MO261LUPUS NEPHRITIS AND COVID-19 INFECTION

Abstract

Objectives: Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune systemic diseases. This is likely due to a combination of immune dysfunction, immunosuppressive therapy and excess co-morbidities. 1, 2 The aim of this study is to describe clinical characteristics of patients with lupus nephritis (LN) and Corona virus disease 2019 (COVID-19), and to identify baseline variables associated with a severe infection requiring hospitalization. Method(s): A telephone survey investigating the impact of COVID-19 on patients with biopsy -proven LN was administered. Data extraction included diagnosis, disease activity status, demographics, occupational exposure, adherence to social distancing advise, therapy, comorbidities, and laboratory tests. COVID-19 was classified as definite diagnosis of COVID-19 disease: presence of symptomatic COVID-19 infection, confirmed by nasopharyngeal SARSCoV-2 polymerase chain reaction test. Comparisons between patients with or without hospitalization were performed. Result(s): 114 patients (median age 34,9 +/- 12,4 years) with LN were included in the study. 31 patients (26 women, 5 men) developed at least one symptom (flulike symptoms, chest pain, fever, asthenia, chills, cough, sore throat, dyspnea, headaches, arthromyalgias, odynophagia, diarrhea, conjunctivitis, hypo-, ageusia, hypo-, anosmia) of COVID-19 and were PCR test positive. 31 patients were treated with methylprednisolone, 21 -with hydroxychloroquine, 8 -with azathioprine, 4 -with cyclophosphamide prior to their COVID-19 illness. Conclusion(s): Covid-19 is more frequent in the subgroup of LNpatients without therapy with hydroxychloroquine, which might play some protective role against the most harmful manifestations of COVID-19. Six patients required hospitalization -these were more frequently men, older and with comorbidities (lung diseases, hypertension) and active LN (3 -class IV LN, 2 -class V LN, 1 -class III LN and 1 -class II LN, according the 2003 ISN/RPS classification). Male sex, previous lung disease, serum creatinine level, proteinuria, glucocorticoids use >5 mg/day, were significantly associated with hospitalization.