1. Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance.
- Author
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Ugarte-Gil MF, Alarcón GS, Izadi Z, Duarte-García A, Reátegui-Sokolova C, Clarke AE, Wise L, Pons-Estel GJ, Santos MJ, Bernatsky S, Ribeiro SLE, Al Emadi S, Sparks JA, Hsu TY, Patel NJ, Gilbert EL, Valenzuela-Almada MO, Jönsen A, Landolfi G, Fredi M, Goulenok T, Devaux M, Mariette X, Queyrel V, Romão VC, Sequeira G, Hasseli R, Hoyer B, Voll RE, Specker C, Baez R, Castro-Coello V, Maldonado Ficco H, Reis Neto ET, Ferreira GAA, Monticielo OAA, Sirotich E, Liew J, Hausmann J, Sufka P, Grainger R, Bhana S, Costello W, Wallace ZS, Jacobsohn L, Taylor T, Ja C, Strangfeld A, Mateus EF, Hyrich KL, Carmona L, Lawson-Tovey S, Kearsley-Fleet L, Schäfer M, Machado PM, Robinson PC, Gianfrancesco M, and Yazdany J
- Subjects
- Humans, Male, Prednisone therapeutic use, Severity of Illness Index, COVID-19, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic drug therapy, Rheumatology
- Abstract
Aim: To determine characteristics associated with more severe outcomes in a global registry of people with systemic lupus erythematosus (SLE) and COVID-19., Methods: People 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., Results: A 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., Conclusions: More 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., Competing Interests: Competing interests: MFU-G has received research grants from Pfizer and Janssen, not related to this manuscript. AD-G is supported by the Rheumatology Research Foundation (Scientist Development Award) and the Centers for Disease Control and Prevention. CR-S has received research grants from Janssen, not related to this manuscript. AEC has received consulting fees from AstraZeneca, BMS and GSK, all unrelated to this manuscript. LW has received consulting fees and speaker’s honoraria from Aurinia Pharma unrelated to this manuscript. GJP-E reports no competing interests related to this work. Outside of this work, he reports personal consulting and/or speaking fees from Pfizer, GSK, Janssen and Sanofi (all
- Published
- 2022
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