any reason why you're not building a query like this?
query = db.session.query(label('sid',
distinct(a[1].c.patient_sid)))
if n >= 2
query = query.\
join(a[2],a[2].c.patient_sid==a[1].c.patient_sid)
if n >= 3
query = query.\
join(a[3],a[3].c.patient_sid==a[1].c.patient_sid)
or
query = db.session.query(label('sid',
distinct(a[1].c.patient_sid)))
for i in range(2, n):
query = query.\
join(a[i],a[i].c.patient_sid==a[1].c.patient_sid)
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