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Int J Rheum Dis . Analysis of related factors for systemic lupus erythematosus flare after SARS-Cov-2 infection: A retrospective cohort study

tetano

Editor, Senior Moderator
Int J Rheum Dis


. 2025 Jan;28(1):e15407.
doi: 10.1111/1756-185X.15407. Analysis of related factors for systemic lupus erythematosus flare after SARS-Cov-2 infection: A retrospective cohort study

Qian Li[SUP] 1 [/SUP], Jun-Kang Zhao[SUP] 2 [/SUP], Jun-Yan Zhang[SUP] 2 [/SUP], Rong Li[SUP] 1 [/SUP], Li Zhao[SUP] 1 [/SUP], Ya-Zhen Su[SUP] 1 [/SUP], Yang Liu[SUP] 3 [/SUP], Ke Xu[SUP] 1 [/SUP], Li-Yun Zhang[SUP] 1 [/SUP]



Affiliations
Abstract

Objective: Since COVID-19 infections are more common in systemic lupus erythematosus (SLE) patients, most recent research has focused on the outcome of COVID-19, with fewer studies on disease activity in SLE. This research aims to evaluate flares in SLE with COVID-19 infection while investigating predictive factors.
Methods: A questionnaire survey was conducted to collect information on patients with previously diagnosed SLE from multi-center. SLE patients infected with COVID-19 after December 7, 2022, were selected. Detailed information covering demographic characteristics, SLE and COVID-19 clinical features, disease activity, and medication was collected through an electronic questionnaire. A multivariate logistic regression model was constructed to evaluate the predictive factors for SLE disease onset after COVID-19 infection.
Results: A total of 240 patients were finally included in our analysis. Thirty (12.5%) of those enrolled reported an SLE flare. Multivariate analysis with logistic models confirmed that SLE in the active stage (OR 2.617, 95% CI 1.008-6.514, p = .041) and COVID-19 duration (OR 4.140, 95% CI 1.412-11.694, p = .008) were predictors for flare in SLE patients with Covid-19 infection. In contrast, immunosuppressants were associated with a low incidence of flare of SLE (OR 0.138, 95% CI 0.042-0.46, p = .005).
Conclusions: The active phase of SLE and the progression of COVID-19 were the main risk factors for disease exacerbation in SLE patients, while the use of immunosuppressive medications was associated with a lower risk of flare-ups. These findings provide valuable insights for managing SLE patients during the COVID-19 pandemic.

Keywords: COVID‐19; SLE management; immunosuppressive therapy.

 
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