Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance
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Published:2022-02-16
Issue:7
Volume:81
Page:970-978
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ISSN:0003-4967
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Container-title:Annals of the Rheumatic Diseases
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language:en
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Short-container-title:Ann Rheum Dis
Author:
Ugarte-Gil Manuel FranciscoORCID, Alarcón Graciela SORCID, Izadi ZaraORCID, Duarte-García AliORCID, Reátegui-Sokolova CristinaORCID, Clarke Ann Elaine, Wise Leanna, Pons-Estel Guillermo JORCID, Santos Maria JoseORCID, Bernatsky SashaORCID, Ribeiro Sandra Lúcia EuzébioORCID, Al Emadi SamarORCID, Sparks Jeffrey AORCID, Hsu Tiffany Y -TORCID, Patel Naomi J, Gilbert Emily L, Valenzuela-Almada Maria O, Jönsen Andreas, Landolfi Gianpiero, Fredi Micaela, Goulenok Tiphaine, Devaux Mathilde, Mariette XavierORCID, Queyrel Viviane, Romão Vasco CORCID, Sequeira Graca, Hasseli Rebecca, Hoyer Bimba, Voll Reinhard E, Specker ChristofORCID, Baez Roberto, Castro-Coello Vanessa, Maldonado Ficco Hernan, Reis Neto Edgard TorresORCID, Ferreira Gilda Aparecida AparecidaORCID, Monticielo Odirlei Andre AndréORCID, Sirotich EmilyORCID, Liew Jean, Hausmann JonathanORCID, Sufka Paul, Grainger Rebecca, Bhana Suleman, Costello Wendy, Wallace Zachary S, Jacobsohn Lindsay, Taylor Tiffany, Ja Clairissa, Strangfeld AnjaORCID, Mateus Elsa FORCID, Hyrich Kimme LORCID, Carmona LoretoORCID, Lawson-Tovey SaskiaORCID, Kearsley-Fleet LianneORCID, Schäfer MartinORCID, Machado Pedro MORCID, Robinson Philip CORCID, Gianfrancesco Milena, Yazdany Jinoos
Abstract
AimTo determine characteristics associated with more severe outcomes in a global registry of people with systemic lupus erythematosus (SLE) and COVID-19.MethodsPeople with SLE and COVID-19 reported in the COVID-19 Global Rheumatology Alliance registry from March 2020 to June 2021 were included. The ordinal outcome was defined as: (1) not hospitalised, (2) hospitalised with no oxygenation, (3) hospitalised with any ventilation or oxygenation and (4) death. A multivariable ordinal logistic regression model was constructed to assess the relationship between COVID-19 severity and demographic characteristics, comorbidities, medications and disease activity.ResultsA total of 1606 people with SLE were included. In the multivariable model, older age (OR 1.03, 95% CI 1.02 to 1.04), male sex (1.50, 1.01 to 2.23), prednisone dose (1–5 mg/day 1.86, 1.20 to 2.66, 6–9 mg/day 2.47, 1.24 to 4.86 and ≥10 mg/day 1.95, 1.27 to 2.99), no current treatment (1.80, 1.17 to 2.75), comorbidities (eg, kidney disease 3.51, 2.42 to 5.09, cardiovascular disease/hypertension 1.69, 1.25 to 2.29) and moderate or high SLE disease activity (vs remission; 1.61, 1.02 to 2.54 and 3.94, 2.11 to 7.34, respectively) were associated with more severe outcomes. In age-adjusted and sex-adjusted models, mycophenolate, rituximab and cyclophosphamide were associated with worse outcomes compared with hydroxychloroquine; outcomes were more favourable with methotrexate and belimumab.ConclusionsMore severe COVID-19 outcomes in individuals with SLE are largely driven by demographic factors, comorbidities and untreated or active SLE. Patients using glucocorticoids also experienced more severe outcomes.
Funder
European League Against Rheumatism American College of Rheumatology Research and Education Foundation
Subject
General Biochemistry, Genetics and Molecular Biology,Immunology,Immunology and Allergy,Rheumatology
Cited by
53 articles.
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