Poor outcomes for gout patients with COVID-19 may be due to high rates of comorbid conditions, according to findings from the COVID-19 Global Rheumatology Alliance registry.

A majority of patients with gout who were hospitalised with COVID-19 during the first two years of the pandemic required ventilatory support, the data show. And people with gout had a high prevalence of established risk factors and comorbidities for poor COVID-19 outcomes, the GRA researchers noted.

Of 163 gout patients hospitalised with COVID-19 between March 2020 and October 2021, 85% were male with a mean age of 63 years. Patients were mostly from the Western pacific region (53.7%) but spread across all other WHO-designated regions.

Nearly half the patients (46%) had two or more comorbidities including hypertension (56%), cardiovascular disease (28%), diabetes mellitus (26%), chronic kidney disease (25%), obesity (23%) and lung disease (15%).

Gout medication use was relatively low – 12% colchicine, 11% glucocorticoids – with most patients reported as in remission or with low activity disease (79%).

The study, published in ACR Open Rheumatology, reported that 55% of people with gout hospitalised for COVID-19 required oxygenation or noninvasive ventilation. Invasive ventilation or ECMO was required in 13% and there were 25 deaths (16%) reported.

“When stratified by the number of comorbidities, 25% of people with two or more comorbidities died compared to 2% in those without comorbidity and 13% in those with one comorbidity.”

“The overall prevalence of death in the gout cohort (16%) was comparable to hospitalised people with RA (18%) and SLE (17%) during the same period.”

The investigators, including Australians Associate Professor Helen Keen (University of WA) and Associate Professor Philip Robinson (University of Queensland), said the majority (73%) of those who died in the gout cohort had two or more comorbid conditions – higher than the prevalence in RA (49%) and SLE (39%) in the same C-19-GRA registry.

“These observations provided some support for the hypothesis that COVID-19 mortality in people with gout was driven at least partially by the presence of comorbid conditions,” they said.

The investigators acknowledged study limitations including small sample size, but called for more research on the possible connections between comorbid gout and COVID-19 diagnosis and outcomes.

“Such knowledge may help clinicians make the most informed decisions when managing people with gout during the ongoing COVID-19 pandemic,” they concluded.

Read more in the journal article here.