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Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network

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 dat...

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Autores principales: Raiker, Rahul, Pakhchanian, Haig, DeYoung, Charles, Gupta, Latika, Kardeş, Sinan, Ahmed, Sakir, Kavadichanda, Chengappa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501265/
https://www.ncbi.nlm.nih.gov/pubmed/34649723
http://dx.doi.org/10.1016/j.jaut.2021.102730
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author Raiker, Rahul
Pakhchanian, Haig
DeYoung, Charles
Gupta, Latika
Kardeş, Sinan
Ahmed, Sakir
Kavadichanda, Chengappa
author_facet Raiker, Rahul
Pakhchanian, Haig
DeYoung, Charles
Gupta, Latika
Kardeş, Sinan
Ahmed, Sakir
Kavadichanda, Chengappa
author_sort Raiker, Rahul
collection PubMed
description 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
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spelling pubmed-85012652021-10-12 Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network Raiker, Rahul Pakhchanian, Haig DeYoung, Charles Gupta, Latika Kardeş, Sinan Ahmed, Sakir Kavadichanda, Chengappa J Autoimmun Article 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 Elsevier Ltd. 2021-12 2021-10-09 /pmc/articles/PMC8501265/ /pubmed/34649723 http://dx.doi.org/10.1016/j.jaut.2021.102730 Text en © 2021 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Raiker, Rahul
Pakhchanian, Haig
DeYoung, Charles
Gupta, Latika
Kardeş, Sinan
Ahmed, Sakir
Kavadichanda, Chengappa
Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network
title Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network
title_full Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network
title_fullStr Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network
title_full_unstemmed Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network
title_short Short term outcomes of COVID-19 in lupus: Propensity score matched analysis from a nationwide multi-centric research network
title_sort short term outcomes of covid-19 in lupus: propensity score matched analysis from a nationwide multi-centric research network
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501265/
https://www.ncbi.nlm.nih.gov/pubmed/34649723
http://dx.doi.org/10.1016/j.jaut.2021.102730
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