Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 global rheumatology alliance

Ugarte-Gil M.F.; Alarcón G.S.; Izadi Z.; Duarte-García A.; Reátegui-Sokolova C.; Clarke A.E.; Wise L.; Pons-Estel G.J.; Santos M.J.; Bernatsky S.; Ribeiro S.L.E.; Al Emadi S.; Sparks J.A.; Hsu T.Y.-T.; Patel N.J.; Gilbert E.L.; Valenzuela-Almada M.O.; Jönsen A.; Landolfi G.; Fredi M.; Goulenok T.; Devaux M.; Mariette X.; Queyrel V.; Romão V.C.; Sequeira G.; Hasseli R.; Hoyer B.; Voll R.E.; Specker C.; Baez R.; Castro-Coello V.; Ficco H.M.; Neto E.T.R.; Ferreira G.A.A.; Monticielo O.A.A.; Sirotich E.; Liew J.; Hausmann J.; Sufka P.; Grainger R.; Bhana S.; Costello W.; Wallace Z.S.; Jacobsohn L.; Taylor T.; Ja C.; Strangfeld A.; Mateus E.F.; Hyrich K.L.; Carmona L.; Lawson-Tovey S.; Kearsley-Fleet L.; Schäfer M.; MacHado P.M.; Robinson P.C.; Gianfrancesco M.; Yazdany J. · Annals of the Rheumatic Diseases (2022) · DOI: 10.1136/annrheumdis-2021-221636

Resumen

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. © Author(s) (or their employer(s)) 2022.

Instituciones: Universidad Peruana Cayetano Heredia; Universidad Científica del Sur; Universidad San Ignacio de Loyola