Association Between Race/Ethnicity and COVID-19 Outcomes in Systemic Lupus Erythematosus (SLE) Patients from the United States: Data from the COVID-19 Global Rheumatology Alliance

Manuel F. Ugarte-Gil, Graciela S. Alarcón, Andrea M. Seet, Zara Izadi, Anna D. Montgomery, Alí Duarte-García, Emily L. Gilbert, Maria O. Valenzuela-Almada, Leanna Wise, Jeffrey A. Sparks, Tiffany Y.T. Hsu, Kristin M. D'Silva, Naomi J. Patel, Emily Sirotich, Jean W. Liew, Jonathan S. Hausmann, Paul Sufka, Rebecca Grainger, Suleman Bhana, Zachary WallaceLindsay Jacobsohn, Anja Strangfeld, Elsa F. Mateus, Kimme L. Hyrich, Laure Gossec, Loreto Carmona, Saskia Lawson-Tovey, Lianne Kearsley-Fleet, Martin Schaefer, Pedro M. Machado, Philip C. Robinson, Milena Gianfrancesco, Jinoos Yazdany

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Abstract

Objective: To determine the association between race/ethnicity and COVID-19 outcomes in individuals with systemic lupus erythematosus (SLE). Methods: Individuals with SLE from the United States with data entered into the COVID-19 Global Rheumatology Alliance (GRA) registry between 24 March 2020 and 27 August 2021 were included. Variables included age, sex, race and ethnicity (White, Black, Hispanic, other), comorbidities, disease activity, pandemic time period, glucocorticoid dose, antimalarials, and immunosuppressive drug use. The ordinal outcome categories were: not hospitalized, hospitalized with no oxygenation, hospitalized with any ventilation or oxygenation, and death. We constructed ordinal logistic regression models evaluating the relationship between race/ethnicity and COVID-19 severity, adjusting for possible confounders. Results: We included 523 patients; 486 (90.7%) were female and the mean age was 46.6 (SD: 14.0) years. Three hundred and fifty-eight (74.6%) patients were not hospitalized; 40 (8.3%) patients were hospitalized without oxygen, 64 (13.3%) patients were hospitalized with any oxygenation and 18 (3.8%) died. In a multivariable model, Black [OR=2.73 (1.36-5.53)] and Hispanic [OR=2.76 (1.34-5.69)] individuals had higher odds of more severe outcomes than White individuals. Conclusions: Black and Hispanic individuals with SLE experienced more severe COVID-19 outcomes, which is consistent with findings in the US general population. These results likely reflect socioeconomic and health disparities and suggest that more aggressive efforts are needed to prevent and treat infection in this population. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalArthritis Care and Research
DOIs
StateAccepted/In press - 2022
Externally publishedYes

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This article is protected by copyright. All rights reserved.

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