Avaliação do impacto e da frequência de comorbidades nos pacientes com Lúpus Eritematoso Sistêmico com e sem COVID-19 do Amazonas

Abstract

Introduction: The ReumaCoV-Brazil project was a multicenter study carried out by the Brazilian Society of Rheumatology with the aim of identifying the behavior of immune mediated rheumatic diseases (IMRDs) in the face of COVID-19 infection. It had a prospective, longitudinal design with 1,300 patients, 604 of whom had systemic lupus erythematosus (SLE). Demographic, epidemiological, clinical and morbid outcome and lethality variables were observed. Methods: This study is a post-hoc evaluation of the ReumaCoV-Brazil project database, focusing exclusively on 144 patients with SLE admitted to the state of Amazonas, with the primary outcome being the effect of comorbidities on disease activity, as measured by SLEDAI-2K and patient global assessment (PGA), in patients affected by COVID-19 (n=93) and unaffected controls (n=57). Immunosuppressants for other causes (cancer, HIV) were excluded. The following variables were taken into account gender, age, length of disease (SLE), form of COVID-19 acquisition, systemic arterial hypertension (SAH), diabetes mellitus, body mass index (obesity), kidney involvement (GFR<25ml/s), hyperlipidemia, smoking, alcohol consumption, medications in use (corticosteroids, hydroxychloroquine, cyclophosphamide, mycophenolate mofetil), SLEDAI, PGA and COVID-19 severity indicators (hospitalization, mechanical ventilation and death). Results: None of the demographic, epidemiological or nosological variables (comorbidities) showed an association with COVID-19 severity. Systemic arterial hypertension showed a tendency towards severe COVID-19, but without statistical significance. When comparing lupus patients with COVID-19 to those without COVID-19, there were no clinical elements that indicated susceptibility and poor prognosis to COVID-19. Conclusions: Comorbidities had no influence on severity (hospitalization, mechanical ventilation and death) in patients with SLE and COVID-19 in the state of Amazonas. It should be noted that the low sample size and low sensitivity methods for diagnosing COVID-19 weaken the results of the study.