COVID-19 in systemic lupus erythematosus: Data from a survey on 417 patients

https://doi.org/10.1016/j.semarthrit.2020.06.012Get rights and content

Highlights

  • Systemic lupus erythematosus (SLE) associates with infection susceptibility.

  • COVID-19 is a pandemic infectious disease with high morbidity and mortality.

  • The impact of COVID-19 in SLE is poorly characterised.

  • A web-based survey amongst patients with SLE suggest a moderate increase in morbidity due to COVID-19.

  • Hydroxychloroquine does not seem able to prevent COVID-19 in patients with SLE.

Abstract

Background

Systemic lupus erythematosus (SLE) is a chronic disease characterised by autoimmunity and increased susceptibility to infections. COVID-19 is a systemic viral disease currently spreading as a pandemic. Little is known about the impact of COVID-19 in patients with SLE.

Objective

to acquire information on the impact of COVID-19 in SLE.

Methods

A 26-item anonymous questionnaire investigating demographics, SLE clinical features, COVID-19 diagnoses and changes in treatments and daily habits was administered to patients with SLE from three referral centres through www.surveymonkey.com over 10 days. Data from the survey were compared to those from published estimates about the general population.

Results

Four-hundred-seventeen patients responded to the survey. More than 60% of subjects complained of symptoms that are also associated to COVID-19. Fourteen COVID-19 diagnoses (five confirmed by polymerase chain reaction) were reported, in contrast to a 0.73% prevalence of confirmed cases in Lombardy. One hospitalisation was reported. Fever, anosmia, dry cough, a self-reported history of neuropsychiatric SLE and a recent contact with confirmed COVID-19 cases were more strongly associated with COVID-19, as were symptoms and lower compliance to behavioural preventive measures in patients’ contacts. No protective effect was seen in subjects on hydroxychloroquine.

Conclusion

COVID-19 morbidity might only moderately be increased in most patients with SLE, although limited information can be inferred on more severe cases. Hydroxychloroquine apparently seems not to confer protection to infection per se, although other beneficial roles cannot be excluded. Containment policies and behavioural preventive measures could have a major role in limiting the impact of COVID-19 in patients with SLE.

Keywords

COVID-19
Coronavirus
Systemic lupus erythematosus
Epidemiology
Hydroxychloroquine
Web

Abbreviations

COVID-19
coronavirus-related disease
cCOVID-19
COVID-19 confirmed by RT-PCR
pCOVID-19
presumptive COVID-19
totCOVID-19
confirmed + presumptive COVID-19
HCQ
hydroxychloroquine
noCOVID-19
patients without COVID-19
NPSLE
neuropsychiatric SLE
RT-PCR
reverse-transcriptase polymerase chain reaction
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
SLE
systemic lupus erythematosus

Cited by (0)

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Dr Bozzolo and Prof. Dagna share senior co-authorship

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