Prevalence and risk of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis

Feier Wang; Yubo Ma; Shanshan Xu; Huanhuan Liu; Yuting Chen; Hui Yang; Ming Shao; Wei Xu; Jiangping Kong; Liwen Chen; Shengqian Xu; Zongwen Shuai; Faming Pan

doi:10.1007/s10067-022-06087-1

Prevalence and risk of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis

Clin Rheumatol. 2022 Jul;41(7):2213-2223. doi: 10.1007/s10067-022-06087-1. Epub 2022 Mar 30.

Authors

Feier Wang^#^{1

2}, Yubo Ma^#^{1

2}, Shanshan Xu^{1

2}, Huanhuan Liu³, Yuting Chen^{1

2}, Hui Yang^{1

2}, Ming Shao^{1

2}, Wei Xu^{1

2}, Jiangping Kong^{1

2}, Liwen Chen³, Shengqian Xu⁴, Zongwen Shuai⁴, Faming Pan^{5

6}

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
² The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
³ Department of Clinical Laboratory, the Second Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China.
⁴ Department of Rheumatism and Immunity, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
⁵ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. famingpan@ahmu.edu.cn.
⁶ The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. famingpan@ahmu.edu.cn.

^# Contributed equally.

Abstract

Objectives: COVID-19 pandemic has already had a tremendous impact on the process of human society; the survival of mankind and the healthy living environment deterioration with the influence will last for many years. This meta-analysis aims to assess the risk of COVID-19 in patients with rheumatic diseases.

Methods: PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Database (CBM) were systematically searched with no language restriction up to July 5, 2021. The pooled rates were synthesized by fixed effect model or random effect model depending on heterogeneity.

Results: A total of 83 articles were included in this meta-analysis. The incidence of COVID-19 in patient with rheumatic diseases was 0.0190 (95% CI: 0.0136-0.0252), and the hospitalization rate, intensive care unit admission rate, mechanical ventilation rate, and case fatality rate of patients with rheumatic diseases infected with COVID-19 were 0.4396 (95% CI: 0.3899-0.4898), 0.0635 (95% CI: 0.0453-0.0836), 0.0461 (95% CI: 0.0330-0.0609), and 0.0346 (95% CI: 0.0218-0.0493), respectively.

Conclusions: Our research shows that patients with rheumatic diseases have great risk of COVID-19. Differences in COVID-19 incidence, hospitalization rates, and mortality rates in regions were statistically significant. We still need to pay attention to the risk of COVID-19 in patients with rheumatic diseases.

Key points: • Although the risk of COVID-19 in patients with rheumatic diseases has been discussed in previous meta-analysis, their research directions were inconsistent, and few studies focus on prevalence or serious outcomes of COVID-19 in patient with rheumatic diseases, while the quality of these articles was variable. • The incidence of COVID-19 and serious clinical outcomes in patients with rheumatic diseases were still high along with differential risks in most regions. • The use of glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs did not affect the hospitalization rate and mortality in rheumatism patients with COVID-19.

Keywords: COVID-19; Meta-analysis; Prevalence; Rheumatic disease.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

COVID-19* / epidemiology
Humans
Pandemics
Prevalence
Rheumatic Diseases* / complications
Rheumatic Diseases* / epidemiology
SARS-CoV-2