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Lancet Reg Health West Pac . Omicron variant infection in inflammatory rheumatological conditions - outcomes from a COVID-19 naive population in Ao

tetano

Editor, Senior Moderator
Lancet Reg Health West Pac


. 2023 Jul 18;38:100843.
doi: 10.1016/j.lanwpc.2023.100843. eCollection 2023 Sep. Omicron variant infection in inflammatory rheumatological conditions - outcomes from a COVID-19 naive population in Aotearoa New Zealand

Jonathon Brooks[SUP] 1 [/SUP], Anna Montgomery[SUP] 2 [/SUP], Nicola Dalbeth[SUP] 3 4 [/SUP], Mark Sapsford[SUP] 1 [/SUP], Rachel Ngan Kee[SUP] 5 [/SUP], Amy Cooper[SUP] 5 [/SUP], Vicki Quincey[SUP] 6 [/SUP], Suleman Bhana[SUP] 7 [/SUP], Monique Gore-Massy[SUP] 8 [/SUP], Jonathan Hausmann[SUP] 9 10 [/SUP], Jean Liew[SUP] 11 [/SUP], Pedro M Machado[SUP] 12 13 14 [/SUP], Paul Sufka[SUP] 15 [/SUP], Emily Sirotich[SUP] 16 [/SUP], Philip Robinson[SUP] 17 18 [/SUP], Zachary Wallace[SUP] 19 [/SUP], Jinoos Yazdany[SUP] 2 [/SUP], Rebecca Grainger[SUP] 5 20 [/SUP]



Affiliations
Abstract

Background: Due to geographic isolation and border controls Aotearoa New Zealand (AoNZ) attained high levels of population coronavirus disease-19 (COVID-19) vaccination before widespread transmission of COVID-19. We describe outcomes of SARS-CoV-2 infection (Omicron variant) in people with inflammatory rheumatic diseases in this unique setting.
Methods: This observational study included people with inflammatory rheumatic disease and SARS-CoV-2 infection in AoNZ between 1 February and 30 April 2022. Data were collected via the Global Rheumatology Alliance Registry including demographic and rheumatic disease characteristics, and COVID-19 vaccination status and outcomes. Multivariable logistic regression was used to explore associations of demographic and clinical factors with COVID-19 hospitalisation and death.
Findings: Of the 1599 cases included, 96% were from three hospitals that systematically identified people with inflammatory rheumatic disease and COVID-19. At time of COVID-19, 1513 cases (94.6%) had received at least two COVID-19 vaccinations. Hospitalisation occurred for 104 (6.5%) cases and 10 (0.6%) patients died. Lower frequency of hospitalisation was seen in cases who had received at least two vaccinations (5.9%), compared to the unvaccinated (20.6%) or those with a single vaccine dose (10.7%). In multivariable adjusted models, people with gout or connective tissue diseases (CTD) had increased risk of the combined outcome of hospitalisation/death, compared to people with inflammatory arthritis. Glucocorticoid and rituximab use were associated with increased rates of hospitalisation/death. All patients who died had three or more co-morbidities or were over 60 years old.
Interpretation: In this cohort with inflammatory rheumatic diseases and high vaccination rates, severe outcomes from SARS-CoV-2 Omicron variant were relatively infrequent. The outcome of Omicron variant infection among vaccinated but SARS-CoV-2 infection-naive people with inflammatory rheumatic disease without other known risk factors were favourable.
Funding: Financial support from the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) included management of COVID-19 Global Rheumatology Alliance funds.

Keywords: COVID-19; Outcomes; Rheumatic disease; SARS-CoV-2.

 
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