Prolonged COVID-19 symptom duration in people with systemic autoimmune rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey
Michael DiIorio, Kevin Kennedy, Jean W. Liew, Michael Putman, Emily Sirotich, Sebastian E. Sattui, Gary Foster, Carly Harrison, Maggie Larché, Mitchell Levine, Tarin T Moni, Lehana Thabane, Suleman Bhana, Wendy Costello, Rebecca Grainger, Pedro Machado, Philip C. Robinson, Paul Sufka, Zachary S. Wallace, Jinoos Yazdany, Monique Gore‐Massy, Richard A. Howard, More A Kodhek, Nadine Lalonde, Laura-Ann Tomasella, John Wallace, Akpabio Akpabio, D. Alpizar-Rodriguez, Richard Beesley, Françis Berenbaum, Inita Buliņa, Eugenia Yupei Chock, Richard Conway, Alí Duarte‐García, Eimear Duff, Tamer A. Gheita, Elizabeth R. Graef, Evelyn Hsieh, Lina El Kibbi, David Liew, Chieh Lo, Michal Nudel, Aman Dev Singh, Jasvinder A. Singh, Namrata Singh, Manuel F. Ugarte‐Gil, Jonathan S. Hausmann, Julia F. Simard, Jeffrey A. Sparks
Abstract
OBJECTIVE: We investigated prolonged COVID-19 symptom duration, defined as lasting 28 days or longer, among people with systemic autoimmune rheumatic diseases (SARDs). METHODS: We analysed data from the COVID-19 Global Rheumatology Alliance Vaccine Survey (2 April 2021-15 October 2021) to identify people with SARDs reporting test-confirmed COVID-19. Participants reported COVID-19 severity and symptom duration, sociodemographics and clinical characteristics. We reported the proportion experiencing prolonged symptom duration and investigated associations with baseline characteristics using logistic regression. RESULTS: We identified 441 respondents with SARDs and COVID-19 (mean age 48.2 years, 83.7% female, 39.5% rheumatoid arthritis). The median COVID-19 symptom duration was 15 days (IQR 7, 25). Overall, 107 (24.2%) respondents had prolonged symptom duration (≥28 days); 42/429 (9.8%) reported symptoms lasting ≥90 days. Factors associated with higher odds of prolonged symptom duration included: hospitalisation for COVID-19 vs not hospitalised and mild acute symptoms (age-adjusted OR (aOR) 6.49, 95% CI 3.03 to 14.1), comorbidity count (aOR 1.11 per comorbidity, 95% CI 1.02 to 1.21) and osteoarthritis (aOR 2.11, 95% CI 1.01 to 4.27). COVID-19 onset in 2021 vs June 2020 or earlier was associated with lower odds of prolonged symptom duration (aOR 0.42, 95% CI 0.21 to 0.81). CONCLUSION: Most people with SARDs had complete symptom resolution by day 15 after COVID-19 onset. However, about 1 in 4 experienced COVID-19 symptom duration 28 days or longer; 1 in 10 experienced symptoms 90 days or longer. Future studies are needed to investigate the possible relationships between immunomodulating medications, SARD type/flare, vaccine doses and novel viral variants with prolonged COVID-19 symptoms and other postacute sequelae of COVID-19 among people with SARDs.