Factors affecting different COVID-19 outcomes in patients with systemic lupus erythematosus during the second pandemic wave of COVID-19 in China

Liu et al., Lupus, doi:10.1177/09612033241230736, Feb 2024
Severe case 39% improvement lower risk ← → higher risk HCQ for COVID-19  Liu et al.  PROPHYLAXIS Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 301 patients in China (December 2022 - February 2023) Lower severe cases with HCQ (not stat. sig., p=0.26) c19early.org Liu et al., Lupus, February 2024 0 0.5 1 1.5 2+ RR
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 424 studies, used in 59 countries.
Lower risk for mortality, hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,200+ studies for 200+ treatments. c19early.org
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Retrospective 301 consecutive SLE patients with COVID-19, showing lower risk of severe outcomes with HCQ use, with statistical significance in multivariable adjusted model 1 but not model 2.
Standard of Care (SOC) for COVID-19 in the study country, China, is average with moderate efficacy for approved treatments1.
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risk of severe case, 39.0% lower, OR 0.61, p = 0.26, treatment 55, control 246, adjusted per study, multivariable, model 2, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Liu et al., 5 Feb 2024, retrospective, China, peer-reviewed, 6 authors, study period December 2022 - February 2023.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 China United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Pakistan Argentina Vietnam Peru Philippines Spain Brazil Italy France Japan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR China favored low-cost treatments.The average efficacy of treatments was moderate.Low-cost treatments improve early treatment, andprovide complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 China United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Pakistan Argentina Vietnam Peru Philippines Spain Brazil Italy France Japan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Côte d'Ivoire Eritrea Togo Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria China favored low-cost treatments.The average efficacy was moderate.Low-cost protocols improve early treatment,and add complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
DOI record: { "DOI": "10.1177/09612033241230736", "ISSN": [ "0961-2033", "1477-0962" ], "URL": "http://dx.doi.org/10.1177/09612033241230736", "abstract": "<jats:sec><jats:title>Objective</jats:title><jats:p> To investigate characteristics associated with different COVID-19 outcomes of people with systemic lupus erythematosus (SLE) and COVID-19 during the second pandemic wave of COVID-19 in China. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> In this retrospective study, people with SLE and COVID-19 who visited the First Affiliated Hospital of Nanchang University from December 2022 and February 2023 were subjected to this study. The three possible outcomes were listed in order of ordinal severity: (1) not hospitalized, (2) hospitalized but not receiving oxygenation, and (3) hospitalized with any ventilation or oxygenation. A multivariable ordinal logistic regression model was built to examine the association between COVID-19 severity and demographic traits, medications, comorbidities, and disease activity. Furthermore, among the 301 SLE patients included in our study, only two patients experienced mortality. In order to maintain statistical rigor, we have included these two deceased patients in the outcome measure of hospitalized with any ventilation or oxygenation. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> A total of 301 patients with SLE were enrolled in this study. The multivariate ordinal logistic regression analyses indicated that high SLE disease activity (vs remission; OR 39.04, 95% CI 3.08 to 494.44, p = .005) was associated with more severe outcomes. Three doses of COVID-19 vaccination (OR 0.19, 95% CI 0.07 to 0.51, p = .001), glucocorticoids dose (1–5 mg/day 0.14, 0.03 to 0.73, p = .020, and 6–9 mg/day 0.12, 0.02 to 0.61, p = .010), and more intensive immunosuppression drugs (0.34, 0.12 to 0.97, p = .044) were associated with better outcomes. In age-adjusted and sex-adjusted models, telitacicept (6.66, 1.35 to 32.86, p = .020) and rituximab (7.81, 1.87 to 32.66, p = .005) were associated with more severe outcomes. Hydroxychloroquine (0.47, 0.25 to 0.88, p = .018) was associated with favorable outcomes. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Different COVID-19 outcomes in people with SLE are mostly driven by COVID-19 vaccination, medications, and activity SLE. More importantly, three doses of COVID-19 vaccination may be associated with better outcomes. </jats:p></jats:sec>", "alternative-id": [ "10.1177/09612033241230736" ], "author": [ { "ORCID": "http://orcid.org/0000-0002-9144-1623", "affiliation": [ { "name": "Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China" } ], "authenticated-orcid": false, "family": "Liu", "given": "Peng-Cheng", "sequence": "first" }, { "affiliation": [ { "name": "Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China" } ], "family": "Zhang", "given": "Min", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-9629-8558", "affiliation": [ { "name": "Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China" } ], "authenticated-orcid": false, "family": "Li", "given": "Jian-Bin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China" } ], "family": "Peng", "given": "Yi-Lin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China" } ], "family": "Yu", "given": "Shu-Jiao", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-0110-4912", "affiliation": [ { "name": "Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China" } ], "authenticated-orcid": false, "family": "Wu", "given": "Rui", "sequence": "additional" } ], "container-title": "Lupus", "container-title-short": "Lupus", "content-domain": { "crossmark-restriction": true, "domain": [ "journals.sagepub.com" ] }, "created": { "date-parts": [ [ 2024, 2, 5 ] ], "date-time": "2024-02-05T11:44:34Z", "timestamp": 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