Incidence and risk factors for moderate/severe COVID-19 in rheumatic diseases patients on hydroxychloroquine: a 24-week prospective cohort

Objective To evaluate the incidence of COVID-19 and its main outcomes in rheumatic disease (RD) patients on hydroxychloroquine (HCQ) compared to household cohabitants (HC).Methods This is a 24-week nationwide prospective multi-centre cohort with a control group without RD and not using HCQ. All participants were monitored through scheduled phone interviews performed by health professionals. Details regarding COVID-19 symptoms, and epidemiological, clinical, and demographic data were recorded on a specific web-based platform. COVID-19 was defined according to the Brazilian Ministry of Health criteria and classified as mild, moderate or severe.Results A total of 9,585 participants, 5,164 (53.9%) RD patients on HCQ and 4,421 (46.1%) HC were enrolled from March 29th, 2020 to September 30th, 2020, according to the eligibility criteria. COVID-19 confirmed cases were higher in RD patients than in cohabitants [728 (14.1%) vs. 427 (9.7%), p<0.001] in a 24-week follow-up. However, there was no significant difference regarding outcomes related to moderate/ severe COVID-19 (7.1% and 7.3%, respectively, p=0.896). After multiple adjustments, risk factors associated with hospitalisation were age over 65 (HR=4.5;95%CI 1.35-15.04, p=0.014) and cardiopathy (HR=2.57;95%CI 1.12-5.91, p=0.026). The final survival analysis demonstrated the probability of dying in 180 days after a COVID-19 diagnosis was significantly higher in patients over 65 years (HR=20.8;95%CI 4.5-96.1) and with 2 or more comorbidities (HR=10.8;95%CI 1.1-107.9 and HR=24.8;95%CI 2.5-249.3, p=0.006, respectively).Conclusion Although RD patients have had a higher COVID-19 incidence than individuals from the same epidemiological background, the COVID-19 severity was related to traditional risk factors, particularly multiple comorbidities and age, and not to underlying RD and HCQ.

Sentinel-1A/-1B mission and performance status, sentinel-1C/-1D improvements

The Copernicus Sentinel-1 mission ensures continuity of C-band SAR observations for Europe. The routine operations of the constellation are on-going and performed at full mission capacity. The mission is characterized by large-scale and repetitive observations, systematic production and free and open data policy. Sentinel-1 data are routinely used by Copernicus and many operational services, as well as in the scientific and commercial domain. The paper addresses the mission status, the Sentinel-1 observation scenario, the impact on the COVID-19 crisis, and an overview on the recent mission performance aspects. It also presents the mission perspective for the years to come, in particular preliminary information on the new concept of a Sentinel-1 satellite in stand-by in orbit. In a second part, the paper addresses the improvements in system robustness and performance for the Sentinel-1C/-1D units. In addition, it discusses the main characteristics of the Automatic Identification System (AIS) instrument to augment the SAR payload data for ship marine traffic applications. © 2022 Institute of Electrical and Electronics Engineers Inc.. All rights reserved.

IMMUNOGENICITY and SAFETY of the CHADOX 1 COVID-19 VACCINE in PATIENTS with AUTOIMMUNE DISEASES and HEALTHY CONTROLS: DATA from SAFER STUDY

