What is the risk of SARS-CoV-2 infection among gout patients?

A recent study published in the journal Arthritis & Rheumatology has revealed that people with gout are at higher risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, irrespective of the coronavirus disease 2019 (COVID-19) vaccination status.

Background

The COVID-19 pandemic caused by SARS-CoV-2 has put the global general population under tremendous health and economic threat. Although most people develop only mild SARS-CoV-2 infection, severe and often fatal disease may develop among susceptible people, including elderly persons and those with comorbidities.

One of the major hallmarks of severe COVID-19 is hyperinflammation. Thus, people with pre-existing inflammatory diseases, including gout, are at higher risk of developing severe disease. In general, people with gout present with various comorbidities, including obesity, cardiovascular complications, and chronic kidney disease. These pre-existing health conditions make them more susceptible to SARS-CoV-2 infection and its severity.

Previous studies investigating the risk of SARS-CoV-2 infection among gout patients have produced conflicting results. Moreover, none of the studies have evaluated the association between COVID-19 vaccination status and risk of severe infection among gout patients.

In the current study, scientists have estimated the risk of SARS-CoV-2 infection and its severity among vaccinated and unvaccinated gout patients.

Study design

The study was conducted on UK residents categorized into two distinct groups, including people with and without gout. The study groups included both vaccinated and unvaccinated adults. A medical database representing the UK general population was used to collect information about the demographic characteristics and medical conditions of the participants.

The participants were followed between December 2020 and October 2021. The main outcome of the study was to assess the risk of SARS-CoV-2 infection among gout patients. In addition, the risk of COVID-19-related hospitalization and death was determined as a secondary outcome.

Various influencing factors, including sociodemographic features, geographical locations, comorbidities, and use of medications, were considered while estimating the weighted incidence rate of SARS-CoV-2 infection and related hospitalization and mortality.

Important observations

A total of 54,576 individuals with gout and 1,336,377 individuals without gout were selected from the general population who received COVID-19 vaccination. Among unvaccinated study participants, 61,111 were with gout and 1,697,168 were without gout.

Risk of infection among vaccinated study population

A significantly higher risk of SARS-CoV-2 infection was observed among vaccinated gout patients compared to vaccinated individuals without gout. While a weighted incidence rate of 3.76 per 1000 person months was calculated among individuals without gout, individuals with gout exhibited a weighted incidence rate of 4.68 per 1000 person months.

Regarding the risk of severe COVID-19, vaccinated gout patients were found to have a higher rate of hospitalization and mortality compared to those without gout.

Risk of infection among unvaccinated study population

A comparatively higher risk of SARS-CoV-2 was also observed among unvaccinated gout patients compared to those without gout. Specifically, the weighted incidence rates were 8.69 and 6.89 per 1000 person-months among individuals with and without gout, respectively.

Regarding the risk of severe COVID-19, a higher rate of hospitalization was observed among gout patients compared to that among individuals without gout. However, no significant difference in mortality rate was observed between individuals with and without gout.

Gender-specific risk

An increased risk of SARS-CoV-2 infection was observed among male gout patients compared to men without gout. This association was observed among both vaccinated and unvaccinated male participants.

Although both men and women with gout exhibited a higher risk of COVID-19-related hospitalization than those without gout, comparatively higher mortality risk was observed among female gout patients.

All gender-specific associations observed between gout and risk of SARS-CoV-2 and severe COVID-19 were irrespective of the vaccination status.

Study significance

The study highlights that gout patients have a significantly higher risk of SARS-CoV-2 infection and severe COVID-19 (hospitalization and mortality) than those without gout. Notably, COVID-19 vaccination status does not seem to have any protective benefit in gout patients.

Another important finding is that women with gout have a relatively higher risk of severe COVID-19 than those without gout.

As mentioned by the scientists, the current study findings are robust. They also have the potential to be generalized, as the study has been conducted on a large proportion of the general population.

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.