Survival after COVID-19-associated organ failure among inpatients with systemic lupus erythematosus in France: a nationwide study
Survival after COVID-19-associated organ failure among inpatients with systemic lupus erythematosus in France: a nationwide study
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DOI：
10.1136/annrheumdis-2021-221599
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发表时间：
2021-12-09
影响因子：
27.4
通讯作者：
Timsit, Jean-Francois
中科院分区：
文献类型：
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作者：
Mageau, Arthur;Papo, Thomas;Timsit, Jean-Francois
目的分析法国系统性红斑狼疮（SLE）患者中COVID-19相关器官衰竭（AOF）的发生率、具体结局和相关因素。方法我们使用法国国家医疗/行政医院数据库进行了一项队列研究，时间为2011年1月至2020年11月。每名在法国医院诊断为COVID-19-AOF的SLE患者（直至2020年11月）与5名患有COVID-19-AOF的非SLE患者随机匹配。我们进行了精确匹配程序，将年龄+/- 2岁、性别和合并症作为匹配变量。COVID-19-AOF定义为至少一个COVID-19诊断代码与一个涉及器官衰竭诊断代码的组合。结果从2020年3月至11月，法国有127380例住院符合COVID-19-AOF的定义，其中196例符合SLE诊断。基于合并症的存在，我们将908名患有COVID-19-AOF的非SLE患者与190名患有COVID-19-AOF的SLE患者进行了匹配。在第30天，SLE合并COVID-19-AOF患者发生43例（22.6%）院内死亡，而匹配的非SLE合并COVID-19-AOF患者发生198例（21.8%）院内死亡：HR 0.98（0.71-1.34）。SLE COVID-19-AOF组中的75名患者和匹配的对照组中的299名患者从第30天到第90天进行了随访。在此期间，SLE组发生了19例住院死亡（25.3%），而匹配对照组发生了46例（15.4%）; SLE患者COVID-19-AOF后死亡相关的HR为1.83（1.05-3.20）。结论COVID-19-AOF与SLE患者迟发性预后不良相关。
Objective We analysed the incidence of, the specific outcomes and factors associated with COVID-19-associated organ failure (AOF) in patients with systemic lupus erythematosus (SLE) in France. Methods We performed a cohort study using the French national medical/administrative hospital database for the January 2011-November 2020 period. Each patient with SLE diagnosed in a French hospital with a COVID-19-AOF until November 2020 was randomly matched with five non-SLE patients with COVID-19-AOF. We performed an exact matching procedure taking age +/- 2 years, gender and comorbidities as matching variables. COVID-19-AOF was defined as the combination of at least one code of COVID-19 diagnosis with one code referring to an organ failure diagnosis. Results From March to November 2020, 127 380 hospital stays in France matched the definition of COVID-19-AOF, out of which 196 corresponded with patients diagnosed with SLE. Based on the presence of comorbidities, we matched 908 non-SLE patients with COVID-19-AOF with 190 SLE patients with COVID-19-AOF. On day 30, 43 in-hospital deaths (22.6%) occurred in SLE patients with COVID-19-AOF vs 198 (21.8%) in matched non-SLE patients with COVID-19-AOF: HR 0.98 (0.71-1.34). Seventy-five patients in the SLE COVID-19-AOF group and 299 in the matched control group were followed up from day 30 to day 90. During this period, 19 in-hospital deaths occurred in the SLE group (25.3%) vs 46 (15.4%) in the matched control group; the HR associated with death occurring after COVID-19-AOF among patients with SLE was 1.83 (1.05-3.20). Conclusions COVID-19-AOF is associated with a poor late-onset prognosis among patients with SLE.