New evidence shows that gout is a risk factor for death from COVID-19, particularly in women.
Data from the UK Biobank that included 15,560 people with gout found that in multivariate analysis there was a statistically significant 30% higher risk of death from COVID-19 compared to people without gout.
The database, which covers a population cohort of almost 460,000 people, was used by Australian and New Zealand researchers to analyse the risks of COVID-19 disease and death for those with gout.
In an initial analysis gout was associated strongly with diagnosis of COVID-19 (Odd Ratio=1.5) and remained so (OR= 1.2) after adjusting for other variables including co-morbidities. Notably women with gout were 50% more likely to be diagnosed with COVID-19 than men.
The proportion of people with gout who died with COVID-19 was 0.86% compared to 0.24% in the general cohort.
People who died with COVID-19 had a higher proportion of metabolic-based co-morbidities such as diabetes mellitus (30.7% vs 7.3%), and in males these co-morbidities could have contributed to the excess risk of death from COVID-19, said researchers from Otago University.
However, while men were more likely than women to have gout (6.4% vs 1% of the entire cohort), a greater proportion of women with gout died with COVID-19 than did men with gout (1.3% vs 0.8%).
The researchers noted there was a highly statistically significant unadjusted risk estimate for death related to COVID-19 in the general population, with an Odds Ratio of of 3.9 for gout overall, and particularly high risk (OR=9.4) for women with gout.
Unlike in men with gout, the risk of COVID-19 related death remained almost double for women (OR= 1.9) after adjusting for other factors and co-morbidities.
“These raw estimates can be used in clinician-patient discussions regarding patient decisions to get vaccinated against SARS-Cov-2,” the researchers suggested.
And they said the findings may be particularly relevant in population groups with a high prevalence of gout such as Māori (8%) and Pacific Islanders (gout prevalence 14%), compared to 4% in the non-Māori non-Pacific population
“These figures justify a targeted strategy for vaccination of Māori and Pacific people with gout in all healthcare settings,” wrote the authors, who included rheumatologists Professor Philip Robinson from the Queensland University and Professor Nicola Dalbeth from Auckland University.
They also noted that in contrast to the findings of the previous COLCORONA trial, there appeared to be no significant differences in risk of death related to COVID-19 according to prescription of urate-lowering therapy (ULT) or colchicine
The findings are published in the medRxiv preprint server.