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Case Reports
. 2020 Oct 14;15(1):1054-1060.
doi: 10.1515/med-2020-0238. eCollection 2020.

A case of SLE with COVID-19 and multiple infections

Ruoqi Ning  1 , Silu Meng  1 , Fangxu Tang  1 , Chong Yu  2 , Dong Xu  3 , Xiaofang Luo  1 , Haiying Sun  1
Affiliations
Case Reports

A case of SLE with COVID-19 and multiple infections

Ruoqi Ning et al. Open Med (Wars). .

Abstract

The coronavirus disease 2019 (COVID-19) has become a global pandemic, which is induced by infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with systemic lupus erythematosus (SLE) are susceptible to infections due to the chronic use of immunosuppressive drugs and the autoimmune disorders. Now we report a case of SLE infected with SARS-CoV-2, influenza A virus and Mycoplasma pneumoniae concurrently. The patient used hydroxychloroquine and prednisone chronically to control the SLE. After infection of SARS-CoV-2, she was given higher dose of prednisone than before and the same dosage of hydroxychloroquine. Besides, some empirical treatments such as antiviral, antibiotic and immunity regulating therapies were also given. The patient finally recovered from COVID-19. This case indicated that hydroxychloroquine may not be able to fully protect SLE patient form SARS-CoV-2. Intravenous immunoglobulin therapies and increased dose of corticosteroids might be adoptable for patient with both COVID-19 and SLE. Physicians should consider SARS-CoV-2 virus test when SLE patient presented with suspected infection or SLE flare under the epidemic of COVID-19.

Keywords: COVID-19; SARS-CoV-2; SLE; hydroxychloroquine; multiple infections.

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Conflict of interest statement

Conflict of interest: The authors state no conflicts of interest.

Figures

Figure 1
Figure 1
Treatments, radiology and pathogen findings according to day of illness and day of hospitalization. Symbols: X, CT conducted; +, positive result; −, negative result. Abbreviations: IVIg, intravenous immunoglobulin; CT, computed tomography; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; IgM, immunoglobulin M.
Figure 2
Figure 2
Thoracic CT images. (a) Thoracic CT of day 6 of hospitalization showed bilateral ground-glass, patchy and cord-like shadows. (b) Thoracic CT of day 15 of hospitalization showed that pulmonary infiltration was partly absorbed. (c) Thoracic CT of day 22 of hospitalization showed that pulmonary infiltration was absorbed obviously.
See this image and copyright information in PMC

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