Yihua Fan ^1,2* Yiwen Wang ² Juanli Du ³ Rui Wu ⁴ Jianbin Li ⁴ Changhong Xiao ⁵ Qing Li ⁶ Mi Zhou ⁷ Ying Liu ⁸ Di Zhang ⁸ Bei Wang ⁹ Songwei Li ¹⁰ Zhina Zhao ¹¹ Xinliang Lv ¹² Yuan-hao Wu ² Yan Liu ² Xiaomei Ning ² Zhiteng Li ¹³ Shujiao Yu ⁴ Ensheng Chen ⁵ Guangzhao Zhu ⁶ Yuxing Zhao ² Juan Liu ⁹ Yuquan Liu ¹² Dongyi He ¹⁴ Wei Liu ²

• ¹ Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
• ² First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, Tianjin, China
• ³ Xi’an No.5 Hospital, Xi’an, China
• ⁴ The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
• ⁵ Southern Medical University Hospital of Integrated Traditional Chinese and Western, Southern Medical University, Guangzhou, China
• ⁶ Qinghai Hospital of Traditional Chinese Medicine, Xining, Qinghai Province, China
• ⁷ Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ⁸ Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
• ⁹ Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, Beijing Municipality, China
• ¹⁰ Henan Provincial Hospital of Chinese Medicine, Zhengzhou, China
• ¹¹ First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan Province, China
• ¹² Inner Mongolia Traditional Chinese Medicine, Hohhot, Inner Mongolia Autonomous Region, China
• ¹³ Xi’an No.5 Hospita, Xi’an, China
• ¹⁴ Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China

Background: In order to explore the differences in clinical features and prognosis of Corona Virus Disease 2019 (COVID-19) infection between patients with rheumatic diseases and the general population (family members), a retrospective investigative study was used to analyze the differences between the two populations. Methods: The study was conducted in 13 Grade A Tertiary hospitals in China to investigate the clinical symptoms and prognostic factors of patients with rheumatic diseases who were infected with COVID-19 for the first time and their families. Results: A total of 2,889 participants were included in this study, including 1,530 patients with rheumatic diseases and 1,359 family members. In terms of clinical symptoms, the complete recovery time from COVID-19 for patients with rheumatic disease patients was 13 days (8.00, 18.00), which was shorter than that of family members (16 days, 11.00, 20.00). The risk of developing moderate to severe cases of COVID-19 was lower in patients with rheumatic disease patients than in their family members (OR=0.524, P=0.0032). Compared with non-use of non-steroidal antiinflammatory drugs (NSAIDs), the risk of developing mild cases of COVID-19 was 0.595 times greater with pre-infection use of NSAIDs (P=0.00003). The use of glucocorticoids and Chinese herbal decoctions before infection increased the probability of developing mild cases of COVID-19 (OR=1.773, P<0.05). The risk of developing moderate to severe cases with disease-modifying anti-rheumatic drugs (DMARDs) used before infection was 0.350 times that without such drugs (P<0.001).In terms of prognosis, compared with family members, the complete recovery time of patients with rheumatic diseases was reduced by 2.303 days on average (P<0.001), and the complete recovery time of patients with mild rheumatism was reduced by 4.351 days on average (P<0.001). Compared with their family members, patients with rheumatic diseases had milder symptoms after infection with COVID-19, which was related to the use of glucocorticoids, DMARDs, and Chinese herbal decoctions before infection. During the COVID-19 infection phase, the use of NSAIDs, glucocorticoids, DMARDs, biologics, Chinese patent medicine, and Chinese herbal decoctions might shorten the recovery time from symptoms of COVID-19.