Patients with gout and COVID-19 need close monitoring
Four experts who were not involved in the study encourage greater attention to the needs of patients with gout.
Dr. Pamela B. Davis
Pamela B. Davis, MD, PhD, research professor at Case Western Reserve University, Cleveland, told this news organization, “This study brings to attention yet another potentially vulnerable group for physicians to monitor closely if they are infected with SARS-CoV-2.
“It is not clear why women with gout are more vulnerable, but fewer women than men were in the cohort with gout, and the confidence intervals for the results in women were, in general, larger,” she said.
“The authors suggest that women with gout tend to be older and have more comorbidities than men with gout,” Dr. Davis added. “The excess risk diminishes when the model is fully adjusted for comorbidities, such as obesity, hypertension, or heart disease, suggesting that already-known antecedents of infection severity account for a great deal of the excess risk.”
Kevin D. Deane, MD, PhD, associate professor of medicine and chair in rheumatology research at the University of Colorado at Denver, Aurora, advises physicians to keep in mind other conditions linked with increased risk for severe COVID-19, including advanced age; heart, lung, or kidney problems; and autoimmune diseases.
Dr. Kevin D. Deane
“I would be very cautious about the finding that there was not a difference in outcomes in individuals with gout based on vaccination status,” he cautioned, urging clinicians to “still strongly recommend vaccines according to guidelines.”
Sarah E. Waldman, MD, associate clinical professor of infectious diseases at UC Davis Health in Sacramento, Calif., called the study interesting but not surprising.
Dr. Sarah E. Waldman
“The reason for increased risk for COVID-19 infection among those with gout may have to do with their underlying inflammatory state. Additional research needs to be done on this topic.
“Retrospective population-based cohort studies can be difficult to interpret due to biases,” she added. Associations identified in this type of study do not determine causation.
“As the researchers noted, those with gout tend to have additional comorbidities as well as advanced age,” she said. “They may also seek medical care more often and be tested for SARS-CoV-2 more frequently.”
Dr. Waldman advises clinicians to counsel patients with gout about their potential increased infection risk and ways they can protect themselves, including COVID-19 vaccinations.
Dr. Thanda Aung
“The strong association between gout and COVID-19 infection could involve coexisting conditions such as diabetes, hypertension, cardiovascular disease, and chronic kidney disease,” Dr. Aung added.