Lupus & antiphospholipid syndrome
Risks of mortality and severe coronavirus disease 19 (COVID-19) outcomes in patients with or without systemic lupus erythematosus
Authors' conclusion
Patients with SLE had increased risk of severe COVID-19-related outcomes compared with matched controls. Patients with severe SLE disease activity or prior use of corticosteroids experienced worse outcomes.
Study context
- Population
- Patients with COVID-19 in the deidentified Optum COVID-19 electronic health record dataset, 1/1/2020 to 31/12/2020matched cohort
- Participants
- 687 vs 6,870
- Exposure
- Systemic lupus erythematosus (SLE) vs matched general controls
- SLEn = 687
- Controlsn = 6,870reference
- Outcome
- COVID-19 outcomes:
- 30-day mortality
- Mechanical ventilation
- Hospitalisation
Methodological detailsmatched 1:10 by age, sex, race and ethnicity and COVID-19 diagnosis date, multivariable logistic regression
- Matched 1:10 by age, sex, race and ethnicity and COVID-19 diagnosis date
- Multivariable logistic regression
Main finding
As reported in the abstract
Each group vs controlsEstimate (95% CI)
SLE
OR (mechanical ventilation, multivariable-adjusted) 1.81(1.16–2.82)
SLE
OR (hospitalisation, multivariable-adjusted) 1.32(1.05–1.65)
Observational data: associations, not effects.
Further findings
Mechanical ventilation with severe SLE disease activity (within SLE)
| OR (95% CI) | ||
|---|---|---|
| Severe disease activity | 5.83 (2.60–13.07) | |
| 0.050.21520Odds ratio (log scale) |
Hospitalisation with severe SLE disease activity (within SLE)
| OR (95% CI) | ||
|---|---|---|
| Severe disease activity | 3.97 (2.37–6.65) | |
| 0.10.31310Odds ratio (log scale) |
Prior GC, mycophenolate and tacrolimus use (within SLE)
- Use of GC, mycophenolate and tacrolimus before COVID-19 associated with worse outcomes
Original publication
Risks of mortality and severe coronavirus disease 19 (COVID-19) outcomes in patients with or without systemic lupus erythematosus. Lupus Sci Med. Published 14 February 2023. doi:10.
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