Systemic lupus erythematosus nephritis and COVID-19 disease.

Abstract

Of the more than 20 studies published on SLE patients with COVID-19, none of the studies focused on lupus nephritis. We report the outcomes of renal biopsy-proven systemic lupus erythematosus (SLE) nephritis patients after COVID-19 disease. Our institute has been declared as a state COVID-19 hospital in the last week of March 2020. From then till now, we have admitted and managed COVID-19 patients from several districts of Andhra Pradesh and neighbouring states. We collected the data of patients with SLE nephritis contemporaneously from admission to the outcomes on a computerised proforma. We had identified sixteen patients with SLE nephritis who were admitted with COVID-19 disease. Of them, fourteen were females and two were males. The mean age was 29.3 years. Out of sixteen patients, seven required a mechanical ventilator and dialysis and eventually succumbed. One more patient died due to disseminated tuberculosis. Our results suggested that with an approximately 50% mortality rate, the COVID-19 disease had a calamitous effect on SLE nephritis patients. Key Points • We identified the significant risk factors for mortality: younger age, higher serum creatinine at presentation, higher CT severity score and lower serum albumin. • After the analysis done for this article, we decided to reduce the medications for SLE nephritis to prednisolone 10 mg/day when COVID-19 disease is contracted.