{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:32:14Z","timestamp":1788971534085,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK2\u2010CX\u2010002203"],"award-info":[{"award-number":["IK2\u2010CX\u2010002203"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["I01\u2010BX\u2010004660"],"award-info":[{"award-number":["I01\u2010BX\u2010004660"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["I01\u2010CX\u2010001703"],"award-info":[{"award-number":["I01\u2010CX\u2010001703"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54\u2010GM\u2010115458"],"award-info":[{"award-number":["U54\u2010GM\u2010115458"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Rheumatoid arthritis (RA) and its treatments are associated with an increased risk of infection, but it remains unclear whether these factors have an impact on the risk or severity of COVID\u201019. The present study was undertaken to assess the risk and severity of COVID\u201019 in a US Department of Veterans Affairs (VA) cohort of patients with RA and those without RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A matched cohort study using national VA data was conducted. Patients diagnosed as having RA were identified among nondeceased individuals who were active in the VA health care system as of January 1, 2020 and who had received care in a VA medical center in 2019; patients for whom no RA diagnostic code was indicated were matched to the RA patients (1:1) by age, sex, and VA site (non\u2010RA controls). Patients diagnosed as having COVID\u201019 and those with severe COVID\u201019 (defined as requiring hospitalization or leading to death) were ascertained from a national VA COVID\u201019 surveillance database through December 10, 2020. Multivariable Cox models were used to compare the risk of COVID\u201019 and COVID\u201019 hospitalization or death between RA patients and non\u2010RA controls, after adjusting for demographic characteristics, comorbidities, health care utilization and access, and county\u2010level COVID\u201019 incidence rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This VA cohort of RA patients and non\u2010RA controls (n = 33,886 subjects per group) predominantly comprised male patients (84.5%), and the mean age was 67.8 years. During follow\u2010up, 1,503 patients in the cohort were diagnosed as having COVID\u201019; among them, 388 patients had severe COVID\u201019 (hospitalization or death), while in 228 patients, the deaths were not related to COVID\u201019. In the multivariable model, RA was associated with a higher risk of COVID\u201019 (adjusted hazard ratio [HR] 1.25 [95% confidence interval (95% CI) 1.13\u20131.39]) and a higher risk of COVID\u201019 hospitalization or death (adjusted HR 1.35 [95% CI 1.10\u20131.66]) as compared to non\u2010RA controls. Use of disease\u2010modifying antirheumatic drugs and prednisone, as well as self\u2010reported Black race, self\u2010reported Hispanic ethnicity, and presence of several chronic conditions, but not seropositivity for RA autoantibodies, were each associated with risk of COVID\u201019 and severe COVID\u201019 (hospitalization or death).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with RA are at higher risk of developing COVID\u201019 and severe COVID\u201019 (leading to hospitalization or death) compared to those without RA. With a risk of COVID\u201019 that approaches that of other recognized chronic conditions, these findings suggest that RA patients should be prioritized for COVID\u201019 prevention and management strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41800","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T15:58:05Z","timestamp":1620316685000},"page":"2179-2188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":109,"title":["Risk of COVID\u201019 in Rheumatoid Arthritis: A National Veterans Affairs Matched Cohort Study in At\u2010Risk Individuals"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-3588","authenticated-orcid":false,"given":"Bryant R.","family":"England","sequence":"first","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punyasha","family":"Roul","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyuna","family":"Yang","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre C.","family":"Kalil","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaleb","family":"Michaud","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center, Omaha, and FORWARD\u2014The National Databank for Rheumatic Diseases  Wichita Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey M.","family":"Thiele","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3546-3051","authenticated-orcid":false,"given":"Brian C.","family":"Sauer","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System and University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-7563","authenticated-orcid":false,"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VAMC and University of Pennsylvania  Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0897-2272","authenticated-orcid":false,"given":"Ted R.","family":"Mikuls","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/AITC201901010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000598"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes305"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.0994"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm695152e1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-219498"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102021\u2010220134."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41567"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41619"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-219279"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2521-4"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2013.03.075"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.21465"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09610620"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.12.003"},{"key":"e_1_2_7_18_1","unstructured":"US Department of Veterans Affairs.VA informatics and computing infrastructure: updates to the VA COVID\u201019 Shared Data Resource and its use for research. 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