Heart failure and age, but not immune-mediated inflammatory diseases (IMIDs) or immunomodulatory drugs, were strongly associated with COVID-19 severity, according to study results presented at the European Alliance of Associations for Rheumatology (EULAR) Congress 2022, held June 1 to 5, 2022 in Copenhagen, Denmark.

Researchers evaluated COVID-19 illness characteristics among a large group of patients with and without IMIDs. They analyzed data from patients who tested for COVID-19 at a large health system in the western United States. Data regarding immunomodulatory drug use within 3 months prior to testing and IMID disease history was collected. Analyses included multivariate logistic regression using machine learning metrics (feature importance, P-value) on an 80% training set and area under the receiver operating characteristic (AUROC) on a 20% test set.

Among a total of 1,101,431 patients who were tested for COVID-19, the rates of positive COVID-19 tests, hospitalization, invasive mechanical ventilation, and death were similar between rheumatologic IMID, non-rheumatologic IMID, and non-IMID populations.

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Feature importance analyses showed that the most important risk factors for COVID-19 severity were age and heart failure. With the exception of spondyloarthritis, which was weakly associated with decreased hospitalization, invasive mechanical ventilation, and death, patients with IMIDs did not experience worse outcomes compared with patients without IMIDs.

Conventional synthetic disease-modifying antirheumatic drugs and corticosteroid use was weakly associated with increased hospitalization and rituximab with increased mortality.

Limitations of the study included a lack of data on vaccination status and IMID disease severity.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Mease PJ, Wei Q, Chiorean M, Iles-Shih L, Hadlock J. Risk factors for severe COVID-19 outcomes: A study of immune-mediated inflammatory diseases, therapies and comorbidities in a large US healthcare system. Presented at: EULAR Congress 2022; June 1-4, 2022; Copenhagen, Denmark. Abstract OP0247.

This article originally appeared on Rheumatology Advisor