<h3>Background:</h3> COVID-19 has been suggested as a possible trigger of disease flares in patients with rheumatoid arthritis (RA). However, factors associated with disease flares remain unknown. <h3>Objectives:</h3> This study aimed to identify factors associated with disease flares in patients with RA following COVID-19. <h3>Methods:</h3> We selected patients with RA from an online e-survey data from the COVID-19 vaccination in autoimmune diseases (COVAD) study. Demographic data, patient-reported outcomes, comorbidities and pharmacologic treatment were extracted from the database. Disease flare-ups were derived from the e-survey database. Factors associated with disease flare-ups were determined by multivariate logistic regression analysis. <h3>Results:</h3> In total, 1928 patients with RA were extracted from the COVAD database. Younger age (odds ratio (OR): 0.98, 95% CI: 0.96 – 0.99, p<0.001), ethnicity other than Asian, past history of tuberculosis (OR: 3.80, 95% CI: 1.12 – 12.94, p=0.033), treatment with methotrexate (OR: 2.55, 95% CI: 1.56 – 4.17, p<0.001), poor global physical health (OR: 1.07, 95% CI: 1.00 –1.15, p=0.044) and mental health (OR: 0.91, 95% CI: 0.87 –0.95, p<0.001) were independent factors associated disease flares in patients with RA. Table 1 represents factors associated with disease flare in patients with RA after COVID breakthrough infections and Figure 1 represents forest plots of symptoms of disease flare. <h3>Conclusion:</h3> Our study highlights important socio-demographic, clinical characteristics and mental health to be associated with flares in patients with RA. This finding may help determine relevant strategies to proactively manage RA patients at risk of flares. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> Myositis Association, Myositis India, Myositis UK, Myositis Support and Understanding, the Myositis Global Network, Deutsche Gesellschaft für Muskelkranke e.V. (DGM), Dutch and Swedish Myositis patient support groups, Cure JM, Cure IBM, Sjögren's India Foundation, Patients Engage, Scleroderma India, Lupus UK, Lupus Sweden, Emirates Arthritis Foundation, EULAR PARE, ArLAR research group, AAAA patient group, Myositis Association of Australia, APLAR myositis special interest group, Thai Rheumatism association, PANLAR, AFLAR NRAS, Anti-Synthetase Syndrome support group, and various other patient support groups and organizations. <h3>Disclosure of Interests:</h3> <b>None declared.</b>