Background: Patients with autoimmune infammatory diseases (AID) have been prioritized for urgent vaccination to mitigate COVID-19 risk. However, few studies in the literature assessed the immunogenicity and safety of the COVID-19 vaccine in patients with AID. Objectives: In this context, the present study aims to evaluate the immunogenic-ity and safety of the vaccine against COVID-19 in patients with AID. Methods: These data are from 'Safety and efficacy on COVID-19 Vaccine in Rheumatic Disease'-SAFER study, a Brazilian multicentric prospective phase IV study to evaluate COVID-19 Vaccine in AID, in the real-life, in Brazil. Immunogenicity and adverse events (AE) from a single center were assessed, after 2 doses of ChAdOx1 (Oxford/AstraZeneca), 8 weeks of interval, in patients with AID and healthy controls (HC). Inclusion criteria were age ≥ 18 years and fulflling criteria according to international classifcation for AID. Exclusion criteria: pregnancy, previous severe AE to any vaccine, other immunosuppression causes. Stratifcation of post-vaccination AE was performed using a diary, flled out daily and returned at the end of 28 days for each dose. Participants were followed up through blood collection for measurement of IgG antibodies against SARS-CoV-2 spike receptor-binding domain by chemiluminescence (SARS-CoV-2 IgG II Quant assay, Abbott Laboratories, Abbott Park, IL, USA) at baseline and 28 days after the second dose. The seropositivity was defned for titers ≥50 AU/mL. Quantitative analyses were presented as observed frequency, percentage, central tendency, and variability measurements. The sample's normal distribution was verifed through the Shapiro-Wilk test. The Kruskal-Wallis test and the post-hoc Dwass-Steel-Critchlow-Fligner pairwise comparisons test were used to compare the IgG-S titers between the groups through the evaluation period. Categorical data were addressed using the Fisheŕs exact or Chi-squared (χ2) test. An alpha level of 5% signifcance was used in all analyses. Results: A total of 377 volunteers with AID and 50 HC were included in the study. Patients with spondyloarthritis (N=64), systemic lupus erythematosus (N=63), rheumatoid arthritis (N=61), primary Sjögren's syndrome (N=61), vasculitis (N=31), systemic sclerosis (N=14), inflammatory myopathy (N=9), Crohńs disease (N=49), ulcerative colitis (N=11) and other systemics AID (N=12) were evaluated. Both groups had female predominance (73.5% vs. 74.0%, p=0.937) and were homogeneous for age (43.5 vs. 41.7,p=0.308). The seroconversion among those not reactive (IgG-S negative at baseline) (46 HC and 191 AID), 28 days after second dose was 97.1% for spondyloar-thritis (p=0.425), systemic lupus erythematosus 88.2% (0.006), rheumatoid arthritis 93.5% (0.158), primary Sjögren's syndrome 92.6% (0.133), systemic sclerosis or inflammatory myopathy 47.1% (0.001), inflammatory bowel disease 100% (0.999) and vasculitis 80% (0.006), while in healthy control was 100%. In comparison with HC, there was a statistically significant difference in IgG-S titles only in systemic sclerosis or inflammatory myopathy (1.694 AU/ml vs. 3.719 AU/ml;p=0.006). Both groups only presented mild AE. Pain at the injection (85.7% vs. 78.4%, p=0.239), headache (67.3% vs. 53.8, p=0.074) and fatigue (59.2% Vs. 46.2%, p=0.089) were more common in HC than AID. Overall, reactions like arthralgia (52.6 vs. 22.4%, p<0.001), hematoma (14.1 vs. 4.1%, p=0.05), cutaneous rash (9.5 vs. 0%, p=0.024) were more frequent in AID. Most participants related that they felt safer after receiving a COVID-19 vaccination, and 52.4% did not reported a worse patient global assessment (PGA) index. Conclusion: In conclusion, our data indicated that ChAdOx1 vaccine is safe and induced high titers and seroconversion rate in AID. More severe AID, such as vasculitis, systemic lupus erythematosous, and systemic sclerosis and myositis showed a lower seroconversion rate. Further analysis will explore the association between immunossupressant and reactivity, and booster dose.

