COVID-19 FAQs: Recovery and Outcomes

UPDATED 7/29/2022

News, scientific understanding and guidelines about COVID-19 are continually evolving. As such, please note that some information on this page may have changed since its original publication date.

Question: Am I more likely to have severe disease or be hospitalized with a COVID-19 infection if I have autoimmune or inflammatory arthritis?

A: While patients with rheumatic and musculoskeletal diseases are more likely to experience severe outcomes if infected with the COVID-19 virus, outcomes are improving. Doctors have a better understanding of the virus and treatment protocols are proving more effective. Additionally, increased testing helps to identify infections more quickly, and there are effective therapeutic options.

These factors are more common in people (including patients with rheumatic disease) who experience severe disease or require hospitalization:

• Having a comorbid condition. According to COVID-19 hospitalization data reported by the CDC, approximately 90% of hospitalized patients identified through COVID-NET had one or more underlying conditions, the most common being obesity, hypertension, chronic lung disease, diabetes and cardiovascular disease.
• Taking corticosteroids at a dose of 10 milligrams or more.
• Being 65 years or older.

There's also some evidence to suggest that getting reinfected with COVID-19 is associated with more health risks, especially for immunocompromised patients. Taking measures to protect yourself, like wearing a mask in crowded indoor spaces, keeping up to date with vaccines and boosters, and keeping your arthritis well controlled can improve your outcomes if you develop a COVID-19 infection or reinfection.

Question: How are people with autoimmune disease faring when hospitalized with COVID-19?

A: There are limited studies about the experiences of rheumatology patients who are hospitalized due to a COVID-19 infection.  However, the data from a study published in the Lancet Rheumatology has reported encouraging results.

The study, which was published in December 2020, followed 8540 patients with rheumatic and musculoskeletal diseases diagnosed with COVID-19. It reviewed the outcomes of those patients hospitalized in January 2020 compared to patients hospitalized in April 2020. The study found that patients in the April group had lower rates of intensive care unit admission, mechanical ventilation, acute kidney injury, renal replacement therapy and death. Study participants 65 years or older were more likely to be hospitalized. These findings suggest that as the pandemic progresses, rates of severe complications seem to be decreasing.

Question: Are people with osteoarthritis more likely to be hospitalized when they have a COVID-19 infection?

A: People with OA are at the same risk as the general population. Comorbid diseases frequently occurring in patients with OA such as diabetes and obesity put patients at higher risk.

Question: Are people with autoimmune or inflammatory arthritis who have COVID-19 infections more likely to die than people who have COVID-19 infections but no autoimmune disease?

A: Data regarding rheumatology patients are limited because the virus is so new.  An analysis of existing studies was reported in an article published in the Journal of Infection in September 2020.

Drawing from a review of five studies representing 2091 patients, study authors reported that autoimmune disease was associated with:

• A 1.21-fold increased risk of severe COVID-19 disease
• A 1.31-fold increased risk of mortality in patients with COVID-19.

That means people with autoimmune diseases and COVID-19 infections are slightly more likely than people without autoimmune diseases and COVID-19 infections to have severe disease and die.

Study authors say that the results should be interpreted with caution since the sample size of patients is small, and five of the six studies are from China. They acknowledge that more, high-quality studies are needed.