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Irish Society for Rheumatology, Autumn Meeting, virtual, 30 September – 1 October 2021
The Global Rheumatology Alliance (GRA) database established during the Covid-19 pandemic was a “grass roots” initiative and has been a “great success”, the recent Irish Society for Rheumatology (ISR) Autumn Meeting, which took place virtually on 30 September – 1 October, was told. Prof Kimme Hyrich, Professor of Epidemiology Centre for Musculoskeletal Research, University of Manchester and Manchester University NHS Trust, UK, told then meeting that the GRA database contains case reports of patients with a rheumatic and musculoskeletal disease
(RMD) who develop Covid-19.
The title of Prof Hyrich’s presentation was ‘Covid-19 and rheumatology: Lessons learned from an international database’. On the importance of the database itself, she said during the early months of the pandemic “a group of
investigators from around the world pooled together and thought that we need to do something different
and what came out of this was what was called the Covid-19 Global Rheumatology Alliance”.
Prof Hyrich said this “grass roots initiative” had “overall… been a great success”, adding that close to 20,000 cases are registered on the database. She noted that the database is reliant on individual physicians to report cases that they are aware of, so therefore the database will not cover all cases. Prof Hyrich added that, because of the nature of the reporting, database is biased towards more severe Covid-19 cases. Despite these limitations, she said it was an “incredibly valuable” resource for understanding the relative associations between different age groups, different co-morbidities, different levels of disease activity, and different RMD treatments.
Prof Kimme Hyrich
In terms of findings, the database found “factors associated with hospitalisation or death to be quiet similar to the general population”. “But [we] did see some association with some of our therapies, particularly rituximab, and some of the immune suppressing drugs for higher odds of death.” Prof Hyrich said that “one of the strongest risk factors was, in fact, high disease activity rather than any of the treatments themselves”.
She said that the data from the GRA found that patients who developed severe Covid-19 were also likely to have had higher disease activity. She added: “I think the advice to continue treatments and to continue to treat our RMDs [patients] as if there is not a pandemic, was good advice.” On the issue of vaccines, she said they “are an incredibly important step in protecting our patients, but we are desperate for real-world effectiveness studies to really understand the booster programme that is launching”.