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Multicenter Study
. 2021 Dec:125:102730.
doi: 10.1016/j.jaut.2021.102730. Epub 2021 Oct 9.

Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network

Rahul Raiker  1 , Haig Pakhchanian  2 , Charles DeYoung  3 , Latika Gupta  4 , Sinan Kardeş  5 , Sakir Ahmed  6 , Chengappa Kavadichanda  7
Affiliations
Multicenter Study

Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network

Rahul Raiker et al. J Autoimmun. 2021 Dec.

Abstract

Objectives: To determine the severity and outcome of COVID-19 among individuals with lupus as compared to controls. The secondary objective was to identify the risk association of sex, race, presence of nephritis, and use of various immunomodulators with COVID-19 outcomes.

Methods: Retrospective data of individuals with lupus with and without COVID-19 between January 2020 to May 2021 was retrieved from the TriNetX. A one-to-one matched COVID-19 positive control was selected using propensity score(PS) matching. We assessed several outcomes, including all-cause mortality, hospitalisation, intensive care unit (ICU) admission, mechanical ventilation, severe COVID, acute kidney injury (AKI), Haemodialysis, acute respiratory distress syndrome (ARDS), ischemic stroke, venous thromboembolism (VTE) and sepsis were assessed.

Results: We identified 2140 SLE patients with COVID-19, 29,853 SLE without COVID-19 and 732,291controls. Mortality within 30 days of COVID-19 diagnosis was comparable among SLE and controls [RR-1.26; 95%CI-0.85,1.8]. SLE with COVID-19 had a higher risk of hospitalisation [RR-1.28; 95% CI 1.14-1.44], ICU admission [RR-1.35; 95% CI 1.01-1.83], mechanical ventilation [RR- 1.58 95% CI 1.07-2.33], stroke [RR-2.18; 95% CI 1.32,3.60], VTE [RR-2.22; 95% CI 1.57-03.12] and sepsis [RR-1.37; 95% CI 1.06-1.78].Individuals with SLE who contracted COVID-19 had higher mortality, hospitalisation, ICU admission, mechanical ventilation, AKI, VTE and sepsis (p < 0.001) compared to SLE without COVID-19. Males with SLE had a higher risk of AKI [RR-2.05; 95% CI 1.27-3.31] than females. Lupus nephritis was associated with higher risk of hospitalisation [RR-1.36; 95% CI 1.05-1.76], AKI [RR-2.32; 95% CI 1.50-3.59] and sepsis [RR-2.07; 95% CI-1.12-3.83].

Conclusion: The mortality of individuals with SLE due to COVID-19 is comparable to the general population but with higher risks of hospitalisation, ICU admission, mechanical ventilation, stroke, VTE and sepsis. The presence of nephritis increases the risk of AKI, thus probably increasing hospitalisation and sepsis.

Keywords: Immunosuppressants; Nephritis; SARS CoV-2; SLE.

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Conflict of interest statement

SA has received an honorarium as a speaker for Pfizer (unrelated to the current study) and has no other potential conflicts of interest. SK has received congress travel, accommodation, and participation fee support (12th Anatolian Rheumatology Days) from Abbvie. All other authors declare no competing interests.

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