We thank Giollo and colleagues for their correspondence acknowledging the challenges of understanding those risk factors which contribute to severe outcomes in patients with underlying rheumatic musculoskeletal diseases (RMDs) who acquire the novel SARS-CoV‐2 infection.1 In their short case series, they highlight the balance and relative importance between disease activity and dose of glucocorticoid therapy, two factors which are highly linked within an individual. It is already known that both disease activity and glucocorticoid dose are independent risk factors for serious infection in patients with RMD, such as rheumatoid arthritis and systemic lupus erythematosus,2–4 as are age, the underlying RMD diagnosis itself and the presence of other comorbidities. Disentangling the individual contribution of any of these individual risk factors will require robust analysis of large and diverse patient datasets. The Global Rheumatology Alliance (GRA)5 aims to capture cases of COVID-19 among patients with pre-existing RMD and is reliant on the nature and diversity of the individual cases reported in order to provide a greater understanding of individual risk. By leveraging such a large dataset, we are able to conduct multivariable analyses that control for a number of different factors to estimate the contribution of individual risk factors. Future analyses of the GRA and other large patient registries will hopefully provide further insight into individual risk factors for severe outcomes in this patient group, such that we can offer the most relevant evidence to our colleagues and patients.

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