학술논문
Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance
Document Type
article
Author
Ugarte-Gil, Manuel Francisco; Alarcón, Graciela S; Izadi, Zara; Duarte-García, Ali; Reátegui-Sokolova, Cristina; Clarke, Ann Elaine; Wise, Leanna; Pons-Estel, Guillermo J; Santos, Maria Jose; Bernatsky, Sasha; Ribeiro, Sandra Lúcia Euzébio; Emadi, Samar Al; Sparks, Jeffrey A; Hsu, Tiffany Y-T; Patel, Naomi J; Gilbert, Emily L; Valenzuela-Almada, Maria O; Jönsen, Andreas; Landolfi, Gianpiero; Fredi, Micaela; Goulenok, Tiphaine; Devaux, Mathilde; Mariette, Xavier; Queyrel, Viviane; Romão, Vasco C; Sequeira, Graca; Hasseli, Rebecca; Hoyer, Bimba; Voll, Reinhard E; Specker, Christof; Baez, Roberto; Castro-Coello, Vanessa; Ficco, Hernan Maldonado; Neto, Edgard Torres Reis; Ferreira, Gilda Aparecida Aparecida; Monticielo, Odirlei Andre André; Sirotich, Emily; Liew, Jean; Hausmann, Jonathan; Sufka, Paul; Grainger, Rebecca; Bhana, Suleman; Costello, Wendy; Wallace, Zachary S; Jacobsohn, Lindsay; Taylor, Tiffany; Ja, Clairissa; Strangfeld, Anja; Mateus, Elsa F; Hyrich, Kimme L; Carmona, Loreto; Lawson-Tovey, Saskia; Kearsley-Fleet, Lianne; Schäfer, Martin; Machado, Pedro M; Robinson, Philip C; Gianfrancesco, Milena; Yazdany, Jinoos
Source
Annals of the Rheumatic Diseases. 81(7)
Subject
Language
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.