Respiratory medicine · 2026
Risk of influenza-related hospitalization and mortality in autoimmune inflammatory rheumatic diseases (AIIRD): Insights on polymyositis/dermatomyositis, Sjögren's disease, and systemic sclerosis.
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Chang Yu-Sheng, Lin Yi-Chun, Chien Yu-Ning, Su Chin-Fang, Kao Jui-Hung, Lin Sheng-Hong, Lai Chien-Chih, Lee I-Ping
Аннотация
OBJECTIVES: To investigate the incidence and risk of influenza-related hospitalization and mortality among patients with autoimmune inflammatory rheumatic diseases (AIIRDs), with a specific focus on polymyositis/dermatomyositis (PM/DM), Sjögren's disease (SjD), and systemic sclerosis (SSc).
METHODS: This nationwide, population-based cohort study analyzed data from Taiwan's National Health Insurance Research Database (2010-2020). We identified 116,609 patients with AIIRDs (53,514 rheumatoid arthritis [RA], 27,841 systemic lupus erythematosus [SLE], 29,203 SjD, 3123 PM/DM, and 2928 SSc) and 466,436 age-, sex-, and index date-matched controls. Influenza-related hospitalization and mortality were identified using ICD-9/10 codes, with mortality defined as death within 30 days of influenza diagnosis. Incidence rate ratios (IRRs) were calculated using Poisson regression.
RESULTS: All AIIRD subtypes demonstrated significantly higher influenza-related hospitalization rates compared with matched controls, with PM/DM showing the highest proportion (3.04% vs. 0.86%). SLE and PM/DM exhibited the highest hospitalization risks (IRR 3.91, 95% CI 3.54-4.32, and IRR 3.84, 95% CI 2.97-4.96, respectively). For mortality, PM/DM showed the highest risk (IRR 14.88, 95% CI: 3.09-71.63), followed by SLE (IRR 11.6), RA (IRR 3.36), and SjD (IRR 1.97), while the increase in SSc was not statistically significant. Comorbidities were unevenly distributed between AIIRD patients and non-AIIRD controls, potentially influencing differences both compared with controls and among AIIRD subgroups.
CONCLUSION: Patients with AIIRDs face significantly elevated risks of influenza-related hospitalization and mortality, with substantial variation across disease subtypes. Mortality findings in PM/DM and SSc should be interpreted with caution due to the limited number of events.
METHODS: This nationwide, population-based cohort study analyzed data from Taiwan's National Health Insurance Research Database (2010-2020). We identified 116,609 patients with AIIRDs (53,514 rheumatoid arthritis [RA], 27,841 systemic lupus erythematosus [SLE], 29,203 SjD, 3123 PM/DM, and 2928 SSc) and 466,436 age-, sex-, and index date-matched controls. Influenza-related hospitalization and mortality were identified using ICD-9/10 codes, with mortality defined as death within 30 days of influenza diagnosis. Incidence rate ratios (IRRs) were calculated using Poisson regression.
RESULTS: All AIIRD subtypes demonstrated significantly higher influenza-related hospitalization rates compared with matched controls, with PM/DM showing the highest proportion (3.04% vs. 0.86%). SLE and PM/DM exhibited the highest hospitalization risks (IRR 3.91, 95% CI 3.54-4.32, and IRR 3.84, 95% CI 2.97-4.96, respectively). For mortality, PM/DM showed the highest risk (IRR 14.88, 95% CI: 3.09-71.63), followed by SLE (IRR 11.6), RA (IRR 3.36), and SjD (IRR 1.97), while the increase in SSc was not statistically significant. Comorbidities were unevenly distributed between AIIRD patients and non-AIIRD controls, potentially influencing differences both compared with controls and among AIIRD subgroups.
CONCLUSION: Patients with AIIRDs face significantly elevated risks of influenza-related hospitalization and mortality, with substantial variation across disease subtypes. Mortality findings in PM/DM and SSc should be interpreted with caution due to the limited number of events.