TY - JOUR
T1 - Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus
T2 - data from the COVID-19 global rheumatology alliance
AU - Ugarte-Gil, Manuel Francisco
AU - Alarcón, Graciela S.
AU - Izadi, Zara
AU - Duarte-García, Ali
AU - Reátegui-Sokolova, Cristina
AU - Clarke, Ann Elaine
AU - Wise, Leanna
AU - Pons-Estel, Guillermo J.
AU - Santos, Maria Jose
AU - Bernatsky, Sasha
AU - Ribeiro, Sandra Lúcia Euzébio
AU - Al Emadi, Samar
AU - Sparks, Jeffrey A.
AU - Hsu, Tiffany Y.T.
AU - Patel, Naomi J.
AU - Gilbert, Emily L.
AU - Valenzuela-Almada, Maria O.
AU - Jönsen, Andreas
AU - Landolfi, Gianpiero
AU - Fredi, Micaela
AU - Goulenok, Tiphaine
AU - Devaux, Mathilde
AU - Mariette, Xavier
AU - Queyrel, Viviane
AU - Romão, Vasco C.
AU - Sequeira, Graca
AU - Hasseli, Rebecca
AU - Hoyer, Bimba
AU - Voll, Reinhard E.
AU - Specker, Christof
AU - Baez, Roberto
AU - Castro-Coello, Vanessa
AU - Ficco, Hernan Maldonado
AU - Neto, Edgard Torres Reis
AU - Ferreira, Gilda Aparecida Aparecida
AU - Monticielo, Odirlei Andre André
AU - Sirotich, Emily
AU - Liew, Jean
AU - Hausmann, Jonathan
AU - Sufka, Paul
AU - Grainger, Rebecca
AU - Bhana, Suleman
AU - Costello, Wendy
AU - Wallace, Zachary S.
AU - Jacobsohn, Lindsay
AU - Taylor, Tiffany
AU - Ja, Clairissa
AU - Strangfeld, Anja
AU - Mateus, Elsa F.
AU - Hyrich, Kimme L.
AU - Carmona, Loreto
AU - Lawson-Tovey, Saskia
AU - Kearsley-Fleet, Lianne
AU - Schäfer, Martin
AU - MacHado, Pedro M.
AU - Robinson, Philip C.
AU - Gianfrancesco, Milena
AU - Yazdany, Jinoos
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - COVID-19
KW - epidemiology
KW - lupus erythematosus
KW - systemic
KW - Severity of Illness Index
KW - Prednisone/therapeutic use
KW - Humans
KW - Rheumatology
KW - Male
KW - Lupus Erythematosus, Systemic/complications
UR - http://www.scopus.com/inward/record.url?scp=85131336148&partnerID=8YFLogxK
U2 - 10.1136/annrheumdis-2021-221636
DO - 10.1136/annrheumdis-2021-221636
M3 - Artículo
C2 - 35172961
AN - SCOPUS:85131336148
SN - 0003-4967
VL - 81
SP - 970
EP - 978
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 7
ER -
