Previous research has demonstrated that individuals living with Sjögren’s are at higher risk of hospitalization due to infections. However, little is known about the specific incidence, causes and outcomes of severe infections requiring hospitalization. A study titled Hospitalizations for infections in primary Sjögren’s syndrome patients: a nationwide incidence study was published in the journal Annals of Medicine in Sept 2022 and aimed to answer these questions.
A research team led by Dr. Radjiv Goulabchand used data from the French Health Insurance database. They examined hospitalization rates in Sjögren’s patients between 2011 and 2018. In total, 25,661 Sjögren’s patients and 252,543 age- and sex-matched controls (1 to 10 ratio) were compared in the retrospective analysis. Most participants were assigned female sex at birth (87.7%), with a mean age of 60. Patients were followed for an average of four years. From the data, the researchers observed that Sjögren’s patients were more likely to be living with co-morbidities including high blood pressure, obesity, diabetes, cardiovascular disease and lung conditions. Likewise, an increased incidence of airway infections, including pneumonia (50% higher), bronchitis (70% higher), and influenza (98% higher), were observed in those living with Sjögren’s.
Within the study period, 2,254 individuals with Sjögren’s (8.78%) experienced at least one hospitalization. After controlling for socioeconomic status and history of previous infections, the incidence of hospitalizations was found to be 29% higher in Sjögren’s patients compared with controls. The leading causes of hospitalization in Sjögren’s patients included infections of the intestines (18% higher), kidneys (55% higher), ears/nose/throat (27% higher) and airways (50% higher).
The team then evaluated the incidence of opportunistic infections, which are those that typically arise when one has a weakened immune system. Over the course of the study, 104 Sjögren’s patients (0.04%) had at least one opportunistic infection, which was 98% higher than controls. In Sjögren’s patients, hospitalizations rates were 3.32 times higher for chickenpox/shingles and 2.54 times higher for mycobacteria infections than controls.
Overall, in-hospital mortality for infections of the kidney, intestines, and ears/nose/throat and pneumonia (airway) were similar across groups. Yet, hospital mortality due to other airway infections, including bronchitis and influenza, was significantly elevated for individuals with Sjögren’s. In future, targeted vaccination campaigns against respiratory pathogens may help reduce hospitalization and mortality in Sjögren’s patients. For now, practicing good hygiene such as regular hand washing can lower the risk of infection.
