AB1045 LONG COVID SYMPTOMS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE-CONTROL STUDY
Authors: K. L. Chan, C. C. Mok, C. L. Cheung
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Long COVID was defined by the WHO as continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for ≥2 months without an alternative explanation. Data on the incidence of long COVID in patients with systemic lupus erythematosus (SLE) are scant. <h3>Objectives:</h3> To compare the incidence of long COVID symptoms in patients with SLE with matched controls after an SARS-CoV2 infection. <h3>Methods:</h3> Consecutive adult patients (≥18years) who fulfilled either the ACR or SLICC criteria for SLE and attended our rheumatology clinics between July to November 2023 were recruited. Those with SARS-nCoV-2 infection (either by rapid antigen test or PCR) were identified by a self-reported questionnaire, which also captured the duration and severity of a number of pre-defined symptoms of long COVID. An equal number of healthy subjects, matched for gender and age, who had a history of COVID-19 during the same time period were also recruited for the same survey. Demographic data including sex, age, SARS-CoV2 vaccination, clinical symptoms of COVID-19 and their duration were collected. Clinical data of SLE patients were retrieved through their electronic medical records. The incidence of long COVID, its symptomatology was compared between the two groups, and risk factors for long COVID in SLE patients were evaluated. <h3>Results:</h3> 211 SLE patients (97.6% women, age 44.2±11.9 years) and 211 healthy controls (97.6% women, age 44.2±11.9 years) were studied. The prevalence of organ manifestations in SLE patients was: musculoskeletal (68%), mucocutaneous (64%), hematological (57%), renal (56%) and serosal (23%). Compared to controls, long COVID symptoms were significantly more common in SLE patients than controls (54.5% vs 34.6%; OR=2.27[1.53-3.35]). The commonest reported long COVID symptoms, in decreasing order, were fatigue (30.1%), worsening of memory (29.1%), difficulty to concentrate (26.3%), cough (23.2%) and insomnia (18.9%). Among the long COVID symptoms, worsening of memory (39.3% vs 19.0%; OR=2.77[1.78-4.31]), chest pain (5.7% vs 1.2%; OR=4.18[1.16-15.0]), palpitation (13.3% vs 4.3%, OR=3.43[1.58-7.47]) and arthralgia (12.8% vs 5.2%, OR=2.67[1.29-5.53]) were significantly more frequent in SLE patients than controls. In contrast, headache (7.6% vs 14.7%, OR=0.48[0.25-0.90]), loss of taste or smell (5.7% vs 18.0%, OR=0.28[0.14-0.54]) and rhinorrhea (9.5% vs 19.9%, OR=0.42[0.24-0.75]) were less common in SLE patients. The duration of certain long COVID symptoms were significantly longer in SLE patients than controls: loss of fitness (3.05 vs 2.41 months; p&lt;0.01), worsening of memory (3.94 vs 2.55 months; p&lt;0.01), difficulty to concentrate (3.25 vs 2.67; p=0.02), palpitation (2.80 vs 1.99; p=0.02), fatigue (3.33 vs 2.62 months; p&lt;0.01), arthralgia (3.29 vs 2.18; p=0.02) and rash (3.27 vs 1.89 months; p=0.02). In patients with SLE, the occurrence of long COVID was not significantly associated with age, sex, smoking status, previous COVID-19 vaccination, diabetes mellitus, obesity, chronic kidney disease, or pre-existing organ damage (SLICC/ACR Damage Index ≥1). However, the ever use of hydroxychloroquine (HCQ) (83.0% vs 70.7%, OR=2.03[1.04-3.96]) were significantly associated with occurrence of long COVID. No relationship between the ever use of other medications and long COVID was observed. <h3>Conclusion:</h3> Long COVID symptoms are more common in SLE patients than matched controls after a SARS-CoV2 infection. The occurrence of long COVID in SLE patients is largely unpredictable, and the use of HCQ does not appear to be protective. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>