COVID-19 Risk Factors & Mortality in SLE Patients

April 12, 2023

Systemic Lupus Erythematosus (SLE) is uniquely poised at crossroads between the dysregulated immune system and the risk of viral infections, especially in the context of the current COVID-19 pandemic. This risk can be attributed to a multitude of factors such as lupus-related critical organ system dysfunction, accompanying comorbidities and the use of immunosuppressive drugs” (1).  

Researchers in India aimed to study the impact of common SLE immunosuppressive drugs in SLE patents with COVID-19, as well as to reaffirm the risk factors associated with COVID-19 in this patient population. 1,379 SLE patients amongst a cohort of 9,212 patients with AIRDs (autoimmune rheumatic diseases) were included in the study and followed-up for six months between April and December 2020.

A series of baseline datapoints were evaluated by researchers, including SLE disease characteristics, current immunosuppressants and doses, and comorbidities. 2.6% of SLE patients experienced PCR-test confirmed COVID-19 during the six month study period; of this group, one patient died of COVID-19. Researchers note that incidence of COVID-19 was 1.7% amongst the general population where patients lived (Kerala and Karnataka, India). 

In an adjusted model, male sex and diabetes correlated with a higher risk for acquiring COVID-19. That being said, duration of illness and disease subsets (including lupus nephritis, neurophsyiatric and antiphospholipid positivity) did not have a significant impact on mortality. Additionally, low dose prednisolone or moderate-to-high doses of steroids (namely, glucocorticoids) were found to influence the risk of contracting COVID-19. Immmunosuppressive therapies did not have “any impact” on the risk of COVID-19 in patients with SLE. 

Researchers note that these results both confirm and differ from similarly run studies in other parts of the world.