COVID-19 in French patients with chronic inflammatory rheumatic diseases: Clinical features, risk factors and treatment adherence

Joint Bone Spine. 2021 Jan;88(1):105095. doi: 10.1016/j.jbspin.2020.105095. Epub 2020 Nov 2.


Objective: To explore how patients with chronic inflammatory rheumatic diseases (CIRDs) coped with their disease during the COVID-19 pandemic and to identify possible predictive factors of SARS-CoV-2 infection in this population.

Methods: Patients followed in a single rheumatology department in France or registered on the Spondy+ platform, a secure e-health platform for spondyloarthritis patients, were invited to complete a questionnaire focused on their experiences around COVID19 symptoms, testing and medications access during the lockdown period. Descriptive statistics were used to report questionnaire's results. Factors associated with COVID-19 or with treatment discontinuation were assessed by logistic regression.

Results: We obtained 655 answers from the 2,081 contacted patients: 474 with spondyloarthritis, 129 with rheumatoid arthritis and 52 with psoriatic arthritis. The population was predominantly female (61.8%) with a mean age of 51.0±13.4 years. Incidence of COVID-19 was 6.9% (95%CI: 5.1-9.2%), including 12 confirmed and 33 highly suspicious cases. No death was observed and five patients needed to be hospitalized. Factors independently associated with an increased risk of infection were SARS-CoV-2 exposure, younger age and non-smoking. More than 30% of the patients suspended or decreased the dosage of one of their drugs during the lockdown period. This was followed in 63.4% of them by increased disease activity. Modifications were mostly motivated by fear of contagion (79.3%).

Conclusion: We did not observe any increase of incidence or severity of COVID-19 in patients suffering of the 3 most common CIRDs. This survey also adds evidence of the safety of anti-rheumatic drugs use regarding COVID-19.

Keywords: COVID-19; Non-steroidal anti-inflammatory drugs; Psoriatic arthritis; Rheumatoid arthritis; Spondyloarthritis.

MeSH terms

  • Antirheumatic Agents / therapeutic use*
  • COVID-19 / epidemiology*
  • Comorbidity
  • Female
  • France / epidemiology
  • Glucocorticoids / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Prognosis
  • Retrospective Studies
  • Rheumatic Diseases / drug therapy*
  • Rheumatic Diseases / epidemiology
  • Risk Factors
  • SARS-CoV-2*
  • Treatment Adherence and Compliance*


  • Antirheumatic Agents
  • Glucocorticoids