Background: The global impact of the COVID-19 pandemic has been profound, with significant disparities in infection and mortality rates, particularly in high-risk populations. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that complicates patient management in the context of COVID-19, given the increased risk of infections and limited guidance on pharmacological management.
Methods: This study employed a retrospective cohort design using data from the National Inpatient Sample (NIS) for 2020. We identified hospitalizations with a primary diagnosis of COVID-19 and a secondary diagnosis of SLE. Data analysis included demographic and clinical characteristic comparisons and multivariable regression to determine the association between SLE and various clinical outcomes in COVID-19 hospitalizations.
Results: From 1,050,040 primary COVID-19 hospitalizations, 5,745 (0.54%) were SLE patients. The SLE group was younger, predominantly female, and had higher proportions of Black and Hispanic individuals. After adjustment, SLE was associated with increased odds of acute kidney injury requiring dialysis (adjusted odds ratio [aOR] 1.55, 95% CI 1.06-2.26, p=0.024). In-hospital mortality was higher in the SLE cohort (aOR 1.25, 95% CI 1.01-1.55, p=0.036), particularly in the 18-44 age group.
Conclusions: SLE patients hospitalized with COVID-19 have unique demographic characteristics and are at higher risk for severe outcomes, including acute kidney injury and increased mortality. This study highlights the need for tailored management and monitoring strategies for SLE patients during the COVID-19 pandemic.