INCIDENT CASES of COVID-19 and VACCINATION ADHERENCE in A MULTICENTRIC COHORT of INFLAMMATORY ARTHRITIS in BRAZIL

Background: The SARS-CoV-2 virus has caused a worldwide health crisis. Patients with infammatory arthritis are at higher risk of hospitalization and death by COVID-19 due to comorbidities or immunosuppressive treatments. Vaccination is one the most important strategies to control the pandemic. Objectives: To evaluate the incident cases of SARS-CoV-2 infection in a multi-centric cohort of infammatory arthritis in Brazil. Methods: BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their frst bDMARD or tsDMARD (1). The present analysis is a retrospective evaluation of adult patients with infam-matory arthritis (rheumatoid arthritis-RA, spondylarthritis-SpA and psoriatic arthritis-PsA) that were alive since the beginning of the COVID-19 pandemics in Brazil in February 2020. We evaluated the incidence and severity of COVID-19 infection and the adherence to anti-SARS-CoV-2 vaccines schedules, up to January 2022. Results: A total of 300 patients were interviewed and 69 (23.0%) reported con-frmed anti-SARS-CoV infection and 5 (1.7%) had a second infection. Among known infected patients, 18.8% need hospitalization and oxygen support, 7.2% were admitted at ICU, and 5.8% died. After COVID-19 infection, 31.8% reported worsening of disease activity but only 6.1% had modifcation in medication due to disease activity. Distribution of cases followed the pattern of waves observed in Brazil (Figure 1). Regarding vaccination, 285 (95%) reported to have received at least one dose of any anti-SARS-CoV-2 vaccine: 43% received the frst with the adenovirus ChAdOx1 nCoV-19 (AstraZeneca) adenovirus vaccine, 32% received the Sinovac-CoronaVac inactivated vaccine, 22% received the BNT162b2 (Pfzer-BioNtech) mRNA vaccine and 3% received the BNT162b2 (Pfzer-BioNtech) adenovirus vaccine. Almost all (98.1%) of these patients had already received the second dose of vaccine and after the frst and second vaccine doses, 6% and 4% of patients, respectively, reported worsening of articular disease activity, while, after the third dose, no patient reported disease activity worsening. Conclusion: During the pandemics, patients with infammatory arthritis had a pattern of distribution of cases very similar to general population. Adherence to vaccination is high and well tolerated.

CHARACTERISTICS ASSOCIATED with POOR COVID-19 OUTCOMES in PEOPLE with PSORIASIS and SPONDYLOARTHRITIS: DATA from the COVID-19 PSOPROTECT and GLOBAL RHEUMATOLOGY ALLIANCE PHYSICIAN-REPORTED REGISTRIES

