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  • Survival after COVID-19-associated organ failure among inpatients with systemic lupus erythematosus in France: a nationwide study

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Epidemiology
Survival after COVID-19-associated organ failure among inpatients with systemic lupus erythematosus in France: a nationwide study
  1. Arthur Mageau1,2,3,
  2. Thomas Papo1,3,
  3. Stephane Ruckly2,
  4. Andrey Strukov4,
  5. Damien van Gysel4,
  6. Karim Sacre1,3,
  7. Jean-François Timsit2,5
  1. 1 Département de Médecine Interne, Assistance Publique Hôpitaux de Paris, Hôpital Bichat - Claude-Bernard, Paris, France
  2. 2 Infection, antimicrobiens, modélisation, évolution (IAME), UMR 1137, Université de Paris, INSERM, Paris, France
  3. 3 Centre de Recherche sur l’Inflammation, UMR1149, CNRS ERL8252, Université de Paris, Laboratoire d’Excellence Inflamex, INSERM, Paris, France
  4. 4 Département d’Information Médicale, Assistance Publique Hôpitaux de Paris, Université de Paris, Hôpital Bichat - Claude-Bernard, Paris, France
  5. 5 Département de Réanimation Médicale et Infectieuse, Assistance Publique Hôpitaux de Paris, Université de Paris, Hopital Bichat - Claude-Bernard, Paris, France
  1. Correspondence to Dr Arthur Mageau, Département de Médecine Interne, Assistance Publique Hôpitaux de Paris, Hôpital Bichat - Claude-Bernard, Paris, Île-de-France, France; arthur.mageau{at}inserm.fr

Abstract

Objective We analysed the incidence of, the specific outcomes and factors associated with COVID-19-associated organ failure (AOF) in patients with systemic lupus erythematosus (SLE) in France.

Methods We performed a cohort study using the French national medical/administrative hospital database for the January 2011–November 2020 period. Each patient with SLE diagnosed in a French hospital with a COVID-19-AOF until November 2020 was randomly matched with five non-SLE patients with COVID-19-AOF. We performed an exact matching procedure taking age ±2 years, gender and comorbidities as matching variables. COVID-19-AOF was defined as the combination of at least one code of COVID-19 diagnosis with one code referring to an organ failure diagnosis.

Results From March to November 2020, 127 380 hospital stays in France matched the definition of COVID-19-AOF, out of which 196 corresponded with patients diagnosed with SLE. Based on the presence of comorbidities, we matched 908 non-SLE patients with COVID-19-AOF with 190 SLE patients with COVID-19-AOF. On day 30, 43 in-hospital deaths (22.6%) occurred in SLE patients with COVID-19-AOF vs 198 (21.8%) in matched non-SLE patients with COVID-19-AOF: HR 0.98 (0.71–1.34). Seventy-five patients in the SLE COVID-19-AOF group and 299 in the matched control group were followed up from day 30 to day 90. During this period, 19 in-hospital deaths occurred in the SLE group (25.3%) vs 46 (15.4%) in the matched control group; the HR associated with death occurring after COVID-19-AOF among patients with SLE was 1.83 (1.05–3.20).

Conclusions COVID-19-AOF is associated with a poor late-onset prognosis among patients with SLE.

  • lupus erythematosus
  • systemic
  • COVID-19
  • epidemiology

Data availability statement

Data are available upon reasonable request.

This article is made freely available for personal 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.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/annrheumdis-2021-221599

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors AM designed and conducted the analysis and wrote the manuscript. TP, SR, DvG, AS and KS were involved in the project development and edited the manuscript. J-FT directed the project and wrote the manuscript. AM is the guarantor of this study.

    • Funding PhD fellowship support for AM was provided by Agence Nationale pour la recherche (n°ANR-19-CE17-0029).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.