This retrospective cohort study was conducted to determine whether the presence of noninfectious uveitis (NIU) leads to higher rates of COVID-19 infection, hospitalization due to severe disease, and/or death.
Study design
Investigators reviewed the records of 5,806,227 patients enrolled in a US national claims database; 29,869 had a diagnosis of NIU. Baseline covariates (e.g, race, age, gender, presence of comorbidities), characteristics of the NIU population, and immunosuppressive medication use during the study period were summarized. Both unadjusted and adjusted hazard ratios were estimated for each variable and COVID-19 outcome among NIU and non-NIU patients.
Outcomes
Patients with NIU had higher unadjusted rates of COVID-19 infection (5.7% vs. 4.5%) and COVID-19–related hospitalization (1.2% vs. 0.6%) and death (0.3% vs. 0.1%) than patients without NIU. However, when adjustments were made for demographics and comorbidities, no significant differences between the 2 patient populations were found. The use of systemic corticosteroids and other immunosuppressive drugs was linked to greater risk of COVID-19 infection and complications.
Limitations
In national claims database studies, there is always a risk of disease misclassification. Also, investigators were unable to obtain information on any deaths that occurred outside of healthcare facilities, and as the patients studied did not include anyone uninsured or receiving Medicaid/Medicare, they may not be representative of the general US population.
Clinical significance
Physicians may consider providing increased counseling to patients with NIU who are being treated with systemic corticosteroids, as they have an increased risk of COVID-19 infection and severe outcomes. Additional studies are needed to further determine the impact of these medications on COVID-19 risk.