This study found that severe COVID-19 outcomes in patients with systemic lupus erythematosus (SLE) were driven by untreated SLE, co-morbidities, as well as demographic factors.
SLE patients using glucocorticoids also experienced more severe COVID-19 outcomes.
Individuals with SLE were of particular concern during the COVID-19 pandemic. SLE patients are often immunosuppressed and have co-morbidities associated with increased risk of severe COVID-19 outcomes.
Why This Study Matters
Previous studies have examined COVID-19 outcomes in rheumatic diseases as a whole. However, studies focused on individuals with SLE are limited and it is unclear which risk factors are associated with poor COVID-19 outcomes in this population. To fill this gap, this study sought to identify the characteristics associated with severe outcomes in patients with SLE and COVID-19.
This study included participants with SLE and COVID-19 from the COVID-19 Global Rheumatology Alliance registry enrolled from March 2020 to June 2021. The outcomes of the study were no hospitalization, hospitalization with no oxygen, hospitalization with any ventilation or oxygenation, and death. Investigators utilized a multivariable ordinal logistic regression model to examine the association between COVID-19 severity and demographic characteristics, co-morbidities, medications and disease activity.
Results and Conclusions
The study included 1606 individuals with SLE. Older age, male gender, prednisone dose, no current treatment, co-morbidities, and moderate or high SLE disease activity was associated with severe outcomes. In comparison to hydroxychloroquine, mycophenolate, rituximab, and cyclophosphamide use were associated with worse outcomes. Methotrexate and belimumab were associated with more favorable outcomes.
Consider these findings from similar research studies:
COVID-19 related death is associated with moderate/high rheumatic disease activity, highlighting the importance of disease control (Source).
SLE patients hospitalized due to COVID-19 have a significantly increased risk of death and adverse outcomes compared with patients without co-morbidities (Source).
Ugarte-Gil MF, Alarcón GS, Izadi Z, et al. Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance. Ann Rheum Dis. Published online February 16, 2022:annrheumdis-2021-221636.