes Partnership (OMOP), autoimmune condition, hospitalization, mortality, open science",

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

note = "The European Health Data & Evidence Network (EHDEN) has received funding from the Innovative Medicines Initiative (IMI) 2 Joint Undertaking (JU) under grant agreement No 806968. The JU receives support from the European Union{\textquoteright}s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations (EFPIA). The University of Oxford received a grant related to this work from the Bill & Melinda Gates Foundation (Investment ID INV-016201). This research received partial support from the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), US National Institutes of Health, US Department of Veterans Affairs, Janssen Research & Development, and IQVIA. This work was also supported by the Bio Industrial Strategic Technology Development Program (20001234) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea) and a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C0992), and the Health Department from the Generalitat de Catalunya with a grant for research projects on SARSCoV-2 and COVID-19 disease organized by the Direcci{\'o} General de Recerca i Innovaci{\'o} en Salut. DPA is funded through a National Institute for Health Research (NIHR) Senior Research Fellowship (Grant number SRF-2018-11-ST2-004). APU is supported by MRC-DTP [MR/K501256/1, MR/N013468/1] and Fundaci{\'o}n Alfonso Mart{\'i}n Escudero (FAME). GHsupported by the US National Library of Medicine (LM006910)",

year = "2021",

month = oct,

day = "6",

doi = "10.1093/rheumatology/keab250",

language = "English",

volume = "60",

pages = "SI37--SI50",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "SI",

}

Tan, EH, Sena, AG, Prats-Uribe, A, You, SC, Ahmed, W-U-R, Kostka, K, Reich, C, Duvall, SL, Lynch, KE, Matheny, ME, Duarte-Salles, T, Bertolin, SF, Hripcsak, G, Natarajan, K, Falconer, T, Spotnitz, M, Ostropolets, A, Blacketer, C, Alshammari, TM, Alghoul, H, Alser, O, Lane, JCE, Dawoud, DM, Shah, K, Yang, Y, Zhang, L, Areia, C, Golozar, A, Recalde, M, Casajust, P, Jonnagaddala, J, Subbian, V, Vizcaya, D, Lai, LYH, Nyberg, F, Morales, DR, Posada, JD, Shah, NH, Gong, M, Vivekanantham, A, Abend, A, Minty, EP, Suchard, M, Rijnbeek, P, Ryan, PB & Prieto-Alhambra, D 2021, 'COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries', Rheumatology, vol. 60, no. SI, pp. SI37-SI50. https://doi.org/10.1093/rheumatology/keab250

TY - JOUR

T1 - COVID-19 in patients with autoimmune diseases

T2 - characteristics and outcomes in a multinational network of cohorts across three countries

AU - Tan, Eng Hooi

AU - Sena, Anthony G.

AU - Prats-Uribe, Albert

AU - You, Seng Chan

AU - Ahmed, Waheed-Ul-Rahman

AU - Kostka, Kristin

AU - Reich, Christian

AU - Duvall, Scott L.

AU - Lynch, Kristine E.

AU - Matheny, Michael E.

AU - Duarte-Salles, Talita

AU - Bertolin, Sergio Fernandez

AU - Hripcsak, George

AU - Natarajan, Karthik

AU - Falconer, Thomas

AU - Spotnitz, Matthew

AU - Ostropolets, Anna

AU - Blacketer, Clair

AU - Alshammari, Thamir M.

AU - Alghoul, Heba

AU - Alser, Osaid

AU - Lane, Jennifer C. E.

AU - Dawoud, Dalia M.

AU - Shah, Karishma

AU - Yang, Yue

AU - Zhang, Lin

AU - Areia, Carlos

AU - Golozar, Asieh

AU - Recalde, Martina

AU - Casajust, Paula

AU - Jonnagaddala, Jitendra

AU - Subbian, Vignesh

AU - Vizcaya, David

AU - Lai, Lana Y. H.

AU - Nyberg, Fredrik

AU - Morales, Daniel R.

AU - Posada, Jose D.

AU - Shah, Nigam H.

AU - Gong, Mengchun

AU - Vivekanantham, Arani

AU - Abend, Aaron

AU - Minty, Evan P.

AU - Suchard, Marc

AU - Rijnbeek, Peter

AU - Ryan, Patrick B.

AU - Prieto-Alhambra, Daniel

N1 - The European Health Data & Evidence Network (EHDEN) has received funding from the Innovative Medicines Initiative (IMI) 2 Joint Undertaking (JU) under grant agreement No 806968. The JU receives support from the European Union’s Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations (EFPIA). The University of Oxford received a grant related to this work from the Bill & Melinda Gates Foundation (Investment ID INV-016201). This research received partial support from the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), US National Institutes of Health, US Department of Veterans Affairs, Janssen Research & Development, and IQVIA. This work was also supported by the Bio Industrial Strategic Technology Development Program (20001234) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea) and a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C0992), and the Health Department from the Generalitat de Catalunya with a grant for research projects on SARSCoV-2 and COVID-19 disease organized by the Direcció General de Recerca i Innovació en Salut. DPA is funded through a National Institute for Health Research (NIHR) Senior Research Fellowship (Grant number SRF-2018-11-ST2-004). APU is supported by MRC-DTP [MR/K501256/1, MR/N013468/1] and Fundación Alfonso Martín Escudero (FAME). GHsupported by the US National Library of Medicine (LM006910)

PY - 2021/10/6

Y1 - 2021/10/6

N2 - Objective: Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization 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 [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017-18 were included. Outcomes were death and complications within 30 days of hospitalization.Results: We studied 133 589 patients diagnosed and 48 418 hospitalized 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 hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2-4.3% vs 6.32-24.6%).Conclusion: Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.

AB - Objective: Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization 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 [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017-18 were included. Outcomes were death and complications within 30 days of hospitalization.Results: We studied 133 589 patients diagnosed and 48 418 hospitalized 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 hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2-4.3% vs 6.32-24.6%).Conclusion: Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.

KW - COVID-19

KW - Observational Health Data Sciences and Informatics (OHDSI)

KW - Observational Medical Outcomes Partnership (OMOP)

KW - autoimmune condition

KW - hospitalization

KW - mortality

KW - open science

UR - http://www.scopus.com/inward/record.url?scp=85111765204&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/keab250

DO - 10.1093/rheumatology/keab250

M3 - Article

C2 - 33725121

SN - 1462-0324

VL - 60

SP - SI37-SI50

JO - Rheumatology

JF - Rheumatology

IS - SI

ER -

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

Abstract

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Approaches for Creating Clinical Evidence of Treatment Effects in Routine Populations Excluded from Trials (ACCEPT) (Clinical Research Career Development Fellowship)

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

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

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Approaches for Creating Clinical Evidence of Treatment Effects in Routine Populations Excluded from Trials (ACCEPT) (Clinical Research Career Development Fellowship)

Cite this