medwireNews: People with gout, particularly women, may have an elevated risk for COVID-19 diagnosis and related death, suggest the results of a population-based study reported in The Lancet Rheumatology.
“This information could inform clinical decision making in people with gout diagnosed with COVID-19 and inform advice on vaccination decisions for people with gout,” say Tony Merriman (University of Alabama at Birmingham, USA) and colleagues.
The study analyzed data pertaining to 459,837 individuals from the UK Biobank cohort, of whom a sub-cohort of 16,898 (3.7%) individuals were diagnosed with COVID-19 between March 16, 2020 and April 6, 2021.
In the total cohort, 15,871 patients (13,345 men and 2526 women) were diagnosed with gout and 840 of these people had COVID-19. The researchers found that people with gout had a significantly higher risk for COVID-19 than those without gout, with an odds ratio (OR) of 1.41 after adjusting for age, sex, ethnicity, deprivation level, BMI, and smoking status (model 1). This association remained significant after adjusting for an additional 16 comorbidities (model 2), at an OR of 1.20.
Further analysis revealed a sex-based difference in the association between gout and COVID-19 diagnosis, at an OR of 1.44 for women versus 1.12 for men in model 2. Vaccination status also influenced risk for COVID-19. Among patients with gout, the OR for COVID-19 was a significant 1.21 among those who were not vaccinated compared with a nonsignificant 1.09 among those who were vaccinated against COVID-19.
There were a total of 1111 COVID-19-related deaths in the entire cohort and 136 among those with gout, which equated to mortality rates of 0.2% and 0.9%, respectively. Patients with gout had a significantly higher risk for COVID-19-related death than those without gout in model 1 (OR=1.76). This association was significant in model 2 but only after a categorical time variable was introduced (OR=1.29).
Once again, the risk for COVID-19-related mortality was higher for women than men with gout, with a significant OR in model 2 of 1.98 and a nonsignificant OR of 1.16 (with overlapping 95% confidence intervals), respectively.
The study authors note that “[w]omen with gout have an elevated risk of metabolic comorbidities (hypertension, dyslipidaemia, type 2 diabetes, chronic kidney disease, obesity, coronary heart disease, cerebrovascular disease, and heart failure.” They therefore adjusted for these eight comorbidities in model 1 to determine whether metabolic comorbidities account for women with gout having a higher risk for COVID-19-related death than men with gout.
Merriman et al found that women still had a higher risk for COVID-19-related death than men, with a significant OR of 2.10 versus a nonsignificant OR of 1.13.
They also evaluated the association between gout and risk for COVID-19-related mortality in the COVID-19 sub-cohort, finding no significant relationship until a categorical time variable was introduced in model 2 “[t]o account for improvements in outcome and SARS-CoV-2 evolution over time,” which gave a significant OR of 1.41.
In conclusion, the researchers say that their “estimates of the risk of COVID-19-related death could be used in clinician-patient discussions regarding patient decisions to be vaccinated against SARS-CoV-2.”
They continue: “Future research should focus on replicating these findings, including a focus on understanding key factors explaining the increased risk of death with COVID-19 in women with gout.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group
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