Objectives To investigate Covid-19-associated risk of hospitalization and death in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) in comparison with the general population during pandemic’s first year and compare their overall mortality with 2019. Methods Interlinking nation-wide electronic registries, we recorded confirmed Covid-19-associated infections, hospitalizations and deaths, and all-cause deaths between 1-March-2020 and 28-February-2021 in all adults with RA, AS, PsA, SLE, and SSc under treatment (n = 74 970, median age 67.5, 51.2, 58.1, 56.2, 62.2 years, respectively) and in matched (1:5) on age, sex, and region of domicile random comparators from the general population. Deaths from all causes during 2019 were also recorded. Results Compared with the general population incidence rates (IR) for Covid-19-associated hospitalization were higher in RA [IR ratio (IRR):1.71(1.50–1.95)], SLE [2.0(1.4–2.7)] and SSc [2.28(1.29–3.90)], while Covid-19-associated death rates were higher in RA [1.91(1.46–2.49)]. When focusing only on SARS-CoV-2 infected subjects, after adjusting for age and gender, the odds ratio for Covid-19 associated death was higher in RA [1.47(1.11– 1.94)] and SSc [2.92(1.07–7.99)] compared with the general population. All-cause mortality rate compared with the general population increased in RA during the first pandemic year (IRR : 0.71) with reference to 2019 (0.59) and decreased in SSc (IRR : 1.94 vs 4.36). Conclusion Covid-19 may have more severe impact in patients with systemic rheumatic disease than the general population. Covid-19-related mortality is increased in subgroups of patients with specific rheumatic diseases, underscoring the need for priority vaccination and access to targeted treatments.

中文翻译：

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全身性风湿病的不同 Covid-19 结果：一项全国范围的队列研究

目的 与普通人群相比，调查类风湿性关节炎 (RA)、强直性脊柱炎 (AS)、银屑病关节炎 (PsA)、系统性红斑狼疮 (SLE) 和系统性硬化症 (SSc) 患者因 Covid-19 住院和死亡的相关风险在大流行的第一年，并将他们的总体死亡率与 2019 年进行比较。方法将全国电子登记处相互关联，我们记录了 2020 年 3 月 1 日至 2 月 28 日期间确认的与 Covid-19 相关的感染、住院和死亡以及全因死亡。 2021 年所有接受治疗的 RA、AS、PsA、SLE 和 SSc 成人（n = 74 970，中位年龄分别为 67.5、51.2、58.1、56.2、62.2 岁）以及年龄、性别匹配 (1:5) ，以及来自一般人群的住所随机比较者的区域。还记录了 2019 年期间因各种原因导致的死亡。结果 与 Covid-19 相关住院的一般人群发病率 (IR) 相比，RA [IR 比率 (IRR)：1.71(1.50–1.95)]、SLE [2.0(1.4–2.7)] 和 SSc [2.28] (1.29-3.90)]，而 RA 中与 Covid-19 相关的死亡率更高 [1.91(1.46-2.49)]。当仅关注 SARS-CoV-2 感染者时，在调整年龄和性别后，RA [1.47(1.11–1.94)] 和 SSc [2.92(1.07–7.99)] 中 Covid-19 相关死亡的比值比更高与一般人群相比。与 2019 年（0.59）相比，RA 的全因死亡率与一般人群相比有所增加（IRR：0.71），而 SSc 的全因死亡率有所下降（IRR：1.94 对 4.36）。结论 Covid-19 对全身性风湿病患者的影响可能比一般人群更严重。