J Korean Med Sci.  2024 Jan;39(4):e37. 10.3346/jkms.2024.39.e37.

The Risk of COVID-19 and Its Outcomes in Korean Patients With Gout: A Multicenter, Retrospective, Observational Study

• Kim MJ
• Ryu B
• Park EG
• Yi S
• Kim K
• Park JW
• Shin K

• KMID: 2551967
• DOI: http://doi.org/10.3346/jkms.2024.39.e37

Abstract

This retrospective cohort study aimed to compare coronavirus disease 2019 (COVID-19)-related clinical outcomes between patients with and without gout. Electronic health recordbased data from two centers (Seoul National University Hospital [SNUH] and Boramae Medical Center [BMC]), from January 2021 to April 2022, were mapped to a common data model. Patients with and without gout were matched using a large-scale propensityscore algorithm based on population-level estimation methods. At the SNUH, the risk for COVID-19 diagnosis was not significantly different between patients with and without gout (hazard ratio [HR], 1.07; 95% confidence interval [CI], 0.59–1.84). Within 30 days after COVID-19 diagnosis, no significant difference was observed in terms of hospitalization (HR, 0.57; 95% CI, 0.03–3.90), severe outcomes (HR, 2.90; 95% CI, 0.54–13.71), or mortality (HR, 1.35; 95% CI, 0.06–16.24). Similar results were obtained from the BMC database, suggesting that gout does not increase the risk for COVID-19 diagnosis or severe outcomes.

Keyword

Gout; COVID-19; SARS-CoV-2; Observational Study

Figure

• 

  Fig. 1 Flowchart of the study population. (A) SNUH database; (B) BMC database.SNUH = Seoul National University Hospital, BMC = Boramae Medical Center.

• 

  Fig. 2 Kaplan-Meier plots for the risk of coronavirus disease 2019 diagnosis in a 1:5 propensity score-matched cohort of individuals with gout and those without in the Boramae Medical Center database.

Reference

1. Shin YH, Shin JI, Moon SY, Jin HY, Kim SY, Yang JM, et al. Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: a nationwide cohort study. Lancet Rheumatol. 2021; 3(10):e698–e706. PMID: 34179832.

2. Roddy E, Doherty M. Epidemiology of gout. Arthritis Res Ther. 2010; 12(6):223. PMID: 21205285.

3. Topless RK, Gaffo A, Stamp LK, Robinson PC, Dalbeth N, Merriman TR. Gout and the risk of COVID-19 diagnosis and death in the UK Biobank: a population-based study. Lancet Rheumatol. 2022; 4(4):e274–e281. PMID: 35128470.

4. Xie D, Choi HK, Dalbeth N, Wallace ZS, Sparks JA, Lu N, et al. Gout and excess risk of severe SARS-CoV-2 infection among vaccinated individuals: a general population study. Arthritis Rheumatol. 2023; 75(1):122–132. PMID: 36082457.

5. Jatuworapruk K, Montgomery A, Gianfrancesco M, Conway R, Durcan L, Graef ER, et al. Characteristics and outcomes of people with gout hospitalized due to COVID-19: data from the COVID-19 Global Rheumatology Alliance Physician-reported registry. ACR Open Rheumatol. 2022; 4(11):948–953. PMID: 36000538.

6. Tai V, Robinson PC, Dalbeth N. Gout and the COVID-19 pandemic. Curr Opin Rheumatol. 2022; 34(2):111–117. PMID: 34907115.

7. Tian Y, Schuemie MJ, Suchard MA. Evaluating large-scale propensity score performance through real-world and synthetic data experiments. Int J Epidemiol. 2018; 47(6):2005–2014. PMID: 29939268.

8. Choi HK, McCormick N, Yokose C. Excess comorbidities in gout: the causal paradigm and pleiotropic approaches to care. Nat Rev Rheumatol. 2022; 18(2):97–111. PMID: 34921301.

9. Peng H, Wu X, Xiong S, Li C, Zhong R, He J, et al. Gout and susceptibility and severity of COVID-19: a bidirectional Mendelian randomization analysis. J Infect. 2022; 85(3):e59–e61. PMID: 35724757.

10. Crișan TO, Cleophas MC, Oosting M, Lemmers H, Toenhake-Dijkstra H, Netea MG, et al. Soluble uric acid primes TLR-induced proinflammatory cytokine production by human primary cells via inhibition of IL-1Ra. Ann Rheum Dis. 2016; 75(4):755–762. PMID: 25649144.

11. Tanaka T, Milaneschi Y, Zhang Y, Becker KG, Zukley L, Ferrucci L. A double blind placebo controlled randomized trial of the effect of acute uric acid changes on inflammatory markers in humans: a pilot study. PLoS One. 2017; 12(8):e0181100. PMID: 28786993.

12. Conway R, Nikiphorou E, Demetriou CA, Low C, Leamy K, Ryan JG, et al. Temporal trends in COVID-19 outcomes in people with rheumatic diseases in Ireland: data from the COVID-19 Global Rheumatology Alliance registry. Rheumatology (Oxford). 2022; 61(SI2):SI151–SI156. PMID: 35258593.

13. Tabatabai M, Juarez PD, Matthews-Juarez P, Wilus DM, Ramesh A, Alcendor DJ, et al. An analysis of COVID-19 mortality during the dominancy of alpha, delta, and omicron in the USA. J Prim Care Community Health. 2023; 14:21501319231170164. PMID: 37083205.

14. Yasmin F, Najeeb H, Moeed A, Naeem U, Asghar MS, Chughtai NU, et al. COVID-19 vaccine hesitancy in the United States: a systematic review. Front Public Health. 2021; 9:770985. PMID: 34888288.

15. Moraliyska R, Georgiev T, Bogdanova-Petrova S, Shivacheva T. Adoption rates of recommended vaccines and influencing factors among patients with inflammatory arthritis: a patient survey. Rheumatol Int. Forthcoming. 2023; DOI: 10.1007/s00296-023-05476-2.