POS1197 IN DEPTH IDENTIFICATION OF RISK FACTORS FOR SEVERE COVID-19, REQUIRING HOSPITALIZATION, IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES: RESULTS OF A DUTCH NESTED CASE CONTROL STUDY (PRELIMINARY RESULTS)

Background: Several risk factors for severe COVID-19 have been identified 1 . An important question is whether in addition to these generic factors, patients with a potentially altered immune response, either by disease (inflammatory rheumatic diseases (IRDs)) or use of immunomodulatory agents (IA), carry higher lower COVID-19. In addition, several other potential suggested, such as vitamin D status and specific medication (NSAIDs, ACE-inhibitors) 2 Objectives: To identify COVID-19, requiring hospitalization, IRDs. Methods: Multicenter, unmatched nested case control study four rheumatology centers the Netherlands. Cases are IRD hospitalization between March st 2020 May 31 2020. Control not hospitalized within this period were included 1:4 ratio. Patient-, disease- treatment characteristics extracted (still ongoing) from electronic patient files, questionnaire was used collect additional data (e.g. on behavioral aspects). Potential analyzed using unconditional logistic regression, corrected confounders. Results: 77 cases 198 controls included. 26 died result 14 admitted ICU. Crude ORs female sex, age, BMI presence one more comorbidities 0.46 (95% CI 0.27-0.29), 1.1 (95%CI 1.0-1.1), 1.0 0.98-1.1) 3.0 1.7-5.2) respectively. Table displays OR, highlighted when OR <0.5/>2.0. Corrected significantly increased any IRD, but trend gout present. Use hydroxychloroquine (HCQ) shows protective effect, while csDMARDs than methotrexate HCQ leads Trends present rituximab (RTX), glucocorticoids ACE inhibitors, effect IL-6R blockers. Conclusion: The outcomes agreement research regarding related IRDs IA suggested RTX concern should be monitored closely. Strengths include low bias due effects only early pandemic included, completeness determinants interest ultimately, it provides answers relevant urgent question. References: [1]Williamson, Elizabeth J et al. “Factors associated COVID-19-related death OpenSAFELY.” Nature vol. 584,7821 (2020): 430-436. [2]Rizk, John G “Pharmaco-Immunomodulatory Therapy COVID-19.” Drugs 80,13 1267-1292. [3]Rentsch, Christopher T “Effect pre-exposure mortality: population-based cohort rheumatoid arthritis systemic lupus erythematosus OpenSAFELY platform.” Lancet Rheumatology 3,1 (2021): e19-e27. 1. factor ) RA* 1.38 (0.68 – 2.8) Spondylarthritis 0.60 (0.25-1.5) Gout 2.8 (0.80-9.8 Polymyalgia 0.54 (0.18-1.6) Systemic 1.6 (0.49-5.0) DMARDs (any 0.39 (0.17-0.88 Methotrexate 0.90 (0.46-1.7) 0.40 (0.16-0.98 Other 2.0 (0.99-4.1 bDMARDs (any) 0.96 (0.43-2.2) TNF-inhibitors (0.43-2.6) IL6R-blockers 0.43 (0.044 4.2 4.5 (0.25-79 tsDMARDs 0.89 (0.08-9.8) Glucocorticoids > 10 mg/day 2.5 (0.70-9.0 NSAIDs 0.82 (0.37-1.8) ACE-inhibitors 3.4 (1.6-7.1 Vitamin sufficient 0.77 (0.40-1.5) *incl. unspecified Disclosure Interests: Merel Opdam Grant/research support from: has received grants (to institution) Gilead, S Benoy: None declared, L.M. Verhoef: Sandra van Bijnen: Femke Lamers-Karnebeek: R.A.M. Traksel: Petra Vos: Alfons den Broeder consultancy honoraria, congress invitations Abbvie, Amgen, Cellgene, Roche, Biogen, Lilly, Novartis, Celltrion Sanofi, Gilead. Is coinventor patent (pending)., Jasper Broen Consultant of: fees Gilead Galapagos.