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Objectives To determine the severity and outcome of COVID-19 among individuals with lupus as compared to controls. The secondary objective was to identify the risk association of sex, race, presence of nephritis, and use of various immunomodulators with COVID-19 outcomes. Methods Retrospective data of individuals with lupus with and without COVID-19 between January 2020 to May 2021 was retrieved from the TriNetX. A one-to-one matched COVID-19 positive control was selected using propensity score(PS) matching. We assessed several outcomes, including all-cause mortality, hospitalisation, intensive care unit (ICU) admission, mechanical ventilation, severe COVID, acute kidney injury (AKI), Haemodialysis, acute respiratory distress syndrome (ARDS), ischemic stroke, venous thromboembolism (VTE) and sepsis were assessed. Results We identified 2140 SLE patients with COVID-19, 29,853 SLE without COVID-19 and 732,291controls. Mortality within 30 days of COVID-19 diagnosis was comparable among SLE and controls [RR-1.26; 95%CI-0.85,1.8]. SLE with COVID-19 had a higher risk of hospitalisation [RR-1.28; 95% CI 1.14–1.44], ICU admission [RR-1.35; 95% CI 1.01–1.83], mechanical ventilation [RR- 1.58 95% CI 1.07–2.33], stroke [RR-2.18; 95% CI 1.32,3.60], VTE [RR-2.22; 95% CI 1.57–03.12] and sepsis [RR-1.37; 95% CI 1.06–1.78].Individuals with SLE who contracted COVID-19 had higher mortality, hospitalisation, ICU admission, mechanical ventilation, AKI, VTE and sepsis (p < 0.001) compared to SLE without COVID-19. Males with SLE had a higher risk of AKI [RR-2.05; 95% CI 1.27–3.31] than females. Lupus nephritis was associated with higher risk of hospitalisation [RR-1.36; 95% CI 1.05–1.76], AKI [RR-2.32; 95% CI 1.50–3.59] and sepsis [RR-2.07; 95% CI-1.12–3.83]. Conclusion The mortality of individuals with SLE due to COVID-19 is comparable to the general population but with higher risks of hospitalisation, ICU admission, mechanical ventilation, stroke, VTE and sepsis. The presence of nephritis increases the risk of AKI, thus probably increasing hospitalisation and sepsis

Oculocutaneous albinism (OCA) encompasses a set of autosomal recessive genetic conditions that affect pigmentation in the eye, skin, and hair. OCA patients display reduced best-corrected visual acuity, reduced to absent ocular pigmentation, abnormalities in fovea development, and/or abnormal decussation of optic nerve fibers. It has been hypothesized that improving eye pigmentation could prevent or rescue some of the vision defects. The goal of the present study was to develop an in vitro model for studying pigmentation defects in human retinal pigment epithelium (RPE). We developed a ''disease in a dish'' model for OCA1A and OCA2 types using induced pluripotent stem cells to generate RPE. The RPE is a monolayer of cells that are pigmented, polarized, and polygonal in shape, located between the neural retina and choroid, with an important role in vision. Here we show that RPE tissue derived in vitro from OCA patients recapitulates the pigmentation defects seen in albinism, while retaining the apical-basal polarity and normal polygonal morphology of the constituent RPE cells.

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At 6 weeks from initiation of treatment, the patient had more severe disease and development of psoriatic nail disease (Fig. 1a). He was commenced on calcipotriol ointment (Dovonex â ; LEO Laboratories) and acitretin, which brought about marked improvement in his skin. He completed 3 months of acitretin with good results, at which point the drug was discontinued. Accelerated elimination of teriflunomide was not required due to the good response to treatment.In postmarketing surveillance of teriflunomide, which was licensed in the European Union in 2013, there was evidence for a potential causal role of teriflunomide in new onset and worsening of psoriasis in patients. The prodrug of teriflunomide, leflunomide, is also known to be associated with the development of psoriasis. 4 Compared with the other published case reports of teriflunomideinduced pustular psoriasis, our patient developed pustular psoriasis within days rather than weeks, but otherwise the cases were similar, in that they all occurred in patients in their fifties without any personal or family history of psoriasis.This case contributes a further example of this uncommon AE of teriflunomide. As it can take 2 years for this drug to be fully eliminated from the body, it is important to be aware of psoriasis in this patient population and recognize the availability of accelerated elimination schedules to limit patient exposure to the drug if their disease is proving difficult to treat.

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