Poor Prognosis of COVID-19 Acute Respiratory Distress Syndrome in Lupus Erythematosus: Nationwide Cross-Sectional Population Study Of 252 119 Patients

Author(s)

Bertoglio, Isabela Maria ^[1] ; de Lucena Valim, Juliana Miranda ^[1] ; Daffre, Danielle ^[1] ; Aikawa, Nadia Emi ^[1] ; Silva, Clovis Artur ^[1] ; Bonfa, Eloisa ^[1] ; Ugolini-Lopes, Michelle Remiao ^[1]

Affiliation

^[1] Univ Sao Paulo, Hosp Clin, Fac Med, Third Floor, Room 3131, 455 Doctor Arnaldo Ave, BR-01246903 Sao Paulo - Brazil

• Document type: Journal article
• Source: ACR OPEN RHEUMATOLOGY; AUG 2021.
• Web of Science Citations: 0

Abstract

Objective Coronavirus disease 2019 (COVID-19) has progressed rapidly around the world, reaching a lethality of up to 20% due to acute respiratory distress syndrome (ARDS). This latter condition is a relevant concern for systemic lupus erythematosus (SLE); however, data on this topic are limited to few case series. Our objective was to evaluate in hospitalized patients with SLE and with COVID-19-associated ARDS (confirmed by reverse transcription-polymerase chain reaction) the risk of mortality and combined poor outcomes (death, intensive care unit {[}ICU] admission, and/or mechanical ventilation {[}MV] use) and to compare with that of patients without SLE. Methods This is a nationwide cross-sectional study of patients with severe acute respiratory syndrome coronavirus 2 nested in the national Influenza Epidemiological Surveillance Information System (Sistema de Informacao de Vigilancia Epidemiologica da Gripe {[}SIVEP-gripe]). Mortality rates, frequencies of ICU admissions, and MV use for 319 patients with SLE and 251 800 patients without SLE were calculated as well as relative risks (RRs). A fully adjusted multiple logistic regression was performed to adjust factors, such as age and well-known comorbidities, that might impact worse outcomes. Results Patients with SLE had an increased risk of death and combined poor outcome compared with patients without SLE (RR = 1.738, 95% confidence interval {[}CI]: 1.557-1.914, and RR = 1.391, 95% CI: 1.282-1.492, respectively). Among all investigated comorbidities, SLE yielded the higher risk of death and combined poor outcomes (RR = 2.205, 95% CI: 1.780-2.633, and RR = 1.654, 95% CI: 1.410-1.88, respectively). Conclusions This study provides novel evidence that patients with SLE hospitalized because of COVID-19 have significantly higher risks of death and poor outcomes compared with patients without comorbidities and patients with other comorbidities. (AU)

• FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Support Opportunities: Research Projects - Thematic Grants