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Are patients with systemic lupus erythematosus at increased risk for COVID-19?
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  1. Ennio Giulio Favalli1,
  2. Maria Gerosa1,2,
  3. Antonella Murgo1,
  4. Roberto Caporali1,2
  1. 1 Division of Clinical Rheumatology, Gaetano Pini-CTO, Milano, Lombardia, Italy
  2. 2 Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milano, Lombardia, Italy
  1. Correspondence to Dr Ennio Giulio Favalli, Division of Clinical Rheumatology, Gaetano Pini-CTO, Milano 20122, Lombardia, Italy; ennio.favalli{at}gmail.com

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The global health emergency generated by the SARS-CoV-2 outbreak has complicated the management of patients with comorbidities, which together with old age seem to be the strongest predictor of mortality from COVID-19.1 We read with great interest the letter published by Mathian and colleagues about the clinical course of COVID-19 in patients with systemic lupus erythematosus (SLE) treated with hydroxychloroquine.2 Their preliminary data seem to suggest a particularly high incidence of severe and even fatal cases of infection, confirming that, despite ongoing treatment with antimalarial drugs, patients with SLE have a high risk of unfavourable course during the current pandemic.

The critical point that remains to be clarified at present is the real incidence of COVID-19 in patients with SLE, regardless of the current treatment. Being operative in the maximum epicentre of the outbreak in Italy (Milan, Lombardy), we have had to face in these weeks the emergency related to the management of …

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