ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1933

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

Manuel Ugarte-Gil1, Graciela Alarcn2, Andrea Seet3, Zara Izadi3, Ali Duarte-Garcia4, Emily Gilbert5, Maria Valenzuela-Almada6, Leanna Wise7, Jeffrey Sparks8, Tiffany Hsu9, Kristin D'Silva10, Naomi Patel10, Emily Sirotich11, Jean Liew12, Jonathan Hausmann13, Paul Sufka14, Rebecca Grainger15, Suleman Bhana16, Wendy Costello17, Zachary Wallace18, Lindsay Jacobsohn19, Anja Strangfeld20, Elsa Frazão Mateus21, Kimme Hyrich22, Laure Gossec23, Loreto Carmona24, Saskia Lawson-Tovey22, Lianne Kearsley-Fleet25, Martin Schaefer26, Pedro Machado27, Philip Robinson28, Milena Gianfrancesco3 and Jinoos Yazdany3, 1Hospital Guillermo Almenara Irigoyen, Essalud/Universidad Científica del Sur, Lima, Peru, 2University of Alabama at Birmingham, Birmingham, AL, 3University of California San Francisco, San Francisco, CA, 4Mayo Clinic, Rochester, MN, 5Mayo Clinic, Jacksonville, FL, 6Division of Rheumatology, Mayo Clinic, Rochester, MN, 7LAC+USC/Keck Medicine of USC, Pasadena, CA, 8Brigham and Women's Hospital, Boston, MA, 9Brigham and Women's Hospital, Jamaica Plain, MA, 10Massachusetts General Hospital, Boston, MA, 11McMaster University, Hamilton, ON, Canada, 12Boston University, Boston, MA, 13Boston Children's Hospital / Beth Israel Deaconess Medical Center, Cambridge, MA, 14HealthPartners, Eagan, MN, 15University of Otago, Wellington, New Zealand, 16Crystal Run Health, Montvale, NJ, 17Irish Children's Arthritis Network, Bansha, Ireland, 18Massachusetts General Hospital, Newton, MA, 19University of California San Francisco, Antioch, CA, 20Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany, 21Liga Portuguesa Contra as Doenças Reumáticas (LPCDR), Lisbon, Portugal, 22University of Manchester, Manchester, United Kingdom, 23Sorbonne Université; APHP, Rheumatology Department, Pitié-Salpêtrière Hospital, Paris, France, 24Instituto de Salud Musculoesqueltica (InMusc), Madrid, Spain, 25Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom, 26German Rheumatism Research Center, Berlin, Germany, 27Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, United Kingdom, 28Faculty of Medicine, The University of Queensland, Herston, Australia

Meeting: ACR Convergence 2021

Keywords: , , ,

Session Information

Date: Tuesday, November 9, 2021

Title: Abstracts: SLE – Diagnosis, Manifestations, & Outcomes II: Predictors & Longitudinal Outcomes (1931–1934)

Session Type: Abstract Session

Session Time: 4:00PM-4:15PM

Background/Purpose: Hispanic and African American race/ethnicities have been associated with poor COVID-19 outcomes in the general population and in rheumatic disease patients within the COVID-19 Global Rheumatology Alliance (GRA); however, such associations within SLE patients have not been evaluated. The aim of this study is to determine the association between race/ethnicity and COVID-19 outcomes in SLE patients from the US.

Methods: US SLE patients from the COVID-19 GRA enrolled between March 24th 2020 and April 12th 2021 were studied. Variables included were age, gender, race/ethnicity (White, African American, Hispanic and others), comorbidities (chronic renal disease, cardiovascular disease, and the number of other comorbidities), disease activity (remission, low, moderate, high), time period, glucocorticoid dose, antimalarials and immunosuppressive (IS) drug use. Drugs were categorized into five groups: antimalarials only (reference), no SLE therapy, classic IS drugs monotherapy, biologics/target synthetic IS drugs, and combination therapy. The ordinal outcome categories were: 1. hospitalized without supplementary oxygen and/or not hospitalized, 2. hospitalized with non-invasive ventilation, 3. hospitalized with mechanical ventilation/extracorporeal membrane oxygenation and 4. death. We constructed ordinal logistic regression models evaluating the relationship between COVID-19 severity and race/ethnicity, adjusting for possible confounders.

