Rebecca Araujo

DocwireNews

A study in <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00006-1/fulltext" target="_blank" rel="noopener">The Lancet Rheumatology</a> sought to understand the experiences and outcomes of patients with rheumatic disease who received outpatient treatment for COVID-19 infection.&ldquo;Some patients with systemic autoimmune rheumatic disease and immunosuppression might still be at risk of severe COVID-19,&rdquo; the authors wrote. &ldquo;The effect of outpatient SARS-CoV-2 treatments on COVID-19 outcomes among patients with systemic autoimmune rheumatic disease is unclear.&rdquo;To fill the gaps in understanding in this population, the investigates conducted a retrospective study of adult patients treated at Mass General Brigham Integrated Health Care system in Boston. Key endpoints included temporal trends, COVID-19 outcome severity, and COVID-19 rebound, compared between patients with pre-existing systematic rheumatic disease who received outpatient treatment and those who did not.COVID-19 status was identified by a positive PCR or antigen test, and diagnosis codes and immunomodulator prescriptions were used to identify autoimmune rheumatic disease status. A medical record review identified whether outpatient SARS-CoV-2 treatments were administered. Severe COVID-19 was defined as hospitalization or death within 30 days of the positive test. Rebound was defined as documentation of a negative COVID-19 test after treatment followed by a newly positive test.In total 704 patients were included; patients were treated between January 23 and May 30, 2022. The mean age was 58.4 years. Seventy-six percent of patients were female. Six percent of patients were Black, and 84% were White. Rheumatoid arthritis was confirmed in 49% of patients.Of the total cohort, 61% received outpatient SARS-CoV-2 treatment. The authors noted that the use of these treatments increased in frequency over the study period (P&lt;0.0001). Treatments administered were:<ul>
<li>nirmatrelvir&ndash;ritonavir (44%) 
monoclonal antibodies (15%)</li>
<li>molnupiravir (1%) 
remdesivir (&lt;1%)</li>
<li>combination treatment (1%)</li>
</ul>Among the 426 patients who received outpatient treatment, there were 9 (2.1%) severe COVID-19 cases, compared with 49 (17.6%) cases among the 278 patients who did not receive the treatment (adjusted odds ratio: 0.12, 95% confidence interval: 0.05&ndash;0.25). Among a subgroup of 318 patients who received oral outpatient treatment, 25 (7.9%) had a documented COVID-19 rebound.&ldquo;Outpatient treatment was associated with lower odds of severe COVID-19 outcomes compared with no outpatient treatment,&rdquo; summarized the authors. &ldquo;These findings highlight the importance of outpatient SARS-CoV-2 treatment for patients with systemic autoimmune rheumatic disease and COVID-19, and the need for further research on COVID-19 rebound.&rdquo;

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Outpatient COVID-19 Treatment in Patients with Rheumatic Diseases Is Associated with Reduced Hospitalization and Mortality

COVID-19

A study in The Lancet Rheumatology sought to understand the experiences and outcomes of patients with rheumatic disease who received outpatient treatment for COVID-19 ...

Outpatient COVID-19 Treatment in Patients with Rheumatic Diseases Is Associated with Reduced

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