Document Type

Conference Proceeding

Publication Date

5-2-2025

Abstract

COVID-19 has disproportionately affected racial and ethnic minority groups and immunocompromised groups, including those with autoimmune diseases. Studies have shown that African American, Hispanic, and Asian American individuals have higher risk of COVID-19 positivity and ICU admissions. SARS-CoV-2 shares numerous similarities with autoimmune diseases in its symptomology and ability to dysregulate the immune response. This study seeks to investigate differences in COVID-related outcomes between patients with autoimmune diseases and the general population. Methods A multi-center retrospective study was conducted with data from the EPIC database at Corewell Health System in Michigan from December 2019 to November 2021. Variables collected included age, sex, race and ethnicity, and in-hospital outcomes such as mortality, length of stay, ICU stays. Patients were stratified by preexisting autoimmune disease hospitalized for COVID-19 and a control group of COVID-19 patients without preexisting autoimmune diseases. Statistical comparisons were conducted by chi-square tests for categorical variables and t-test for continuous measures. Results Among 11,600 COVID-19 hospitalizations, 408 patients had preexisting autoimmune diseases. The autoimmune group was predominantly female (67.6%; p< 0.0001). Black patients were slightly more represented in the autoimmune cohort (26.5% vs. 24.1%; p=0.003) Asians and Arabs/Middle Eastern Descendants were more prevalent in the non-autoimmune cohort (p=0.001). The autoimmune cohort had longer hospital stays (mean 9.65 vs. 8.26 days; p < 0.004) and a trend of higher ICU utilization (15% vs 12.8%, p=0.201) and no significant difference in mortality. Autoimmune conditions included rheumatoid arthritis (26.5%), systemic lupus erythematosus (12.7%), type 1 diabetes (87%), and sarcoidosis (14%), among others. Conclusion Autoimmune patients hospitalized with COVID-19 had longer length of hospitalizations and demographic distinctions, reaffirming the propensity for autoimmune disease to affect women and increased comorbidity. Lack of significant difference in ICU metrics and mortality add to the understanding that autoimmune disease may not necessarily increase these risks. In-depth analysis of how different autoimmune diseases fared from one another during the hospital course and the use of chronic immunosuppressants could provide further insight on the relationship between autoimmune diseases and COVID-19 outcomes. Understanding COVID-19 outcomes in this vulnerable population is complex, but necessary in better characterizing risks and improving disease management for those with autoimmune disease in the context of COVID-19.

Comments

American College of Physicians Michigan Chapter and Society of Hospital Medicine Michigan Chapter Resident and Medical Student Day, May 2, 2025, Troy, MI

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