Gout Found to Be a Risk Factor for COVID-19 Diagnosis and Death

Gout was found to be a risk factor for COVID-19-related death, according to study results published in the Lancet Rheumatology.

Researchers aimed to determine whether gout was a risk factor for diagnosis of COVID-19 and related death, as well as to test for sex- and drug-specific differences in risk.

Overall, data from 15,871 patients with gout in the UK Biobank were analyzed using multivariable-adjusted logistic regression and a case-control study design. Researchers examined the association between gout and COVID-19 diagnosis in the entire UK Biobank cohort (n=459,837), the association between gout and COVID-19-related death in those who died from or COVID-19 (n=15,772), and the risk for COVID-19-related death among the entire UK Biobank cohort. In addition, the researchers assessed the risk for COVID-19-related death in a subset of patients (n=341,398) with prescription data, which was stratified by prescriptions for urate-lowering therapy and colchicine.

Adjustments for age group, sex, ethnicity, Townsend deprivation index, body mass index (BMI), and smoking status were made, along with a second model that included adjustments for diagnosis of 16 other diseases that were established comorbidities of gout or risk factors for COVID-19-related death.

Study results showed that a diagnosis with COVID-19 was associated with gout (odds ratio [OR], 1.20; 95% CI, 1.11-1.29); however, gout was not associated with risk for COVID-19-related death among patients diagnosed with COVID-19 (OR, 1.20; 95% CI, 0.96-1.51). Gout was associated with COVID-19-related death among the entire cohort (OR, 1.29; 95% CI, 1.06-1.56), with women with gout having an increased risk for COVID-19-related death (OR, 1.98; 95% CI, 1.34-2.94) but not men with gout (OR, 1.16; 95% CI, 0.93-1.45).

Researchers found no significant differences in risk for COVID-19-related death with regard to prescriptions for urate-lowering therapy or colchicine. After stratification based on vaccination status, the risk for a diagnosis of COVID-19 was significant for nonvaccinated patients (OR, 1.21; 95% CI, 1.11-1.30) but not vaccinated patients (OR, 1.09; 95% CI, 0.65-1.85).

Study limitations included the cohort being mostly middle-aged White individuals of British ethnicity, the possibility of unidentified COVID-19-related deaths among the patients diagnosed with COVID-19, and the change in COVID-19 outcomes with evolving clinical treatments. Before August 2020, it was possible that some deaths attributed to COVID-19 were not related to COVID-19. In addition, the effect of serum urate levels on COVID-19-related death was not investigated, adherence to prescriptions was not accounted for, and the researchers were unable to account for the effect of individual behavior modification on outcomes.

Researchers concluded, “Understanding the drivers of this increased risk in women with gout warrants further investigation in larger datasets.”

Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Topless RK, Gaffo A, Stamp LK, Robinson PC, Dalbeth N, Merriman TR. Gout and the risk of COVID-19 diagnosis and death in the UK Biobank: a population-based study. Lancet Rheumatol. Published online January 28, 2022. doi:10.1016/S2665-9913(21)00401-X