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

Abstract

ObjectiveWe 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.MethodsWe 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.ResultsFrom 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).ConclusionsCOVID-19-AOF is associated with a poor late-onset prognosis among patients with SLE.

Autoantibodies against IFNα in patients with systemic lupus erythematosus and susceptibility for infection: a retrospective case-control study

“…Anti-IFNα testing may help to identify individuals at high risk of life-threatening infection. Despite a high prevalence of anti-IFNα IgG autoantibodies in SLE and a poor prognosis of severe COVID-19 among patients with SLE 14 , 15 , no patients displayed severe COVID-19 in our series.…”

Severely impaired humoral response against SARS-CoV-2 variants of concern following two doses of BNT162b2 vaccine in patients with systemic lupus erythematosus (SLE)

“…Severe COVID-19 is associated with a poor prognosis among patients with systemic lupus erythematosus (SLE) 1. Accordingly, patients with SLE receiving immunosuppressive drugs have been prioritised for vaccination in France 2.…”

SARS-Cov2 acute and post-active infection in the context of autoimmune and chronic inflammatory diseases

“…However, data are now accumulating that counter this hypothesis since COVID-19 incidence in SLE and RA did not exceed that in the general population, and the hospitalization rate appears similar to that identified in the general population. However, such an association needs to be better understood since lupus nephritis represents a predictive risk factor of severe COVID-19 and a poor onset prognosis with long-term COVID-19 is also observed among SLE patients [ [93] , [94] , [95] , [96] , [97] ].…”