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Rheumatoid arthritis (RA) has been found to be a risk factor for death from COVID-19. Gout, however, has not been found to be associated with death from COVID-19.

These were among the key findings of a study published in . The authors used data from the well-known UK Biobank to conduct three separate analyses.

The first analysis found a link between RA and COVID-19 diagnosis (n=473,139); no similar link was found for gout. The second used a cohort of people who had died of or survived COVID-19 (n=2,059) to test for an association between gout and/or RA and COVID-19-related death, and found no connection for RA or gout.

However, in a similar analysis using the entire UK Biobank cohort, a connection did emerge between RA and a higher risk of death related to COVID-19. This finding occurred independently of comorbidities and other risk factors (OR 1.9; 95% CI 1.2-3.0). Gout was not associated with COVID-19 deaths (OR 1.2; 95% CI 0.8-1.7).

Tony Merriman, PhD, a world-renowned gout researcher with the University of Alabama at Birmingham, also served as a co-author of the report. He recently discussed the study and its findings with 口袋女优. The exchange has been edited for length and clarity.

What was the key question this study was designed to address?

Merriman: The key goal was to gain better knowledge of the risks that someone with either of the two most common forms of arthritis (gout and RA) faces in terms of dying from COVID-19.

How would you summarize your findings?

Merriman: We identified RA as a risk factor for death related to COVID-19 in a multivariable-adjusted analysis of the UK Biobank.

We also found that people with RA in the general population were 90% more likely (compared to someone without RA) to die from COVID-19. Gout and RA were respectively associated with a 1.5-fold (95% CI 1.2-1.8) and 2.2-fold (95% CI 1.7-2.9) increased risk of COVID-19 diagnosis.

Importantly, these findings were robust relative to other risk factors for death related to COVID-19, such as age, sex, and dementia. We do not know the underlying reasons for this finding.

What are the next steps on research into these conditions and COVID-19?

Merriman: First, it is important to replicate these findings. To do this, we are studying the latest data from the UK Biobank.

Second, we are also trying to get insights into what it is about RA that contributes to the increased risk of dying. For example, we are testing to determine whether specific drug treatments for RA coincide with the increased risk. Or, is there a shared disease mechanism with susceptibility to dying from COVID-19? This can be tested taking a genetic approach.

What are the clinical takeaways of these findings, and how, if at all, might clinicians adjust their management strategies for people with RA?

Merriman: Clinicians should be aware of the increased risk of death from COVID-19 for people with RA. This would be important information to share with patients in conversations about encouraging them to get vaccinated against the COVID-19 infection. It could even be a tool that could be used to overcome vaccine hesitancy.

Read the study here and expert commentary on the clinical implications here.