Rheumatic Disease Outcomes Being Tracked in COVID-19 Registry

In response to the COVID-19 pandemic, the Global Rheumatology Alliance has been created to collect data on how the virus is affecting patients with rheumatic diseases or those who are taking immunosuppressive therapies. The alliance, which includes 300 rheumatologists, scientists and patients from throughout the world, has created a registry for physicians to report COVID-19 cases.

Writing in Nature Reviews Rheumatology, Philip Robinson, M.D., Ph.D., of the University of Queensland in Brisbane, Australia, noted that many patients infected with SARS-CoV-2 are severely ill and fatality rates are higher than for viruses such as influenza. The nature of the virus also exacerbates already limited resources, as severe cases may require 15 to 20 days of ventilation. Since patients with rheumatic diseases have underlying immune dysfunction and are treated with immunosuppressive therapies, this can increase the risk of serious infections raising their risk for more severe outcomes as compared to the general population.

Data are limited of the effects of COVID-19 on patients with rheumatic disease. Existing data suggests that in general there is an increased serious infection risk in patients treated with commonly used anti-rheumatic agents, biologics and glucocorticoids. During previous coronavirus epidemics (such as the 2002–2003 SARS-CoV epidemic) limited.

The alliance’s rheumatology COVID-19 registry is designed to identify disease outcomes in patients with rheumatic diseases, particularly those treated with immunosuppressive therapies, and to determine the potential harms or benefits of particular immunosuppressive and immunomodulatory therapies in COVID-19 infection. Data on patient demographics, rheumatic disease phenotypes, comorbidities, drug therapies and COVID-19 outcomes, are being collected via a survey that is available on the registry website.

The alliance’s work will include health claims data analyses and literature reviews to gain a population-level view of how people using immunosuppressive therapies fare during the pandemic. This includes working with patient support groups that are administering questionnaires to gather information on the burden of COVID-19 on patients with rheumatic diseases.

Through the registry, “rheumatologists  will be able to gather a rapid, worldwide case series with which to compare trends in COVID-19 outcomes across diseases, therapies and geographical areas,” which may help “generate hypotheses regarding risk and therapy and to provide information to physicians and patients in the short-term,” the authors wrote. “Longer term, the data might serve as preliminary information for the design of larger, systematic studies that address outcomes in specific sub-groups of patients or on the management of immunosuppressive therapies during infection.”

Clinical trials of potential treatments for COVID-19, including antimalarials, tocilizumab, Janus kinase inhibitors, IL-1 inhibitors, IL-6 inhibitors, intravenous immunoglobulin and leflunomide, are progressing.

REFERENCE

Philip C. Robinson, Jinoos Yazdany. “The COVID-19 Global Rheumatology Alliance: collecting data in a pandemic.” Nature Reviews Rheumatology. April 2, 2020. DOI: https://doi.org/10.1038/s41584-020-0418-0