Even with COVID-19 vaccination, patients with gout have increased risks of SARS-CoV-2 infection and severe outcomes compared with the general population, investigators report. Women appear particularly susceptible.

Using data from the Health Improvement Network in the UK, investigators identified a vaccinated and an unvaccinated cohort with and without gout and followed them from December 8, 2020, the beginning of the vaccination effort, to October 31, 2021. The vaccinated cohort received at least 1 dose of a COVID-19 vaccine.

Among the vaccinated cohort, 1955 cases of breakthrough COVID-19 infection occurred in 54,576 adults with gout (4.68 cases per 1000 person-months), and 52,468 cases occurred in 1,336,377 adults without gout (3.76 cases per 1000 person-months). Vaccinated patients with gout had a significant 18% increased risk of breakthrough infection compared with the vaccinated general population in a fully adjusted model, Guanghua Lei, MD, PhD, of Xiangya Hospital, Central South University in Changsha, China, and colleagues reported in Arthritis & Rheumatology. Gout also was significantly associated with a 30% increased risk of hospitalization and a 36% increased risk of death within 30 days.

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Vaccinated men and women with gout had a significant 1.2- and 1.6-fold increased risk for hospitalization, respectively, compared with the non-gout general population. Women had a 2.5-fold increased risk for death compared with women in the non-gout general population. Investigators did not find this association in men.

Among the unvaccinated cohort, 1532 cases of COVID-19 infection occurred in 61,111 adults with gout (8.69 cases per 1000 person-months), and 47,222 cases occurred in 1,697,168 adults without gout (6.89 cases per 1000 person-months). Gout was significantly associated with a 14% increased risk of SARS-CoV-2 infection and 21% increased risk of hospitalization, Dr Lei and colleagues reported. The results for death were not significant. Unvaccinated women with gout had a significant 1.5-fold increased risk of both hospitalization and death.

“These findings suggest that additional measures should be considered to mitigate the risk of SARS–CoV-2 infection and potential severe outcomes for individuals with gout, especially women and even after vaccination,” Dr Lei’s team concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Xie D, Choi HK, Dalbeth N, et al. Gout and excess risk of severe SARS–CoV-2 infection among vaccinated individuals: A general population study. Arthritis Rheumatol. Published online September 9, 2022. doi:10.1002/art.42339