OBJECTIVE: The relative risk of SARS-CoV-2 infection and COVID-19 disease severity among people with rheumatic and musculoskeletal diseases (RMD) compared to those without RMD remains uncertain. We sought to quantify the risk for SARS-CoV-2 infection and describe clinical outcomes of COVID-19 in people with RMD. METHODS: A systematic literature review was conducted using 14 databases from January 1(st) , 2019 to February 13(th) , 2021. We included observational studies and experimental trials in RMD patients reporting comparative rates of SARS-CoV-2 infection, hospitalization, oxygen supplementation/ICU admission/mechanical ventilation, or mortality attributed to COVID-19. Methodological quality was evaluated using the Joanna Briggs Institute Critical Appraisal Tools or the Newcastle-Ottawa scale. Risk ratios (RRs) and odds ratios (ORs) were calculated, as applicable for each outcome, using the Mantel-Haenszel formula with random effect models. RESULTS: Of 5799 abstracts screened, 100 studies met criteria for inclusion in the systematic review and 54/100 had a low risk-of-bias. Among studies included in the meta-analyses, we found an increased prevalence of SARS-CoV-2 infection in people with RMD (RR 1.53 (95%CI 1.16, 2.01)) compared with the general population. Odds of hospitalization, ICU admission, and mechanical ventilation were similar in patients with and without RMD, whereas odds of mortality was increased (OR 1.74 (95%CI 1.08, 2.80)). A smaller number of studies reported adjusted risk for outcomes and variably demonstrated increased risk for no difference in risk. CONCLUSION: Patients with RMDs had higher rates of SARS-CoV-2 infection and increased odds of mortality. This article is protected by copyright. All rights reserved.
- All age groups
- Risk factor
- COVID-19
