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People with certain inflammatory immune conditions affecting the joints, bowel and skin, such as rheumatoid arthritis, may have been more at risk of dying or needing hospital care if they got COVID-19 before vaccination compared with the general population, according to a new study published in The Lancet Rheumatology with the involvement of researchers from the University of Oxford.

A doctor holding a COVID-19 vaccine and another doctor examining a medical record.

The findings are based on an analysis of 17 million patient GP records in England during the first phase of the pandemic from March-September 2020, when the UK was in lockdown and before vaccines were available. Since then, many of the people treated with medicines analysed in this study have been specifically targeted for third primary vaccine doses followed by boosters and are on a list of people to offered anti-viral treatments.

The study was conducted by a team from the London School of Hygiene & Tropical Medicine (LSHTM) and the University of Oxford using the OpenSAFELY platform along with colleagues from St John’s Institute of Dermatology at Guy’s and St Thomas’ NHS Foundation Trust,  King’s College London, the University of Exeter and University of Edinburgh.

More than 1 million patients in the analysis had immune mediated inflammatory diseases (IMIDs). These included inflammatory bowel disease such as Crohn’s disease and ulcerative colitis, conditions affecting the joints such as rheumatoid arthritis, and skin conditions including psoriasis.

After accounting for age, sex, deprivation, and smoking status, the research suggests that people with IMIDs affecting the bowel, joints and skin had a 23% increased risk of COVID-19-related death and 23% increased risk of COVID-related hospitalisation compared to people without IMIDs before the introduction of vaccines and antiviral treatments. People with inflammatory joint disease appeared to be at greatest risk compared to those with gut or skin disease. Compared to the general population, the risk of death was estimated by the researchers to be approximately eight extra deaths per 1,000 people with joint disease in a year (without taking into account other differences between people with and without joint disease, e.g. age and other health conditions).

Read the full story on the University of Oxford website. 

 

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