Abstract
Objectives: To calculate the rates of COVID19 infection and COVID19 related death among people with rare autoimmune rheumatic diseases (RAIRD) during the first wave of the COVID19 pandemic in England compared to the general population. Methods: We used Hospital Episode Statistics to identify all people alive 01 March 2020 with ICD10 codes for RAIRD from the whole population of England. We used linked national health records (demographic, death certificate, admissions and PCR testing data) to calculate rates of COVID19 infection and death up to 31 July 2020. Our primary definition of COVID19 related death was mention of COVID19 on the death certificate. General population data from Public Health England and the Office for National Statistics were used for comparison. We also describe COVID19 related hospital admissions and all cause deaths. Results: We identified a cohort of 168,680 people with RAIRD, of whom 1874 (1.11%) had a positive COVID19 PCR test. The age standardised infection rate was 1.54 (95% CI 1.50, 1.59) times higher than in the general population. 713 (0.42%) people with RAIRD died with COVID19 on their death certificate and the age sex standardised mortality rate for COVID19 related death was 2.41 (2.30, 2.53) times higher than in the general population. There was no evidence of an increase in deaths from other causes in the RAIRD population. Conclusions: During the first wave of COVID19 in England, people with RAIRD had a 54% increased risk of COVID19 infection and more than twice the risk of COVID19 related death compared to the general population. These increases were seen despite shielding policies.
Competing Interest Statement
Competing Interest Statement: FP and PCL are recipients of a grant from Vifor pharma. Vifor pharma had no influence on the design, conduct or interpretation of this study.
Funding Statement
Funding Statement: MR is funded by Vasculitis UK (patient charity) and the British Society for Rheumatology, and would like to thank them for their help and support. FP and PCL are recipients of a grant from Vifor pharma. Vifor pharma had no influence on the design, conduct or interpretation of this study.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
This study received a favourable opinion from the Camden and Kings Cross Research Ethics Committee, study reference 20 HRA 2076, on 18 June 2020. The legal basis to access the data is predominantly covered by NCARDRS Section 251 approval, Reference CAG 10 02d 2015. Where the work extends beyond Section 251 approval, it has been approved under Regulation 3,4 of the Health Service Control of Patient Information Regulations 2002, COPI, allowing the processing of confidential patient information for the purposes of protecting public health and managing the COVID19 outbreak. For quality assurance the data extraction and analysis were re-conducted by an independent analyst from the National Disease Registration Service.
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.
Yes
Paper in collection COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv
Source:https://www.medrxiv.org/content/10.1101/2021.08.17.21260846v1
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