Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance

被引：79

作者：

Ugarte-Gil, Manuel Francisco ^{[1
,2
]}

Alarcon, Graciela S. ^{[3
,4
]}

Izadi, Zara ^{[5
,6
]}

Duarte-Garcia, Ali ^{[7
,8
]}

Reategui-Sokolova, Cristina ^{[2
,9
]}

Clarke, Ann Elaine ^{[10
]}

Wise, Leanna ^{[11
]}

Pons-Estel, Guillermo J. ^{[12
,13
]}

Santos, Maria Jose ^{[14
,15
]}

Bernatsky, Sasha ^{[16
]}

Euzebio Ribeiro, Sandra Lucia ^{[17
]}

Al Emadi, Samar ^{[18
]}

Sparks, Jeffrey A. ^{[19
]}

Hsu, Tiffany Y-T ^{[19
]}

Patel, Naomi J. ^{[20
]}

Gilbert, Emily L. ^{[21
]}

Valenzuela-Almada, Maria O. ^{[7
]}

Jonsen, Andreas ^{[22
]}

Landolfi, Gianpiero ^{[23
]}

Fredi, Micaela ^{[24
,25
]}

Goulenok, Tiphaine ^{[26
,27
]}

Devaux, Mathilde ^{[28
]}

Mariette, Xavier ^{[29
]}

Queyrel, Viviane ^{[30
]}

Romao, Vasco C. ^{[15
,31
]}

Sequeira, Graca ^{[32
]}

Hasseli, Rebecca ^{[33
]}

Hoyer, Bimba ^{[34
]}

Voll, Reinhard E. ^{[35
]}

Specker, Christof ^{[36
]}

Baez, Roberto ^{[37
]}

Castro-Coello, Vanessa ^{[38
]}

Ficco, Hernan Maldonado ^{[39
]}

Reis Neto, Edgard Torres ^{[40
]}

Aparecida Ferreira, Gilda Aparecida ^{[41
,42
]}

Andre Monticielo, Odirlei Andre ^{[43
,44
]}

Sirotich, Emily ^{[45
,46
]}

Liew, Jean ^{[47
]}

Hausmann, Jonathan ^{[48
,49
]}

Sufka, Paul ^{[50
]}

Grainger, Rebecca ^{[51
]}

Bhana, Suleman ^{[52
]}

Costello, Wendy ^{[53
]}

Wallace, Zachary S. ^{[20
]}

Jacobsohn, Lindsay ^{[6
]}

Taylor, Tiffany ^{[6
]}

Ja, Clairissa ^{[6
]}

Strangfeld, Anja ^{[54
]}

Mateus, Elsa F. ^{[55
,56
]}

Hyrich, Kimme L. ^{[57
,58
]}

机构：

[1] Univ Cient Sur, Grp Peruano Estudio Enfermedades Autoinmunes Sist, Lima, Peru

[2] Hosp Nacl Guillermo Almenara Irigoyen, Rheumatol Dept, EsSalud, Lima, Peru

[3] Univ Alabama Birmingham, Heersink Sch Med, Birmingham, AL USA

[4] Univ Peruana Cayetano Heredia, Sch Med, Lima, Peru

[5] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA

[6] Univ Calif San Francisco, Dept Med, Div Rheumatol, San Francisco, CA 94143 USA

[7] Mayo Clin, Div Rheumatol, Rochester, MN USA

[8] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN USA

[9] Univ San Ignacio de Loyola, Unidad Invest Generac & Sintesis Evidencias Salud, Lima, Peru

[10] Univ Calgary, Div Rheumatol, Dept Med Cumming, Sch Med, Calgary, AB, Canada

[11] Univ Southern Calif, Dept Internal Med, Div Rheumatol, Los Angeles, CA 90007 USA

[12] Ctr Reg Enfermedades Autoinmunes & Reumat GO CREA, Rosario, Argentina

[13] Argentine Soc Rheumatol, Res Unit, Buenos Aires, DF, Argentina

[14] Hosp Garcia de Orta, Rheumatol, Almada, Portugal

[15] Univ Lisbon, Fac Med, Rheumatol Res Unit, Inst Med Mol Joao Lobo Antunes, Lisbon, Portugal

[16] McGill Univ, Div Rheumatol, Hlth Ctr, Montreal, PQ, Canada

[17] Univ Fed Amazonas, Fac Med, UFAM, Manaos, Amazonas, Brazil

[18] Hamad Med Corp, Rheumatol Dept, Doha, Qatar

[19] Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, 75 Francis St, Boston, MA 02115 USA

[20] Harvard Med Sch, Div Rheumatol Allergy & Immunol, Massachusetts Gen Hosp, Boston, MA 02115 USA

[21] Mayo Clin, Div Rheumatol, Jacksonville, FL 32224 USA

[22] Lund Univ, Lund, Sweden

[23] Italian Soc Rheumatol, Epidemiol Res Unit, Milan, Italy

[24] ASST Spedali Civili, Rheumatol & Clin Immunol, Brescia, Italy

[25] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy

[26] Bichat Claude Bernard Hosp, AP HP, Internal Med Dept, Paris, France

[27] Univ Paris, Paris, France

[28] Poissy St Germain En Laye Hosp, Internal Med Dept, Poissy, France

[29] Univ Paris Saclay, AP HP, Dept Rheumatol, Le Kremlin Bicetre, France

[30] Univ Nice Sophia Antipolis, Dept Rheumatol, Pasteur 2 Hosp, Nice, France

[31] Ctr Hosp Univ Lisboa Norte, Hosp Santa Maria, Rheumatol Dept, Lisbon, Portugal

[32] Ctr Hosp Univ Algarve, Unidade Faro, Faro, Portugal

[33] Justus Liebig Univ Giessen, Dept Rheumatol & Clin Immunol, Campus Kerckhoff, Bad Nauheim, Germany

[34] Univ Hosp Schleswig Holstein, Dept Rheumatol & Clin Immunol, Clin Internal Med 1, Kiel, Germany

[35] Albert Ludwigs Univ Freiburg, Univ Med Ctr Freiburg, Fac Med, Dept Rheumatol & Clin Immunol, Freiburg, Germany

[36] Kliniken Essen Mitte, Dept Rheumatol & Clin Immunol, Essen, Germany

[37] Hosp Francisco Lopez Lima, Gen Roca, Argentina

[38] Sanatorio Guemes Hosp Privado, Buenos Aires, DF, Argentina

[39] Hosp San Antonio de Padua, Rio Cuarto, Argentina

[40] Univ Fed Sao Paulo, Hosp Sao Paulo, Sao Paulo, Brazil

[41] Hosp Clin, Belo Horizonte, MG, Brazil

[42] Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil

[43] Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil

[44] Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil

[45] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[46] Canadian Arthrit Patient Alliance, Toronto, ON, Canada

[47] Boston Univ, Sch Med, Dept Med, Sect Rheumatol, Boston, MA 02118 USA

[48] Boston Childrens Hosp, Rheumatol, Boston, MA USA

[49] Harvard Med Sch, Div Rheumatol & Clin Immunol, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA

[50] Healthpartners, St Paul, MN USA

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2022年 / 81卷 / 07期

关键词：

lupus erythematosus; systemic; COVID-19; epidemiology;

D O I：

10.1136/annrheumdis-2021-221636

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：970 / 978

页数：9

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