In Hospital Outcome of Sars Cov-2 Infection Among Systemic Lupus Erythematosus Patients on Disease Modifying Drugs

S. J. B. Sayeed, Md. Mujibur Rahman, Reaz Mahmud, A. Kabir, Sabrina Rahman, Mohammed Nazim Uddin, Istiaque Ahmed, Haniful Haque, Md. Arman Hossain, M. Kamal
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Abstract

Background: COVID-19 is associated with hyperinflammatory syndrome causing worsening of disease severity. SLE is a rare autoimmune disease. Concomitant presence of both diseases may worsen COVID-19. Objective: To characterize patients with Systemic Lupus Erythematosus (SLE) affected by COVID- 19 and to observe medications on COVID-19 outcomes. Methodology: SLE with confirmed COVID-19 patients on Hydroxychloroquine admitted in COVID dedicated hospital in Dhaka was included. Data were prospectively collected via a structured questionnaire form and review of medical records. Only hospital outcomes were observed. Results: Total 17 patients were included, 11 of them had only SLE, 5 had lupus nephritis and only 1 had CNS lupus. All of them had confirmed COVID-19 detected by RT-PCR. 17 (100%) were taking immunomodulator (Hydroxychloro-quine), 7 (41.2%) steroids, 5 (29.4%) taking Mycophenolate mofetil before having COVID-19. Eleven (64.7%) of them had mild to moderate severity where 4 (23.5%) had severe & 2 (11.8%) had critical conditions. Of those 17 patients, 11 required supplemental oxygen (64.7%) during hospitalization, 2 (11.8%) admitted into ICU and required mechanical ventilation. Fifteen of them were discharged after 11 days (minimum 9, maximum 21) where 2 (11.8%) died due to hypoxic respiratory failure. Seven patients out of eleven who required supplemental oxygen were on prednisolone before illness only suffered mild to moderate illness. Conclusion: Previous intake of immunosuppressants like Hydroxychloroquine & Mycophenolate mofetil before admission to hospital did not seem to influence the severity of infection. J Dhaka Med Coll. 2021; 29(1): 94-98
治疗药物对系统性红斑狼疮患者Sars - Cov-2感染的影响
背景:COVID-19与高炎症综合征相关,可导致疾病严重程度恶化。SLE是一种罕见的自身免疫性疾病。同时存在这两种疾病可能会加重COVID-19。目的:了解新冠肺炎(COVID-19)感染的系统性红斑狼疮(SLE)患者特征,并观察药物治疗对SLE预后的影响。方法:纳入在达卡专门医院接受羟氯喹治疗的COVID-19确诊SLE患者。通过结构化的问卷调查形式和对医疗记录的回顾前瞻性地收集数据。仅观察医院结果。结果:共纳入17例患者,其中仅SLE 11例,狼疮性肾炎5例,中枢神经系统狼疮1例。均经RT-PCR检测为新冠肺炎确诊病例。感染前服用免疫调节剂(羟氯喹)17例(100%),类固醇7例(41.2%),霉酚酸酯5例(29.4%)。其中轻至中度11例(64.7%),重度4例(23.5%),危重2例(11.8%)。17例患者中有11例(64.7%)在住院期间需要补充氧气,2例(11.8%)进入ICU并需要机械通气。11天后出院15例(最少9例,最多21例),其中2例(11.8%)死于缺氧呼吸衰竭。11名需要补充氧气的患者中,有7名患者在发病前使用强的松龙,仅出现轻度至中度疾病。结论:入院前是否服用羟氯喹、霉酚酸酯等免疫抑制剂对感染的严重程度没有影响。达卡医学院,2021;29 (1): 94 - 98
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