26 Aug Does Lupus Increase Risk of COVID-19 Infection?
MedicalResearch.com Interview with:
Ruth Fernandez-Ruiz, MD
Department of Rheumatology
NYU Langone Heath
MedicalResearch.com: What is the background for this study?
Response: Patients with systemic lupus erythematosus (SLE) represent a unique population in considering risk for COVID-19 with biologic, genetic, demographic, clinical and treatment issues at play. By the nature of their chronic inflammatory autoimmune condition, the presence of comorbidities, and regular use of immunosuppressants, these individuals would traditionally be considered at high risk of contracting SARS-CoV-2 and possibly having worse outcomes from the viral infection.
However, it might be speculated that inherently elevated type I Interferon, characteristic of the majority of patients with SLE, confers a protective effect as a first line anti-viral defense. Additionally, hydroxychloroquine, which was suggested as a potential therapeutic agent for COVID-19 early on, is used in most patients with SLE. Accordingly, we initiated this study to provide critical data needed to address the frequency and severity of COVID-19 in patients with SLE.
MedicalResearch.com: What are the main findings?
Response: The risk factors for hospitalization due to COVID-19 in patients with SLE were similar to those identified in the general population, including the presence of one or more comorbidity, body mass index, and non-white race/ethnicity. The use of immunosuppressants, in aggregate, did not increase the risk for hospitalization in patients with SLE and COVID-19.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our study was limited due to sample size, as SLE approaches the definition of a rare disease and not all of our patients with COVID-19-like symptoms had a PCR-confirmed diagnosis. Therefore, larger studies are needed to further characterize the risk factors for poor outcomes in patients with SLE who develop COVID-19, including specific comorbidities, medications, biomarkers, and social determinants of health. We are also currently evaluating the presence of SARS-CoV-2 antibodies in patients with SLE to identify how widespread COVID-19 has been in this population.
MedicalResearch.com: What should readers take away from your report?
Response: Our study did not find definitive evidence that SLE-specific factors contribute to the risk of hospitalization for COVID-19 in patients with SLE.
Janssen (Haberman); UCB, Janssen, AbbVie, Pfizer, Novartis, Sanofi, Amgen (Scher); GlaxoSmithKline (Izmirly).
Fernandez‐uiz, R., Masson, M., Kim, M.Y., Myers, B., Haberman, R.H., Castillo, R., Scher, J.U., Guttmann, A., Carlucci, P.M., Deonaraine, K.K., Golpanian, M., Robins, K., Chang, M., Belmont, H.M., Buyon, J.P., Blazer, A.D., Saxena, A., Izmirly, P.M. and (2020), Leveraging the United States Epicenter to Provide Insights on COVID‐19 in Patients with Systemic Lupus Erythematosus. Arthritis Rheumatol. Accepted Author Manuscript. doi:10.1002/art.41450
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