Effect of the COVID-19 on Patients with Systemic Lupus Erythematosus during the First Pandemic Wave in China

Abstract

Abstract Objective: This study aimed to investigate the prevalence and clinical manifestations of coronavirus disease (COVID-19) in patients with systemic lupus erythematosus (SLE) during the first wave of the pandemic in China and to evaluate the effects of COVID-19 on the disease activity and treatment of SLE. Methods: A telephone survey was conducted on patients diagnosed with SLE in our hospital between October 2017 and October 2022. Through the survey, we investigated whether the patients had COVID-19, the clinical manifestations of the infection, whether the patients were vaccinated, the effects of the infection on the disease activity of SLE, and whether the treatment regimen for SLE was adjusted due to the infection. Results: A total of 351 patients participated in this study, of whom 261 (74.4%) had COVID-19. Regarding organ involvement, the circulatory system was more commonly affected than the other organs in patients with SLE without COVID-19 (P = 0.002). Regarding concomitant medications, the daily dose of glucocorticoids was higher than that of other medication in SLE patients without COVID-19 (P = 0.000). No differences were observed in age, disease duration, disease activity, of other concomitant medications. While infected with COVID-19, 46 patients (17.6%) discontinued parts of their treatment without experiencing any episodes of SLE. Conclusion: Most SLE patients with COVID-19 had a good prognosis, and all the patients in our study recovered from COVID-19 infection. Abrupt dose reduction and discontinuation of medications by the patients themselves may lead to elevated disease activity or even episodes of SLE. As such, it is recommended that the patients adjust their treatment regimens following the guidance of their specialists after careful evaluation of their condition and SLE disease activity by specialists.