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The Association between Noninfectious Uveitis and Coronavirus Disease 2019 Outcomes: An Analysis of United States Claims-Based Data.
- Source :
-
Ophthalmology [Ophthalmology] 2022 Mar; Vol. 129 (3), pp. 334-343. Date of Electronic Publication: 2021 Oct 11. - Publication Year :
- 2022
-
Abstract
- Purpose: To identify if noninfectious uveitis (NIU) is associated with a greater risk of Coronavirus Disease 2019 (COVID-19) infection, hospitalization, and death.<br />Design: A retrospective cohort study from January 20, 2020 to December 31, 2020, using a national claims-based database.<br />Participants: Enrollees who had continuous enrollment with both medical and pharmacy coverage for 3 years before January 20, 2020. Patients with an NIU diagnosis within 3 years of the start of the study were included in the NIU cohort. Those with infectious uveitis codes or new NIU diagnoses during the risk period were excluded.<br />Methods: Cox proportional hazard models were used to identify unadjusted hazard ratios (HRs) and adjusted HRs for all covariates for each outcome measure. Adjusted models accounted for patient demographics, health status, and immunosuppressive medication use during the risk period.<br />Main Outcome Measures: Rates of COVID-19 infection, COVID-19-related hospitalization, and COVID-19-related in-hospital death identified with International Classification of Disease 10 <superscript>th</superscript> revision codes.<br />Results: This study included 5 806 227 patients, of whom 29 869 (0.5%) had a diagnosis of NIU. On unadjusted analysis, patients with NIU had a higher rate of COVID-19 infection (5.7% vs. 4.5%, P < 0.001), COVID-19-related hospitalization (1.2% vs. 0.6%, P < 0.001), and COVID-19-related death (0.3% vs. 0.1%, P < 0.001). However, in adjusted models, NIU was not associated with a greater risk of COVID-19 infection (HR, 1.05; 95% confidence interval [CI], 1.00-1.10; P = 0.04), hospitalization (HR, 0.98; 95% CI, 0.88-1.09; P = 0.67), or death (HR, 0.90, 95% CI, 0.72-1.13, P = 0.37). Use of systemic corticosteroids was significantly associated with a higher risk of COVID-19 infection, hospitalization, and death.<br />Conclusions: Patients with NIU were significantly more likely to be infected with COVID-19 and experience severe disease outcomes. However, this association was due to the demographics, comorbidities, and medications of patients with NIU, rather than NIU alone. Patients using systemic corticosteroids were significantly more likely to be infected with COVID-19 and were at greater risk of hospitalization and in-hospital death. Additional investigation is necessary to identify the impact of corticosteroid exposure on COVID-19-related outcomes.<br /> (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Databases, Factual
Female
Glucocorticoids therapeutic use
Humans
Immunosuppressive Agents therapeutic use
Male
Middle Aged
Outcome Assessment, Health Care
Proportional Hazards Models
Retrospective Studies
Risk Factors
United States epidemiology
Uveitis diagnosis
Uveitis drug therapy
COVID-19 epidemiology
Hospital Mortality
Hospitalization statistics & numerical data
Insurance Claim Review statistics & numerical data
SARS-CoV-2
Uveitis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1549-4713
- Volume :
- 129
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 34648828
- Full Text :
- https://doi.org/10.1016/j.ophtha.2021.10.007