COVID-19 in patients with rheumatic diseases: what is the real mortality risk?

We read with great interest the paper published by D’Silva et al 1 regarding the main outcomes in rheumatic patients with COVID-19. According to this cohort, there was a mortality rate of 6%, slightly similar to the frequency observed in individuals without rheumatic diseases (RDs) (around 4%). On the other hand, there was a threefold higher risk of intensive care admission and mechanical ventilation in patients with RDs, suggesting some difficulties to handle this subgroup. More recently, Favalli et al 2 stated that the incidence of COVID-19 was also quite similar between patients with RD and individuals from the general population in Lombardia (0.62% vs 0.66%, respectively). Moreover, the disease activity was not worsened or triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in rheumatic patients. Brazil had its first confirmed case of COVID-19 on 26 February, and, to date, it accounts for more than one million cases and more than 50 000 deaths. The lethality rate has …