Ab0067 Covid-19 Reinfection in Patients With Rheumatoid Arthritis

Background: Patients with rheumatologic diseases, including rheumatoid arthritis (RA), have an elevated risk of contracting COVID-19, coupled with heightened morbidity and mortality rates compared with the general population. Despite this, research on the risk of reinfection, especially among patients with RA, remains limited. Objectives: This study aimed to identify the prevalence and risk factors associated with COVID-19 reinfection in patients with RA. Methods: We conducted a retrospective analysis of RA patients with a documented history of COVID-19 infection, treated between January 2021 to December 2022 at tertiary referral hospital in Seoul, South Korea. Patients with a follow-up period of less than 6 months were excluded. COVID-19 reinfection was defined as a subsequent positive SARS-CoV-2 test result following documented recovery from the initial infection. Cox proportional hazards models were employed to assess the association between potential risk factors and the risk of reinfection. Results: A total of 351 RA patients with a history of COVID-19 infection were included in the study. The median age of all patients was 58.0 years (IQR, 48.0–66.0), and 286 (81.5%) were female. At the time of first COVID-19 infection, most patients (n=252 71.8%), were using methotrexate and 12 (3.4%) patients were using leflunomide. Approximately half of the cohort (n=189, 53.8%) used glucocorticoids, with a median dose of 2.5 mg (IQR, 0.0–5.0) per day. After the initial COVID-19 infection, patients were followed-up for a median of 1.5 (1.1–1.6) years. During this period, 43 (12.3%) patients experienced COVID-19 reinfection, with an incidence rate of 8.97 per 100 patient-years. The median time interval between the first and second COVID-19 infection was 0.8 (0.6–1.2) years. Analysis of risk factors for COVID-19 reinfection indicated that age over 60 years and obesity were not significant contributors (age over 60 years, HR 0.808; CI, 0.441–1.481; P=0.491; obesity, HR 1.392; CI, 0.487–3.979; P=0.538) (Table 1). Regarding medication, leflunomide only showed a significant correlation with COVID-19 reinfection (HR, 3.401; CI, 1.097–1.481; P=0.491), otherwise methotrexate (HR, 1.407; CI, 0.655–3.021; P=0.381) and hydroxychloroquine (HR, 1.121; CI, 0.546–2.302; P=0.756) did not exhibit a definite correlation. Conclusion: In this retrospective cohort study of RA patients with COVID-19 infection, approximately 10% of patients experienced COVID-19 reinfection, with an incidence rate of 8.97 per 100 patient-years. Additionally, only leflunomide was significantly associated with a higher risk of COVID-19 reinfection. REFERENCES: 1 Yousefghahari B, Navari S, Sadeghi M, et al. Risk of COVID-19 infection in patients with rheumatic disease taking disease-modifying anti-rheumatic drugs. Clin Rheumatol. 2021;40(10):4309-4315. 2 Abu-Raddad LJ, Chemaitelly H, Malek JA, et al. Assessment of the Risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection in an Intense Reexposure Setting. Clin Infect Dis. 2021;73(7):e1830-e1840. 3 Deng, L., Li, P., Zhang, X et al. Risk of SARS-CoV-2 reinfection: A systematic review and meta-analysis. Scientific reports. 2022;12(1): 20763. Acknowledgements: NIL. Disclosure of Interests: None declared.