Risk factors associated with COVID-19 in systemic lupus erythematosus: Results from a longitudinal prospective cohort

• Published in: Lupus 2023-04, Vol.32 (4), p.560-564
• Main Authors: Patil, Abhishek, Shobha, Vineeta, Shenoy, Padmanabha, S, Chandrashekara, Kumar, Sharath, Daware, Manisha, Haridas, Vikram, Janardana, Ramya, Pinto, Benzeeta, Kodishala, Chanakya, Ramaswamy, Subramanian, S, Nagaraj, Jain, Vikramraj, Singh, Yogesh Preet, Singhai, Shweta, C, Srinivasa, Jois, Ramesh, Rao, Vijay K, Dharmapalaiah, Chethana, KN, Sangeetha, Balebail, Dharmanand
• Format: Article
• Language: English
• Subjects: Concise Report; Coronaviruses; COVID-19; COVID-19 - complications; Diabetes mellitus; Glucocorticoids; Humans; Hydroxychloroquine; Immune system; Immunosuppressive agents; Immunosuppressive Agents - adverse effects; Longitudinal Studies; Lupus; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - drug therapy; Male; Prednisolone; Prospective Studies; Rheumatology; Risk Factors; Systemic lupus erythematosus
• ISSN: 0961-2033; 1477-0962
• DOI: 10.1177/09612033231155837

Introduction Patients with SLE (systemic lupus erythematosus) have a higher risk of infection due to dysregulated immune system as well as long-term use of immunosuppressants (IS). This could influence the risk of COVID-19 and its outcome. Methods We conducted a longitudinal prospective study across 15 rheumatology centres during the first wave of the pandemic to understand the risk factors contributing to COVID-19 in SLE patients. During the 6 months follow-up, those who tested positive for COVID-19, their clinical course and outcome information were recorded. Results Through the study period (April–December 2020), 36/1379 lupus patients (2.9%) developed COVID-19. On analysing the COVID-19 positive versus negative cohort during the study period, male gender (adjusted RR 3.72, 95% C.I. 1.85,7.51) and diabetes (adjusted RR 2.94, 95% C.I. 1.28, 6.79) emerged as the strongest risk factors for COVID-19, in the adjusted analysis. There was no significant influence of organ involvement, hydroxychloroquine, glucocorticoid dosage (prednisolone< 7.5 mg or ≥ 7.5 mg/day) or IS on the risk of COVID-19. There was only one death (1/36) among the lupus patients due to COVID-19. Conclusion Traditional risk factors rather than lupus disease process or IS influenced the risk of COVID-19 in our cohort.