Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19 : A Binational Cohort Study
BACKGROUND: Some data suggest a higher incidence of diagnosis of autoimmune inflammatory rheumatic diseases (AIRDs) among patients with a history of COVID-19 compared with uninfected patients. However, these studies had methodological shortcomings.
OBJECTIVE: To investigate the effect of COVID-19 on long-term risk for incident AIRD over various follow-up periods.
DESIGN: Binational, longitudinal, propensity-matched cohort study.
SETTING: Nationwide claims-based databases in South Korea (K-COV-N cohort) and Japan (JMDC cohort).
PARTICIPANTS: 10 027 506 Korean and 12 218 680 Japanese patients aged 20 years or older, including those with COVID-19 between 1 January 2020 and 31 December 2021, matched to patients with influenza infection and to uninfected control patients.
MEASUREMENTS: The primary outcome was onset of AIRD (per appropriate codes from the International Classification of Diseases, 10th Revision) 1, 6, and 12 months after COVID-19 or influenza infection or the respective matched index date of uninfected control patients.
RESULTS: Between 2020 and 2021, among the 10 027 506 Korean participants (mean age, 48.4 years [SD, 13.4]; 50.1% men), 394 274 (3.9%) and 98 596 (0.98%) had a history of COVID-19 or influenza, respectively. After propensity score matching, beyond the first 30 days after infection, patients with COVID-19 were at increased risk for incident AIRD compared with uninfected patients (adjusted hazard ratio, 1.25 [95% CI, 1.18 to 1.31]) and influenza-infected control patients (adjusted hazard ratio, 1.30 [CI, 1.02 to 1.59]). The risk for incident AIRD was higher with more severe acute COVID-19. Similar patterns were observed in the Japanese cohort.
LIMITATIONS: Referral bias due to the pandemic; residual confounding.
CONCLUSION: SARS-CoV-2 infection was associated with increased risk for incident AIRD compared with matched patients without SARS-CoV-2 infection or with influenza infection. The risk for incident AIRD was higher with greater severity of acute COVID-19.
PRIMARY FUNDING SOURCE: National Research Foundation of Korea.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:177 |
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| Enthalten in: |
Annals of internal medicine - 177(2024), 3 vom: 19. März, Seite 291-302 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kim, Min Seo [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 20.03.2024 Date Revised 20.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.7326/M23-1831 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369275640 |
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| 100 | 1 | |a Kim, Min Seo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19 |b A Binational Cohort Study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Some data suggest a higher incidence of diagnosis of autoimmune inflammatory rheumatic diseases (AIRDs) among patients with a history of COVID-19 compared with uninfected patients. However, these studies had methodological shortcomings | ||
| 520 | |a OBJECTIVE: To investigate the effect of COVID-19 on long-term risk for incident AIRD over various follow-up periods | ||
| 520 | |a DESIGN: Binational, longitudinal, propensity-matched cohort study | ||
| 520 | |a SETTING: Nationwide claims-based databases in South Korea (K-COV-N cohort) and Japan (JMDC cohort) | ||
| 520 | |a PARTICIPANTS: 10 027 506 Korean and 12 218 680 Japanese patients aged 20 years or older, including those with COVID-19 between 1 January 2020 and 31 December 2021, matched to patients with influenza infection and to uninfected control patients | ||
| 520 | |a MEASUREMENTS: The primary outcome was onset of AIRD (per appropriate codes from the International Classification of Diseases, 10th Revision) 1, 6, and 12 months after COVID-19 or influenza infection or the respective matched index date of uninfected control patients | ||
| 520 | |a RESULTS: Between 2020 and 2021, among the 10 027 506 Korean participants (mean age, 48.4 years [SD, 13.4]; 50.1% men), 394 274 (3.9%) and 98 596 (0.98%) had a history of COVID-19 or influenza, respectively. After propensity score matching, beyond the first 30 days after infection, patients with COVID-19 were at increased risk for incident AIRD compared with uninfected patients (adjusted hazard ratio, 1.25 [95% CI, 1.18 to 1.31]) and influenza-infected control patients (adjusted hazard ratio, 1.30 [CI, 1.02 to 1.59]). The risk for incident AIRD was higher with more severe acute COVID-19. Similar patterns were observed in the Japanese cohort | ||
| 520 | |a LIMITATIONS: Referral bias due to the pandemic; residual confounding | ||
| 520 | |a CONCLUSION: SARS-CoV-2 infection was associated with increased risk for incident AIRD compared with matched patients without SARS-CoV-2 infection or with influenza infection. The risk for incident AIRD was higher with greater severity of acute COVID-19 | ||
| 520 | |a PRIMARY FUNDING SOURCE: National Research Foundation of Korea | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Lee, Hayeon |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Seung Won |e verfasserin |4 aut | |
| 700 | 1 | |a Kwon, Rosie |e verfasserin |4 aut | |
| 700 | 1 | |a Rhee, Sang Youl |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jin A |e verfasserin |4 aut | |
| 700 | 1 | |a Koyanagi, Ai |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Lee |e verfasserin |4 aut | |
| 700 | 1 | |a Fond, Guillaume |e verfasserin |4 aut | |
| 700 | 1 | |a Boyer, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jinseok |e verfasserin |4 aut | |
| 700 | 1 | |a Rahmati, Masoud |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Ju-Young |e verfasserin |4 aut | |
| 700 | 1 | |a Min, Chanyang |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Jae Il |e verfasserin |4 aut | |
| 700 | 1 | |a Yon, Dong Keon |e verfasserin |4 aut | |
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