Severe infections in patients with systemic lupus erythematosus from Tunisia: Prevalence and risk factors

Abstract

Since the improvement in management and the reduction of mortality caused by the disease activity, infections have represented the main cause of morbidity and mortality in systemic lupus erythematosus patients. We aimed to determine the prevalence and identify risk factors of severe infections in systemic lupus erythematosus patients. We conducted a retrospective study on 93 Tunisian lupus patients followed between 2010 and 2019. The mean age of the disease was 33.63 ± 13.76 years. Fifty-two patients had 118 infections and 16% of the infections were serious. The bivariate analysis revealed a positive correlation between the total cumulative doses of corticosteroids and the number of serious infections ( p = 0.009). The multivariate study has shown that the number of flares ( p = 0.03), pulmonary manifestations ( p = 0.01), pleuritis ( p = 0.001), and the total cumulative dose of corticosteroids ( p = 0.04) were independent risk factors of severe infections ( p < 0.001). The use of antimalarials exerted a protective effect from severe infection [OR = 0.19 (95% CI 0.03-0.9)] p < 0.03.

Risk factors for initial and recurrent severe infections in first hospitalized patients with systemic lupus erythematosus: A retrospective study of a Chinese cohort

“…Other organ damage including pulmonary and hematological involvements were also demonstrated to increase the risk of infection. 3,24,25 In this study, cardiopulmonary involvement was borderline significant and associated with an approximately 1.6-fold increased risk of initial severe infection. The association of SLEDAI score and infection has also been reported, 6,21 but a significant difference was not observed in our study.…”

“…Similar results were also found in the analysis of factors associated with initial severe infection in SLE patients without severe infection on admission. Other organ damage including pulmonary and hematological involvements were also demonstrated to increase the risk of infection 3,24,25 . In this study, cardiopulmonary involvement was borderline significant and associated with an approximately 1.6‐fold increased risk of initial severe infection.…”

SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort

“…that vary with the severity of the disease, use of immunosuppressants (including glucocorticoids), comorbidities and organ damage. [1][2][3][4][5][6][7] Moreover, infection remains a leading contributor to mortality in patients with SLE. 5 8-10 Properly estimating the risk of infection in patients with SLE is paramount if we are to balance immunosuppression and implement preventive measures.…”