Impact of COVID-19 pandemic on hospitalisation of patients with systemic lupus erythematosus (SLE): report from a tertiary hospital during the peak of the pandemic

Chuah, Seow Lin; Teh, Cheng Lay; Wan, Sharifah Aishah; Cheong, Yaw Kiet; Singh, Benjamin

doi:10.1136/annrheumdis-2020-218475

Cited by 17 publications

(15 citation statements)

References 9 publications

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“…During the COVID‐19 pandemic, studies in Asia showed that only 0.1%‐0.2% of SLE patients had documented infection with COVID‐19 85‐89 (Table 5). Together with other case series and reports, there is a total of 18 reported SLE patients with COVID‐19 infection 90‐94 . Among them, 3 patients died of pneumonia and 7 other patients had moderate to severe pneumonia that required oxygen therapy and intubation.…”

Section: Resultsmentioning

confidence: 96%

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

et al. 2021

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Systemic lupus erythematosus (SLE) is a more common autoimmune rheumatic disease in the Asia‐Pacific region. The prognosis of SLE remains unsatisfactory in some Asian countries because of delayed diagnosis, limited access to medications, increased complications and issues of tolerability and adherence to treatment. The Asia‐Pacific League of Associations for Rheumatology SLE special interest group has recently published a set of consensus recommendations on the management of SLE for specialists, family physicians, specialty nurses, and other healthcare professionals in the Asia‐Pacific region. This article reports a systematic literature review of the infective complications of SLE in Asia and evidence for prevention of these infections by pre‐emptive antimicrobial therapy and vaccination.

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Section: Resultsmentioning

confidence: 96%

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

et al. 2021

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“…Strikingly, only D 1 9 0 X X1 death was attributed to COVID-19. 247 These findings are likely multifactorial; while patients with SLE may have avoided presenting to the hospital due to fear of contracting COVID-19 until it was inevitable, it is also possible that different factors such as lack of close monitoring of clinical or laboratory parameters, issues with access or self-adjustments of the doses of SLE medications, have also contributed to higher severity and mortality rates in this population.…”

Section: Ancestral Background Socioeconomic Factors and Indirect Conmentioning

confidence: 99%

COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease

Fernández-Ruiz

Paredes

Niewold

2021

Translational Research

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As the world navigates the Coronavirus disease 2019 (COVID-19) pandemic, there is a growing need to assess its impact in patients with autoimmune rheumatic diseases, such as systemic lupus erythematosus (SLE). Patients with SLE are a unique population when considering the risk of contracting COVID-19 and infection outcomes. The use of systemic glucocorticoids and immunosuppressants, and underlying organ damage from SLE are potential susceptibility factors. Most patients with SLE have evidence of high type I IFN activity, which may theoretically act as an antiviral line of defense or contribute to the development of a deleterious hyperinflammatory response in COVID-19. Other immunopathogenic mechanisms of SLE may overlap with those described in COVID-19, and thus studies in SLE could provide some insight into immune responses occurring in severe cases of the viral infection. We reviewed the literature to date on COVID-19 in patients with SLE and provide an in-depth review of current research in the area, including immune pathway activation, epidemiology, clinical features, outcomes, and the psychosocial impact of the pandemic in those with autoimmune disease.

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“…On the other hand glucocorticoids might increase the risk of hospitalisation and a subsequent severe outcome [11,12]. Furthermore, studies suggest that pausing the SLE treatment during COVID-19 infection leads to a flare up in the SLE [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Incidence of COVID-19 Hospitalisation in Patients with Systemic Lupus Erythematosus: A Nationwide Cohort Study from Denmark

Cordtz

Kristensen

Dalgaard

et al. 2021

JCM

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Background: Patients with systemic lupus erythematosus (SLE) have an increased risk of infections due to impaired immune functions, disease activity, and treatment. This study investigated the impact of having SLE on the incidence of hospitalisation with COVID-19 infection. Methods: This was a nationwide cohort study from Denmark between 1 March 2020 to 2 February 2021, based on the linkage of several nationwide registers. The adjusted incidence of COVID-19 hospitalisation was estimated for patients with SLE compared with the general population in Cox-regression models. Among SLE patients, the hazard ratio (HR) for hospitalisation was analysed as nested case-control study. Results: Sixteen of the 2533 SLE patients were hospitalised with COVID-19 infection. The age-sex adjusted rate per 1000 person years was 6.16 (95% CI 3.76–10.08) in SLE patients, and the corresponding hazard ratio was 2.54 (95% CI 1.55–4.16) compared with the matched general population group after adjustment for comorbidities. Among SLE patients, hydroxychloroquine treatment was associated with a HR for hospitalisation of 0.61 (95% CI 0.19–1.88), and 1.06 (95% CI 0.3–3.72) for glucocorticoid treatment. Conclusion: Patients with SLE were at increased risk of hospitalisation with COVID-19.

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Impact of COVID-19 pandemic on hospitalisation of patients with systemic lupus erythematosus (SLE): report from a tertiary hospital during the peak of the pandemic

Cited by 17 publications

References 9 publications

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease

Incidence of COVID-19 Hospitalisation in Patients with Systemic Lupus Erythematosus: A Nationwide Cohort Study from Denmark

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