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.
Keywords: COVID-19; epidemiology; lupus erythematosus; systemic.
【저자키워드】 COVID-19, Epidemiology, lupus erythematosus, systemic., 【초록키워드】 Treatment, severe COVID-19, Comorbidities, Ventilation, COVID-19 severity, Comorbidity, systemic lupus erythematosus, outcome, glucocorticoid, outcomes, Characteristics, Older age, death, Kidney disease, Prednisone, methotrexate, medication, moderate, Disease activity, dose, Male sex, Oxygenation, SLE, Cyclophosphamide, demographic characteristics, 95% CI, individual, ordinal logistic regression, Demographic factors, multivariable model, hospitalised, multivariable, defined, reported, determine, driven by, Alliance, 【제목키워드】 outcome, individual, Alliance,