Background: Some factors associated with severe COVID-19 outcomes have been identifed in patients with psoriasis (PsO) and infammatory/autoimmune rheumatic diseases, namely older age, male sex, comorbidity burden, higher disease activity, and certain medications such as rituximab. However, information about specifcities of patients with PsO, psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), including disease modifying anti-rheumatic drugs (DMARDs) specifcally licensed for these conditions, such as IL-17 inhibitors (IL-17i), IL-23/IL-12 + 23 inhibitors (IL-23/IL-12 + 23i), and apremilast, is lacking. Objectives: To determine characteristics associated with severe COVID-19 outcomes in people with PsO, PsA and axSpA. Methods: This study was a pooled analysis of data from two physician-reported registries: the Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection (PsoProtect), comprising patients with PsO/PsA, and the COVID-19 Global Rheumatology Alliance (GRA) registry, comprising patients with PsA/axSpA. Data from the beginning of the pandemic up to 25 October, 2021 were included. An ordinal severity outcome was defned as: 1) not hospitalised, 2) hospitalised without death, and 3) death. A multivariable ordinal logistic regression model was constructed to assess the relationship between COVID-19 severity and demographic characteristics (age, sex, time period of infection), comorbidities (hypertension, other cardiovascular disease [CVD], chronic obstructive lung disease [COPD], asthma, other chronic lung disease, chronic kidney disease, cancer, smoking, obesity, diabetes mellitus [DM]), rheumatic/skin disease (PsO, PsA, axSpA), physician-reported disease activity, and medication exposure (methotrexate, lefunomide, sulfasalazine, TNFi, IL17i, IL-23/IL-12 + 23i, Janus kinase inhibitors (JAKi), apremilast, glucocorticoids [GC] and NSAIDs). Age-adjustment was performed employing four-knot restricted cubic splines. Country-adjustment was performed using random effects. Results: A total of 5008 individuals with PsO (n=921), PsA (n=2263) and axSpA (n=1824) were included. Mean age was 50 years (SD 13.5) and 51.8% were male. Hospitalisation (without death) was observed in 14.6% of cases and 1.8% died. In the multivariable model, the following variables were associated with severe COVID-19 outcomes: older age (Figure 1), male sex (OR 1.53, 95%CI 1.29-1.82), CVD (hypertension alone: 1.26, 1.02-1.56;other CVD alone: 1.89, 1.22-2.94;vs no hypertension and no other CVD), COPD or asthma (1.75, 1.32-2.32), other lung disease (2.56, 1.66-3.97), chronic kidney disease (2.32, 1.50-3.59), obesity and DM (obesity alone: 1.36, 1.07-1.71;DM alone: 1.85, 1.39-2.47;obesity and DM: 1.89, 1.34-2.67;vs no obesity and no DM), higher disease activity and GC intake (remission/low disease activity and GC intake: 1.96, 1.36-2.82;moderate/severe disease activity and no GC intake: 1.35, 1.05-1.72;moderate/severe disease activity and GC intake 2.30, 1.41-3.74;vs remission/low disease activity and no GC intake). Conversely, the following variables were associated with less severe COVID-19 outcomes: time period after 15 June 2020 (16 June 2020-31 December 2020: 0.42, 0.34-0.51;1 January 2021 onwards: 0.52, 0.41-0.67;vs time period until 15 June 2020), a diagnosis of PsO (without arthritis) (0.49, 0.37-0.65;vs PsA), and exposure to TNFi (0.58, 0.45-0.75;vs no DMARDs), IL17i (0.63, 0.45-0.88;vs no DMARDs), IL-23/IL-12 + 23i (0.68, 0.46-0.997;vs no DMARDs) and NSAIDs (0.77, 0.60-0.98;vs no NSAIDs). Conclusion: More severe COVID-19 outcomes in PsO, PsA and axSpA are largely driven by demographic factors (age, sex), comorbidities, and active disease. None of the DMARDs typically used in PsO, PsA and axSpA, were associated with severe COVID-19 outcomes, including IL-17i, IL-23/IL-12 + 23i, JAKi and apremilast.

Online Problem-Based Learning During the Pandemic: SWOT Analysis of the Nursing Student’s Opinion

Problem-based learning enables nursing students to acquire and develop the competencies necessary for professional nursing. The world pandemic COVID-19 impacted nursing education by including a transition to online and digital platforms. The SWOT analysis was used as an instrument to identify strengths and weaknesses during the period referred, for strategic management of the curriculum course Nursing Decision-Making Process (NDMP). The aim of the study was to identify the positive and negative aspects of the online problem-based learning experience with the NDMP course of the Undergraduate Nursing Program, at the Nursing School of Lisbon. It is a qualitative and exploratory study, with data collected through documental analysis of the two final evaluations of the course: the answers to the open-ended question of the individual questionnaire, and the students’ tutorial groups evaluation. The qualitative data analysis was performed according to Bardin through the webQDA software®. The study included 567 students, rom the 2020 and 2021 academic years. The results were: for the strength, the orientation and personalization teaching strategies developed during the tutorial orientation;for weaknesses, the insufficient time available for the development of the learning process;for the opportunities, the absence of travelling time home to school, enhanced learning;for the threats, the focus was on work overload which resulted from semesters adjustments. The qualitative research methodology with interpretation and comprehension for what is `said´ by the students, allowed us to identify the positive and negative aspects of online problem-based learning and delineate strategies for the future. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Pandemic analysis and bioethical considerations on early treatment

The global crisis caused by the SARS-CoV-2 virus, responsible for COVID-19, can be interpreted in different ways, including epidemic behavior, waves of impact on health systems and consequences of measures directly or indirectly linked to fighting the pandemic. Thus, the responses to these challenges must be comprehensive, covering the different levels of prevention. As a possible answer, early treatment should not be seen in isolation, but in a context of comprehensive care. This article presents ways to analyze the current crisis and the ethical elements relevant to early treatment. © 2021, Conselho Federal de Medicina. All rights reserved.

