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Original Research
COVID-19 incidence among Kenyan patients with and without inflammatory rheumatic disease
Submitted: 10 April 2025 | Published: 31 October 2025
About the author(s)
Benwillies Onchong’a, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; and Department of Rheumatic Diseases, Jasmota Hospital, Nairobi, KenyaTuulikki Sokka-Isler, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; and Wellbeing Services County of Central Finland, Hospital Nova, Jyväskylä, Finland
Pekka Mäntyselkä, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; and Teaching Clinic, Wellbeing Services County of North Savo, Kuopio, Finland
Ari Voutilainen, Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
Abstract
Background: Inflammatory rheumatic diseases (IRDs) have been considered potential risk factors for COVID-19, but evidence from Africa remains limited.
Aim: To investigate the association between IRDs and COVID-19 among general patients after hospital discharge in Nairobi, Kenya.
Setting: The prospective cohort study was conducted at Mbagathi County Hospital, a major public hospital in Nairobi, Kenya.
Methods: Patients were classified as IRD and non-IRD cases based on admission diagnosis. After discharge, 348 IRD and 2951 non-IRD patients were followed up for 2 years or until death. Cox proportional hazard models adjusted for baseline characteristics were executed to predict COVID-19 hazard in patients with versus without IRDs.
Results: The cohort included 46.2% women. IRD patients were older (mean 64 years vs. 62 years; p < 0.001), more frequently alcohol drinkers (17.0% vs. 9.5%; p < 0.001), less often vaccinated against COVID-19 (74.0% vs. 78.0%; p = 0.031) and had higher body mass index (BMI) (mean 26.3 kg/m2 vs. 25.3 kg/m2; p < 0.001). The 2-year COVID-19 incidence rate per 100 person-years was 4.5 (95% confidence interval [CI]: 3–7) in IRD patients and 5.0 (95% CI: 4–6) in non-IRD patients. The age- and sex-adjusted hazard of COVID-19 among IRD versus non-IRD patients was 0.9 (95% CI: 0.6–1.4; p = 0.667).
Conclusion: Inflammatory rheumatic diseases did not increase COVID-19 risk in this Kenyan cohort.
Contribution: This study provides valuable African data on IRDs and COVID-19 risk, reflecting potential regional features in clinical practice and public health strategies.
Keywords
Sustainable Development Goal
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