1. Factors associated with poor outcomes in SLE patients with COVID-19: Data from ReumaCoV-Brazil register.
- Author
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Carvalho, Joana S, dos Reis Neto, Edgard T, Kakehasi, Adriana M, Ribeiro, Sandra LE, Studart, Samia AS, Martins, Francielle P, Cavalheiro do Espírito Santo, Rafaela, Ranzolin, Aline, Fernandino, Diana C, Dinis, Valquiria G, Sato, Emília I, Resende, Gustavo G, Marinho, Adriana, Mariz, Henrique A, Sacilotto, Nathália C, Ribeiro, Francinne M, Shinjo, Samuel K, Dias, Laiza H, Yazbek, Michel A, and Omura, Felipe
- Subjects
COVID-19 ,MEDICAL personnel ,COVID-19 pandemic ,SYSTEMIC lupus erythematosus ,TREATMENT effectiveness - Abstract
Objectives: To evaluate factors associated with COVID-19 severity outcomes in patients with systemic lupus erythematosus (SLE). Methods: This was a cross-sectional analysis of baseline data of a prospective, multi-stage cohort study—"The ReumaCoV Brazil"—designed to monitor patients with immune-mediated rheumatologic disease (IMRD) during the SARS-CoV-2 pandemic. SLE adult patients with COVID-19 were compared with those without COVID-19. SLE activity was evaluated by the patient global assessment (PGA) and SLE Disease Activity Index 2000 (SLEDAI-2K). Results: 604 SLE patients were included, 317 (52.4%) with COVID-19 and 287 (47.6%) in the control group. SLE COVID-19 patients reported a lower frequency of social isolation and worked more frequently as health professionals. There was no difference in the mean SLEDAI-2K score between groups in the post–COVID-19 period (5.8 [8.6] vs. 4.5 [8.0]; p = 0.190). However, infected patients reported increased SLE activity according to the Patient Global Assessment (PGA) during this period (2.9 [2.9] vs. 2.3 [2.6]; p = 0.031. Arterial hypertension (OR 2.48 [CI 95% 1.04–5.91], p = 0.041), cyclophosphamide (OR 14.32 [CI 95% 2.12–96.77], p = 0.006), dyspnea (OR: 7.10 [CI 95% 3.10–16.23], p < 0.001) and discontinuation of SLE treatment medication during infection (5.38 [CI 95% 1.97–15.48], p = 0.002), were independently associated with a higher chance of hospitalization related to COVID-19. Patients who received telemedicine support presented a 67% lower chance of hospitalization (OR 0.33 [CI 95% 0.12–0.88], p = 0.02). Conclusion: Hypertension and cyclophosphamide were associated with a severe outcome, and telemedicine can be a useful tool for SLE patients with COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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