TY - JOUR T1 - TNFi is associated with positive outcome, but JAKi and rituximab are associated with negative outcome of SARS-CoV-2 infection in patients with RMD JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2021-001896 VL - 7 IS - 3 SP - e001896 AU - Anne Constanze Regierer AU - Rebecca Hasseli AU - Martin Schäfer AU - Bimba F Hoyer AU - Andreas Krause AU - Hanns-Martin Lorenz AU - Alexander Pfeil AU - Jutta Richter AU - Tim Schmeiser AU - Hendrik Schulze-Koops AU - Anja Strangfeld AU - Reinhard E Voll AU - Christof Specker AU - Ulf Mueller-Ladner Y1 - 2021/10/01 UR - http://rmdopen.bmj.com/content/7/3/e001896.abstract N2 - Introduction Several risk factors for severe COVID-19 specific for patients with inflammatory rheumatic and musculoskeletal diseases (RMDs) have been identified so far. Evidence regarding the influence of different RMD treatments on outcomes of SARS-CoV-2 infection is still poor.Methods Data from the German COVID-19-RMD registry collected between 30 March 2020 and 9 April 2021 were analysed. Ordinal outcome of COVID-19 severity was defined: (1) not hospitalised, (2) hospitalised/not invasively ventilated and (3) invasively ventilated/deceased. Independent associations between demographic and disease features and outcome of COVID-19 were estimated by multivariable ordinal logistic regression using proportional odds model.Results 2274 patients were included. 83 (3.6%) patients died. Age, male sex, cardiovascular disease, hypertension, chronic lung diseases and chronic kidney disease were independently associated with worse outcome of SARS-CoV-2 infection. Compared with rheumatoid arthritis, patients with psoriatic arthritis showed a better outcome. Disease activity and glucocorticoids were associated with worse outcome. Compared with methotrexate (MTX), TNF inhibitors (TNFi) showed a significant association with better outcome of SARS-CoV-2 infection (OR 0.6, 95% CI0.4 to 0.9). Immunosuppressants (mycophenolate mofetil, azathioprine, cyclophosphamide and ciclosporin) (OR 2.2, 95% CI 1.3 to 3.9), Janus kinase inhibitor (JAKi) (OR 1.8, 95% CI 1.1 to 2.7) and rituximab (OR 5.4, 95% CI 3.3 to 8.8) were independently associated with worse outcome.Conclusion General risk factors for severity of COVID-19 play a similar role in patients with RMDs as in the normal population. Influence of disease activity on COVID-19 outcome is of great importance as patients with high disease activity—even without glucocorticoids—have a worse outcome. Patients on TNFi show a better outcome of SARS-CoV-2 infection than patients on MTX. Immunosuppressants, rituximab and JAKi are associated with more severe course.Data are available upon reasonable request. Applications to access the data should be made to the COVID-19 steering committee of the German Society for Rheumatology. ER -