The Prevalence of Systemic Lupus Erythematosus (SLE) Flares During Covid 19 Quarantine Among Syrian Patients

Abstract

Objective: To determine if changes in depressive symptoms or anxiety lead to changes in the activity of systemic lupus erythematosus (SLE) during COVID 19 quarantine. Participants and Methods: Twenty‐eight patients with SLE were examined prospectively every 2 weeks for up to 8 weeks at the time of COVID 19 quarantine in Syria. At each assessment, (CES‐D), Anxiety Inventory, patient’s global assessment, physician global assessment, and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) were done. Results: Changes in depression and anxiety were positively correlated with simultaneous changes in the patient global assessment of SLE activity, but not with changes in the physician global assessment, SLEDAI. Depression and anxiety scores were also correlated with patient global assessments 2 weeks later, but lagged scores were not significantly associated with the patient global assessment after controlling for current depression and anxiety scores. No measure of SLE activity increased in the 2 weeks immediately after a large increase in CES‐D or State Anxiety scores. Conclusion: No evidence was found to support the hypothesis that psychological distress causes increased SLE activity.