COVID-19 infection, admission and death among people with rare autoimmune rheumatic disease in England: results from the RECORDER project

Rutter, Megan; Lanyon, Peter C; Grainge, Matthew J; Hubbard, Richard; Peach, Emily; Bythell, Mary; Stilwell, Peter; Aston, Jeanette; Stevens, Sarah; Pearce, Fiona A

Abstract

Objectives: To calculate the rates of COVID-19 infection and COVID-19-related death among people with rare autoimmune rheumatic diseases (RAIRD) during the first wave of the COVID-19 pandemic in England compared to the general population.

Methods: We used Hospital Episode Statistics to identify all people alive 01 March 2020 with ICD-10 codes for RAIRD from the whole population of England. We used linked national health records (demographic, death certificate, admissions and PCR testing data) to calculate rates of COVID-19 infection and death up to 31 July 2020. Our primary definition of COVID-19-related death was mention of COVID-19 on the death certificate. General population data from Public Health England and the Office for National Statistics were used for comparison. We also describe COVID-19-related hospital admissions and all-cause deaths.

Results: We identified a cohort of 168,680 people with RAIRD, of whom 1874 (1.11%) had a positive COVID-19 PCR test. The age-standardised infection rate was 1.54 (95% CI 1.50-1.59) times higher than in the general population. 713 (0.42%) people with RAIRD died with COVID-19 on their death certificate and the age-sex-standardised mortality rate for COVID-19-related death was 2.41 (2.30 – 2.53) times higher than in the general population. There was no evidence of an increase in deaths from other causes in the RAIRD population.

Conclusions: During the first wave of COVID-19 in England, people with RAIRD had a 54% increased risk of COVID-19 infection and more than twice the risk of COVID-19-related death compared to the general population. These increases were seen despite shielding policies.

Citation

Rutter, M., Lanyon, P. C., Grainge, M. J., Hubbard, R., Peach, E., Bythell, M., …Pearce, F. A. (2022). COVID-19 infection, admission and death among people with rare autoimmune rheumatic disease in England: results from the RECORDER project. Rheumatology, 61(8), 3161-3171. https://doi.org/10.1093/rheumatology/keab794

• Journal Article Type: Article
• Acceptance Date: Oct 17, 2021
• Online Publication Date: Oct 26, 2021
• Publication Date: 2022-08
• Deposit Date: Oct 25, 2021
• Publicly Available Date: Oct 27, 2022
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Peer Reviewed: Peer Reviewed
• Volume: 61
• Issue: 8
• Pages: 3161-3171
• DOI: https://doi.org/10.1093/rheumatology/keab794
• Keywords: COVID-19, coronavirus, mortality, rare autoimmune rheumatic diseases, epidemiology, shielding, infection
• Public URL: https://nottingham-repository.worktribe.com/output/6537045
• Publisher URL: https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keab794/6410658
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Megan Rutter, Peter C Lanyon, Matthew J Grainge, Richard Hubbard, Emily Peach, Mary Bythell, Peter Stilwell, Jeanette Aston, Sarah Stevens, Fiona A Pearce, COVID-19 Infection, Admission and Death Amongst People with Rare Autoimmune Rheumatic Disease in England. Results from the RECORDER Project, Rheumatology, 2021;, keab794 is available online at: https://doi.org/10.1093/rheumatology/keab794