medwireNews: The risk factors for poor COVID-19 outcomes in patients with systemic lupus erythematosus (SLE) are largely similar to those for the general population, but research also indicates an increased risk associated with glucocorticoid use and moderate or high disease activity.
“The COVID-19 GRA [Global Rheumatology Alliance] is the largest and most diverse registry of patients with autoimmune diseases and COVID-19,” commented presenter Manuel Ugarte-Gil (Universidad Científica del Sur, Lima, Peru) at the EULAR 2021 Virtual Congress.
“The relatively large sample size has allowed us to evaluate several factors associated with poor COVID-19 outcomes.”
Data were available for 1734 patients with SLE identified from a physician-reported registry of the COVID-19 GRA. The average age of the patients was 44 years and 90% were women. Just over half of the patients had no comorbidities, and the majority were in remission (37%) or had minimal or low disease activity (43%).
A total of 56.5% of patients were taking glucocorticoids, most of whom were taking doses below 10 mg/day, 34.0% were taking antimalarials only, 11.5% were taking DMARDs, and 42.5% other immunosuppressive therapies.
The patients were categorized according to the level of severity reached during the course of COVID-19: Not hospitalized; hospitalized without oxygen; hospitalized with oxygen or ventilation; or death.
As for the general population, age, male sex, and comorbidities significantly increased the risk for more severe COVID-19 outcomes in patients with SLE.
In addition to these, glucocorticoid use was associated with a significantly increased likelihood of poor COVID-19 outcomes, with the odds ratio increasing from 1.87 among those taking glucocorticoid 0–5 mg/day to 2.46 and 2.32 among those taking 5–10 mg/day and more than 10 mg/day, respectively.
Disease activity also significantly influenced the risk for poor outcomes, but only if it was moderate or high in severity, at which point the odds for poor COVID-19 outcomes increased 1.78- and 4.18-fold, respectively.
The findings “highlight the prioritization of risk-mitigation strategies for these patients,” Ugarte-Gil concluded.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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