Results: Five-hundred and four patients were included; 458 (90.9%) were women and the median age was 46.8 (SD: 13.9) years. Four hundred and three (80.0%) patients were not hospitalized; 36 (7.1%) patients were hospitalized without oxygen or with non-invasive ventilation, 49 (9.7%) patients were hospitalized with mechanical ventilation/extracorporeal membrane oxygenation and 16 (3.2%) died. In a multivariable model, African American [OR=2.18 (1.07-4.31)] and Hispanic [OR=2.14 (1.07-4.31)] race/ethnicities were associated with poorer outcomes. Additionally, prednisone-equivalent doses between 5-10 mg/d [OR=7.33 (1.96-27.40)] and >10 mg/d [OR=2.61 (1.33-5.13)], IS drugs (combinations) [OR =2.25 (1.02, 4.99)] and chronic renal disease [OR =2.61 (1.35, 5.04)] were associated with more severe COVID-19 outcomes. COVID-19 diagnosis between October and April 2021 vs. earlier time periods [OR=0.39 (0.21-0.72)] was associated with less severe COVID-19 outcomes (Table 1).

Conclusion: African American 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 infection in this population.

Disclosures: M. Ugarte-Gil, Pfizer, 5, Janssen, 5; G. Alarcn, None; A. Seet, None; Z. Izadi, None; A. Duarte-Garcia, None; E. Gilbert, None; M. Valenzuela-Almada, None; L. Wise, None; J. Sparks, Bristol-Myers Squibb, 2, 5, Amgen, 5, Gilead, 2, Inova, 2, Janssen, 2, Optum, 2, Pfizer, 2; T. Hsu, None; K. D'Silva, None; N. Patel, None; E. Sirotich, None; J. Liew, Pfizer, 5; J. Hausmann, Novartis, 2, Biogen, 2, Pfizer, 2; P. Sufka, Wiley Publishing, 6; R. Grainger, Pfizer New Zealand, 6, 12, support to travel to conference, Jansenn Autralia, 6, 12, travel to symposia, AbbVie New Zealand, 6, Cornerstones, 6, novartis, 1; S. Bhana, Amgen, 1, Novartis, 1, Horizon, 1, Pfizer, 1, AbbVie, 1; W. Costello, None; Z. Wallace, Bristol-Myers Squibb, 5, Principia/Sanofi, 5, Viela Bio, 2, MedPace, 2; L. Jacobsohn, None; A. Strangfeld, Pfizer, 6, Roche, 6, MSD, 6, BMS, 6, Abbvie, 6, Celltrion, 6; E. Frazão Mateus, Boehringer Ingelheim, 6, Pfizer, 5, 12, Non-financial, Lilly Portugal, 5, Sanofi, 5, AbbVie, 5, Novartis, 5, Grünenthal. SA., 5, MSD, 5, Celgene, 5, Medac, 5, Janssen-Cilag, 5, Pharmakern, 5, GAfPA, 5; K. Hyrich, Abbvie, 6, Pfizer, 5, BMS, 5; L. Gossec, AbbVie, 2, 5, Amgen, 2, 5, Bristol-Myers Squibb, 2, 6, Celgene, 2, 5, Eli Lilly, 2, 5, Janssen, 2, 5, MSD, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, Roche, 2, 5, Sanofi, 2, 5, UCB, 2, 5; L. Carmona, None; S. Lawson-Tovey, None; L. Kearsley-Fleet, None; M. Schaefer, None; P. Machado, Abbvie, 6, BMS, 6, Celgene, 6, Eli Lilly, 2, Janssen, 2, MSD, 6, Galapagos, 6, Novartis, 2, 6, Pfizer, 6, Roche, 6, UCB, 2, 6, Orphazyme, 5, 6; P. Robinson, Abbvie, 5, UCB Pharma, 5, Novartis, 5, 6, Gilead, 6, Eli Lilly, 6, Pfizer Inc, 5, 6, Janssen, 5, 6, Roche, 6, 12, The University of Queensland, 3; M. Gianfrancesco, None; J. Yazdany, Pfizer, 2, Astra Zeneca, 5, Eli Lilly, 2, University of California, San Francisco, 3.

To cite this abstract in AMA style:

Ugarte-Gil M, Alarcn G, Seet A, Izadi Z, Duarte-Garcia A, Gilbert E, Valenzuela-Almada M, Wise L, Sparks J, Hsu T, D'Silva K, Patel N, Sirotich E, Liew J, Hausmann J, Sufka P, Grainger R, Bhana S, Costello W, Wallace Z, Jacobsohn L, Strangfeld A, Frazão Mateus E, Hyrich K, Gossec L, Carmona L, Lawson-Tovey S, Kearsley-Fleet L, Schaefer M, Machado P, Robinson P, Gianfrancesco M, Yazdany J. Association Between Race/Ethnicity and COVID-19 Outcomes in Systemic Lupus Erythematosus (SLE) in United States Patients: Data from the COVID-19 Global Rheumatology Alliance [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/association-between-race-ethnicity-and-covid-19-outcomes-in-systemic-lupus-erythematosus-sle-in-united-states-patients-data-from-the-covid-19-global-rheumatology-alliance/. Accessed .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-race-ethnicity-and-covid-19-outcomes-in-systemic-lupus-erythematosus-sle-in-united-states-patients-data-from-the-covid-19-global-rheumatology-alliance/