Monitoring of patients with systemic lupus erythematosus during the COVID-19 outbreak

Abstract

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication Not required. Ethics approvalThe study was approved by the institutional review board (IRB-MTP_2020_04_202000446).Provenance and peer review Not commissioned; internally peer reviewed. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

Rheumatic Musculoskeletal Diseases and COVID-19 A Review of the First 6 Months of the Pandemic

“…Overall, discontinuation of DMARD therapy was rare in these patients, with higher percentages in RA (10.8%) and SLE (3.3%) ( 91 ). A comparably low prevalence of COVID-19 was seen in other surveys from Milan and Belgium, possibly influenced by a high percentage of patients undertaking precautionary measures early in the pandemic ( 64 , 65 , 92 , 93 ). Also in these surveys the ineffectiveness of HCQ as protection against COVID-19 was noted, as well as a negative effect of higher GC doses in terms of hospitalization and clinical features (anosmia/ageusia and diarrhea) ( 65 ).…”

Challenges of autoimmune rheumatic disease treatment during the COVID-19 pandemic: A review

“…In addition, the more recent published data from the ''COVID-19 Global Rheumatology Alliance'' registry shows that out of 600 patients with chronic autoimmune rheumatic diseases and COVID-19 infection, taking anti-malarial drugs such as hydroxychloroquine does not reduce the hospitalization rate [39]. In another cohort of 120 patients with SLE, the percentage of patients with symptoms of COVID-19 did not differ between those taking HCQ (6.9%) and those who were not (6.3%) [72]. In the United States (Michigan), a rheumatology clinic diagnosed 31 cases of COVID-19.…”

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

“…187 Several other groups have also suggested the lack of benefit of HCQ against contracting or developing severe COVID-19 in patients with SLE and other rheumatic diseases. [188][189][190][191][192][193][194] A retrospective study from Spain included patients with several different rheumatic or autoimmune diseases, nine of which had SLE. They found no statistically significant between-group differences for rheumatologic diagnosis or baseline use of immunosuppressive therapy except for sGC use, which was more frequent in hospitalized patients.…”

“… 187 Several other groups have also suggested the lack of benefit of HCQ against contracting or developing severe COVID-19 in patients with SLE and other rheumatic diseases. 188 , 189 , 190 , 191 , 192 , 193 , 194 …”

“… 193 Several other studies from Spain, Italy, France, and Brazil have also suggested that the main risk factors for poor COVID-19 outcomes are similar to those previously reported in the general population, including age and the presence of comorbidities. 189 , 196 , 197 , 198 Additional potential risk factors suggested by studies of SLE and other autoimmune diagnoses included the presence of interstitial lung disease, moderate or high rheumatic disease activity (or flare preceding the COVID-19 diagnosis), history of neuropsychiatric lupus, and known exposure to a confirmed COVID-19 case. 199 , 200 , 201 However, the small sample size, lack of confirmatory testing for many of the included patients, selection biases, insufficient identification and adjustments for confounders, and several other limitations from these observational data preclude from making definitive statements about these observations.…”