P021 Rheumatology shielded patients, hospitalised COVID-19 and outcomes in Essex: an audit across Mid and South Essex and Barking, Havering and Redbridge Hospitals NHS Trusts

Background/AimsShielding measures were implemented within the United Kingdom inan attempt to slow the rate of COVID-19 infections, with shieldingletters being sent to extremely vulnerable patients. This includedrheumatology patients on immunosuppressive therapies sufficient toincrease their risk of infection. MethodsThis was a retrospective audit assessing the number of rheumatologypatients within the Mid and South Essex NHS Foundation Trust (MSETrust) and Barking, Havering and Redbridge University Trust (BHRTrust) who were sent shielding letters. We audited how effective thesemeasures were in preventing COVID-19 infection during the shieldingperiod (up to 1st July 2020). Risk criteria from NHS Digital and theBritish Society for Rheumatology (BSR) were used by individualdepartments within these Trusts to identify the relevant patients. Weaudited from case records demographic details, rheumatologicaldiagnoses, therapies and associated co-morbidities in these patients.ResultsA total of 5, 876 high risk patients within these Trusts were identifiedand sent shielding letters: 4, 914 within the MSE Trust and 962 patientswithin the BHR Trust. As seen in Table 1, of these 5, 876 patients, 28(0.48%) were hospitalised with positive tests for COVID-19: 23 of the4, 914 (0.47%) in MSE Trust and 5 of the 962 (0.52%) in BHR Trust.Of the 28 COVID-19 admissions, 10 died (36%). The number ofrheumatology patients that developed COVID-19 as a proportion of allpatients admitted across these two Trusts was 0.76% (28 out of3, 695).ConclusionThis audit supports the idea that shielding is an effective tool inprotecting these vulnerable patients. Most of our patients admittedwere elderly, had multiple co-morbidities and generally conformedwith the known risk factors for severe COVID-19 illness. This supportsGovernment guidelines and BSR risk scoring and is particularlyimportant as it is becoming increasingly apparent that COVID-19 willbe prevalent for a long time to come. In line with the recent EULARCOVID-19 registry report, only one of the hospitalised patients fromthese Trusts was on anti-TNF therapy, suggesting that these therapieswere in fact protective. It raises the open question: whetherimmunosuppression may have a protective effect in someRheumatology patients.