Background: In this pandemia, it is essential for rheumatologist and patients to know the relationship between COVID-19 and inflammatory rheumatic diseases (IRD). We want to assess the role of targeted synthetic or biologic disease modifying antirheumatic drugs (ts/bDMARDs) and other variables in the development of moderate-severe COVID-19 disease in IRD. Methods: An observational longitudinal study was conducted (1stMar to 15thApr 2020). All patients from the rheumatology outpatient clinic from a hospital in Madrid with a medical diagnosis of IRD were included. Main outcome: hospital admission related to COVID-19. Independent variable: ts/bDMARDs. Covariates: sociodemographic, comorbidities, type of IRD diagnosis, glucocorticoids, NSAIDs and conventional synthetic DMARDs (csDMARDs). Incidence rate (IR) of hospital admission related to COVID-19, was expressed per 1,000 patients-month. Cox multivariate regression analysis was run to examine the influence of ts/bDMARDs and other covariates on IR. Results: 3,591 IRD patients were included (5,896 patients-month). Concerning csDMARDs, methotrexate was the most used followed by antimalarials. 802 patients were on ts/bDMARDs, mainly anti-TNF agents, and rituximab. Hospital admissions related to COVID-19 occurred in 54 patients (1.36%) with an IR of 9.15 [95%CI: 7-11.9]. In the multivariate analysis, older, male gender, presence of comorbidities and specific systemic autoimmune conditions (Sjoegren, polychondritis, Raynaud and mixed connective tissue disease) had more risk of hospital admissions regardless other factors. Exposition to ts/bDMARDs did not achieve statistical signification. Use of glucocorticoids, NSAIDs, and csDMARDs dropped from the final model. Conclusion: This study provides additional evidence in IRD patients regarding susceptibility to moderate-severe infection related to COVID-19.

中文翻译：

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COVID-19大流行期间炎性风湿病的住院人数：疾病调节剂的发生率和作用

背景：在这种大流行中，风湿病学家和患者必须了解COVID-19与炎性风湿病（IRD）之间的关系。我们想评估靶向合成或生物疾病修饰抗风湿药（ts / bDMARDs）和其他变量在IRD中中重度COVID-19疾病发展中的作用。方法：进行了观察性纵向研究（2020年3月1日至4月15日）。包括来自马德里一家医院的风湿病门诊的所有诊断为IRD的患者。主要结果：与COVID-19相关的医院入院。自变量：ts / bDMARD。协变量：社会人口统计学，合并症，IRD诊断类型，糖皮质激素，NSAID和常规合成DMARD（csDMARD）。与COVID-19相关的入院发病率（IR），每1000名患者每月表达一次。进行Cox多元回归分析以检查ts / bDMARDs和其他协变量对IR的影响。结果：包括3,591名IRD患者（5,896名患者-月）。关于csDMARD，甲氨蝶呤是最常用的，其次是抗疟药。802例患者接受ts / bDMARDs治疗，主要是抗TNF药物和利妥昔单抗。54例患者（1.36％）发生了与COVID-19相关的医院入院，IR值为9.15 [95％CI：7-11.9]。在多变量分析中，无论其他因素如何，老年人，男性，合并症和特定的全身自身免疫性疾病（Sjoegren，多发性软骨炎，Raynaud和混合性结缔组织病）的住院风险均较高。ts / bDMARDs的暴露没有统计学意义。糖皮质激素，NSAID，和csDMARD从最终模型中删除。结论：这项研究为IRD患者提供了与COVID-19相关的中重度感染敏感性的其他证据。