COVID-19 outcomes in patients with inflammatory rheumatic diseases: associations with disease subtypes, treatments, and vaccination status

Feyza Ak; Zeynep Kaya

Abstract: OPEN ACCESS EDITED BY Rafael Coveñas, University of Salamanca, Spain REVIEWED BY Andreea-Iulia Vladulescu-Trandafir, Neuromuscular Clinic Division of the Teaching Emergency Hospital 'Bagdasar- Arseni', Romania Ali Younis, University of Mosul, Iraq *CORRESPONDENCE Zeynep Kaya zeynepkaya00@gmail.com RECEIVED 12 June 2026 REVISED 21 July 2026 ACCEPTED 11 September 2026 PUBLISHED 22 September 2026 CITATION Ak F and Kaya Z (2026) COVID-19 outcomes in patients with inflammatory rheumatic diseases: associations with disease subtypes, treatments, and vaccination status. Front. Public Health 14:1907698. doi: 10.3389/fpubh.2026.1907698 COPYRIGHT © 2026 Ak and Kaya. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. [COVID-19 outcomes in patients with inflammatory rheumatic diseases: associations with disease subtypes, treatments, and vaccination status](https://www.frontiersin.org/articles/10.3389/fpubh.2026.1907698/full) Feyza Ak 1 and Zeynep Kaya 2 * 1 Division of Rheumatology, Department of Internal Medicine, Istanbul Bezmi Alem University Hospital, Istanbul, Türkiye, 2 Division of Rheumatology, Department of Internal Medicine, Istanbul Training and Research Hospital, Istanbul, Türkiye Background: Patients with inflammatory rheumatic diseases (IRDs) may be at increased risk for adverse COVID-19 outcomes because of immune dysregulation, comorbidities, and immunomodulatory treatments. However, the effects of specific rheumatic disease subsets, treatment patterns, and vaccine types remain incompletely understood. Objective: To evaluate clinical characteristics and factors associated with COVID19 infection and hospitalization among patients with IRDs. Methods: This retrospective observational cohort study included 1,024 adult patients with IRDs followed between March 2020 and January 2023. Demographic characteristics, rheumatic disease subtypes, treatments, vaccination status, COVID-19 infection, hospitalization, radiologic findings, and recovery duration were analyzed. Results: Among all patients, 347 (33.9%) developed COVID-19 infection. Patients with COVID-19 were younger than those without COVID-19 (49.1 ± 13.4 vs. 51.5 ± 14.5 years, p = 0.007). Vaccination before infection was significantly more frequent in the COVID-19-negative group (92.3% vs. 23.9%, p < 0.001). Spondyloarthritis frequency was higher among COVID-19-positive patients (25.9% vs. 20.1%, p = 0.030), whereas methotrexate use was lower (14.4% vs. 22.6%, p = 0.002). Among COVID-19-positive patients, 40 (11.5%) required hospitalization. Hospitalized patients were older, had more frequent lung disease, longer rheumatic disease duration, increased radiologic involvement, and prolonged recovery duration (all p < 0.05). In univariate analyses, FMF, colchicine use, and BNT162b2 vaccination were associated with lower hospitalization rates; however, these associations were not retained after multivariable adjustment. Conclusion: Older age, pulmonary comorbidity, longer disease duration, and radiologic involvement were associated with COVID-19-related..

DOI record: { "DOI": "10.3389/fpubh.2026.1907698", "ISSN": [ "2296-2565" ], "URL": "http://dx.doi.org/10.3389/fpubh.2026.1907698", "abstract": "\n Background\n Patients with inflammatory rheumatic diseases (IRDs) may be at increased risk for adverse COVID-19 outcomes because of immune dysregulation, comorbidities, and immunomodulatory treatments. However, the effects of specific rheumatic disease subsets, treatment patterns, and vaccine types remain incompletely understood.\n \n \n Objective\n To evaluate clinical characteristics and factors associated with COVID-19 infection and hospitalization among patients with IRDs.\n \n \n Methods\n This retrospective observational cohort study included 1,024 adult patients with IRDs followed between March 2020 and January 2023. Demographic characteristics, rheumatic disease subtypes, treatments, vaccination status, COVID-19 infection, hospitalization, radiologic findings, and recovery duration were analyzed.\n \n \n Results\n \n Among all patients, 347 (33.9%) developed COVID-19 infection. Patients with COVID-19 were younger than those without COVID-19 (49.1 ± 13.4 vs. 51.5 ± 14.5 years,\n p\n  = 0.007). Vaccination before infection was significantly more frequent in the COVID-19-negative group (92.3% vs. 23.9%,\n p\n  &lt; 0.001). Spondyloarthritis frequency was higher among COVID-19-positive patients (25.9% vs. 20.1%,\n p\n  = 0.030), whereas methotrexate use was lower (14.4% vs. 22.6%,\n p\n  = 0.002). Among COVID-19-positive patients, 40 (11.5%) required hospitalization. Hospitalized patients were older, had more frequent lung disease, longer rheumatic disease duration, increased radiologic involvement, and prolonged recovery duration (all\n p\n  &lt; 0.05). In univariate analyses, FMF, colchicine use, and BNT162b2 vaccination were associated with lower hospitalization rates; however, these associations were not retained after multivariable adjustment.\n \n \n \n Conclusion\n Older age, pulmonary comorbidity, longer disease duration, and radiologic involvement were associated with COVID-19-related hospitalization in IRDs. 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COVID-19 outcomes in patients with inflammatory rheumatic diseases: associations with disease subtypes, treatments, and vaccination status

Colchicine for COVID-19