tetano
Editor, Senior Moderator
Respir Med
. 2026 Apr 16:257:108840.
doi: 10.1016/j.rmed.2026.108840. Online ahead of print.
Risk of influenza-related hospitalization and mortality in autoimmune inflammatory rheumatic diseases (AIIRD): Insights on polymyositis/dermatomyositis, Sjögren's disease, and systemic sclerosis
Yu-Sheng Chang[SUP] 1 [/SUP], Yi-Chun Lin[SUP] 2 [/SUP], Yu-Ning Chien[SUP] 3 [/SUP], Chin-Fang Su[SUP] 4 [/SUP], Jui-Hung Kao[SUP] 4 [/SUP], Sheng-Hong Lin[SUP] 1 [/SUP], Chien-Chih Lai[SUP] 5 [/SUP], I-Ping Lee[SUP] 6 [/SUP]
Affiliations
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.
Keywords: Dermatomyositis; Influenza; Polymyositis; Sjögren's disease; Systemic sclerosis.
. 2026 Apr 16:257:108840.
doi: 10.1016/j.rmed.2026.108840. Online ahead of print.
Risk of influenza-related hospitalization and mortality in autoimmune inflammatory rheumatic diseases (AIIRD): Insights on polymyositis/dermatomyositis, Sjögren's disease, and systemic sclerosis
Yu-Sheng Chang[SUP] 1 [/SUP], Yi-Chun Lin[SUP] 2 [/SUP], Yu-Ning Chien[SUP] 3 [/SUP], Chin-Fang Su[SUP] 4 [/SUP], Jui-Hung Kao[SUP] 4 [/SUP], Sheng-Hong Lin[SUP] 1 [/SUP], Chien-Chih Lai[SUP] 5 [/SUP], I-Ping Lee[SUP] 6 [/SUP]
Affiliations
- PMID: 41999995
- DOI: 10.1016/j.rmed.2026.108840
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.
Keywords: Dermatomyositis; Influenza; Polymyositis; Sjögren's disease; Systemic sclerosis.