MUCORMICOSE: RELATO DE CASO EM MENOR DE IDADE IMUNOCOMPETENTE

Introdução: a Mucormicose é uma infecção fúngica extremamente rara e grave, causada por fungos da ordem Mucorales, a qual pode ser classificada em 6 categorias: cutânea, rinocerebral, pulmonar, gastrointestinal, disseminada e formas raras incomuns. A manifestação clínica imediata varia de acordo com a topografia e o seu diagnóstico frequentemente é atrasado devido a inespecificidade dos sintomas, sendo os exames padrão-ouro para o diagnóstico a biópsia e a avaliação histopatológica dos tecidos infectados. Em relação ao tratamento, este pode ser feito cirurgicamente pelo desbridamento da lesão, ou por meio de antifúngicos, na qual a Anfotericina B com formulação lipídica é o medicamento de primeira escolha. Descrição do caso: Paciente pediátrico do sexo masculino, 10 meses de vida, sem diagnóstico de doenças prévias e com RT-PCR negativo para COVID-19, apresentando lesão aparentemente infiltrativa em face há 4 meses. Foi transferido de hospital oncológico infantil para o Hospital Universitário João de Barros Barreto, referência no tratamento de doenças infecciosas, após a biópsia descartar neoplasia maligna e sugerir infecção fúngica. Neste hospital, o paciente foi admitido acompanhado da mãe, em bom estado geral, sem queixas clínicas, apresentando os resultados diagnósticos do histopatológico e da tomografia computadorizada dos seios da face, os quais demonstraram lesão expansiva, heterogênea e infiltrativa no tecido subcutâneo, compreendendo a área ocular, interocular frontal e nasomalar direita, com inflamação crônica apontando granuloma, necrose e estruturas fúngicas sugestivas de mucormicose. Em sua admissão, realizou exames laboratoriais, os quais apresentaram discreta anemia, microcitose, anisocitose e leucocitose, além de função renal e hepática preservadas e ionograma sem alterações significativas. Iniciou antibioticoterapia no primeiro hospital e deu prosseguimento com Anfotericina B Complexo Lipídico após transferência para o tratamento da mucormicose. Ao finalizar o processo terapêutico, obteve alta hospitalar, na qual a mãe foi instruída a realizar hidratação da pele do bebê, e orientada acerca do tratamento para a anemia e da necessidade de acompanhamento com imunologista. Comentários: Ante o exposto, é imperioso que o diagnóstico seja feito precocemente, para que o manejo da infecção seja o menos traumático e com a menor quantidade de sequelas possíveis para o paciente.

COVID-19 vaccination in pediatric age-what do parents know and think?

Background: Vaccination against COVID-19 in pediatric age has been a hot topic recently. This study aimed to assess parents' intention to vaccinate their children against COVID-19 and identify which factors may influence this decision. Methods: An observational study was conducted between June and July 2021 by applying an anonymous questionnaire to a sample of caregivers of children and adolescents followed in ambulatory care in a Portuguese central hospital. We included sociodemographic data, immunization history, personal background, exposure to COVID-19 and caregivers' beliefs. At the time of the study, there was still no official recommendation from health authorities regarding vaccination in pediatric age. Results: A total of 78 questionnaires were conducted. The mean age of the children was 9.2 years (±5.9), 56.4% were male, 94.8% had an updated immunization history, and 65.8% had extra vaccines. Of these children, 22.1% had comorbidities. Among the caregivers, 83.3% were mothers, the mean age was 39.4 years (±9.4), and 26.9% had attended university. The vaccine was considered safe by 61.5%, and 34.6% answered they did not know whether to consider it safe or not. Information about the vaccine was obtained through television in 84.6%, social networks in 42.3% and 34.6% in the information given by health professionals. Regarding the intention to vaccinate their children, 76.9% answered "yes", 7.7% did not answer and 15.4% answered "no". The vaccine's ineffectiveness (n=5) and inappropriate age (n=3) were the most cited reasons not to vaccinate. In 82.9%, the number of doses of the vaccine would not influence the decision. Conclusions: The study results show that caregivers have considerable resistance to the vaccination of children and adolescents against COVID-19, mainly based on the belief in the vaccine's ineffectiveness. The majority obtained information about the vaccine in the media, which reinforces the importance and the opportunity for intervention by transmitting credible and perceptible information in these media.

Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital.

OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.

Application of Machine Learning to Infer Symptoms and Risk Factors of Covid-19

This article presents a model that aims to identify with Machine Learning (ML) technics the main symptoms and risk factors affected in patients with Coronavirus Covid-19, registered in the database of epidemiological surveillance of state and municipal information in Brazil. The concept behind ML is the ability to learn and reason. Its application can optimize and make the treatment and care process more accurate for the cases diagnosed with the Covid-19, also known as SARS-CoV-2, adjusting the medical data recorded concerning the disease and reducing the number of symptoms and risk factors, denoting an efficient form of attribute engineering, providing those involved with the clinical observation of a minor sign. We propose an approach structured in the composition of Machine Learning algorithms, aiming to discover knowledge and concepts followed by the refinement of the results. In this article, the proposed model is presented, and a shorter trail of symptomatic observations from Covid-19 are provided. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Lupus patients infected by sars-cov2 performed less social isolation with higher hospitalization associated with hypertensionand cyclophosphamide pulsotherapy-data from reumacov Brazil

Objectives: To determine the main risk factors associated with COVID-19 in SLE patients. Methods: The Reuma CoV Brazil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. SLE adult patients according to SLE SLICC criteria classification (2012), with and without (control group-CG) COVID-19 diagnosis were matched. Demographic data, managing of COVID-19, comorbidities, clinical characteristics (disease activity: Patient Report Outcomes-PROs, Physician Global Assessment and SLEDAI-2 K)were collected. Results: From May 2020 to January 2021, 604 SLE patients were included, 317 (52.4%) with COVID-19 and 287 (47.6%) in the CG. Both groups were homogeneous and comparable regarding sex and comorbidities. SLE patients with COVID-19 declared a lower level of social isolation (49.5% vs. 61.9%;p = 0.002), worked more commonly in health professions (10.4% vs. 3.5%;p = 0.002), presented more frequently joint (32.5% vs. 22.0%;p = 0.004) and hematological manifestations (18.0% vs. 11.5%;p = 0.025). SLEDAI-2 K did not differ among groups prior and after COVID-19 infection. However, considering the mean duration of COVID-19 symptoms (12.1 ± 8.8 days), infected patients had more severe disease activity's PROs after resolution of COVID-19 symptoms (2.9 ± 2.9 vs. 2.3 ± 2.6;p = 0.031). The hospitalization rate was 20.5% (n = 65), of whom 23 (7.2%) needed intensive care unit and 14 (4.4%) patients died. Hypertension [5,26 (1,9714,07);p = 0.001] and recently cyclophosphamide pulses [39,21 (4,17-368,53);p = 0.001] were associated with hospitalization and patients who received telemedicine medical care presented 72% less chance of hospitalization [0.28 (0.09-0.83);p = 0.023). Conclusion: COVID-19 was associated with a lower level of declared social isolation and more severe disease activity perception after SARS-CoV-2 infection according to PROs. Hypertension and cyclophosphamide were associated with hospitalization and telemedicine can be a useful tool for SLE patients with COVID-19. These data should be considered to perform public health policy and national guidelines to manage SLE patients during the pandemic, as well as to prioritize some special groups for the immunization program.