ABSTRACT
BACKGROUND: Routine use of immunosuppressive agents in systemic lupus erythematosus (SLE) patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) potentially increases the risk of adverse outcomes. belimumab, a monoclonal antibody for the treatment of SLE, remains untested for its specific impact on coronavirus disease 2019 (COVID-19) symptoms in these patients. Here, this research investigated the effect of belimumab on COVID-19 symptoms in SLE patients infected with SARS-CoV-2. METHODS: This study enrolled SLE patients who underwent treatment with belimumab. After thorough screening based on the inclusion and exclusion criteria, data pertaining to COVID-19 for both the participants and their cohabitants were obtained through telephone follow-up. The potential impact of belimumab on COVID-19 was evaluated by comparing COVID-19 symptoms and medication use across various groups to investigate the association between belimumab treatment and COVID-19 in SLE. RESULTS: This study involved 123 SLE patients, of whom 89.4% tested positive for SARS-CoV-2. Among cohabitants of SLE patients, the SARS-CoV-2 positive rate was 87.2% (p = 0.543). Patients treated with belimumab exhibited a lower incidence of multiple COVID-19 symptoms than their cohabitating counterparts (p < 0.001). This protective effect was found to be partially related to the time of last belimumab administration. Among those with COVID-19, 30 patients opted to discontinue their anti-SLE drugs, and among them, 53% chose to discontinue belimumab. Discontinuing drugs did not increase the risk of hospitalization due to SARS-CoV-2 infection. CONCLUSION: This study concluded that treatment with belimumab did not increase susceptibility to COVID-19 and beneficially alleviated the symptoms of COVID-19.
Subject(s)
Antibodies, Monoclonal, Humanized , COVID-19 , Immunosuppressive Agents , Lupus Erythematosus, Systemic , SARS-CoV-2 , Humans , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/complications , Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/epidemiology , Female , Retrospective Studies , Adult , Male , Middle Aged , Immunosuppressive Agents/therapeutic useABSTRACT
To investigate the clinical manifestations, pathological features, treatment, and prognosis of a special type of podocytopathy in patients with lupus nephritis (LN). The clinical data, including clinical manifestations, pathological features, immunological markers, treatment, and prognosis of one patient with lupus podocytopathy (LP), were retrospectively analyzed. Relevant literature was also reviewed. The patient was clinically diagnosed with a rare type of LP-based on medical history, clinical manifestations, laboratory tests, renal biopsy results, and relevant literature. After treatment with steroids combined immunosuppressive agents, the clinical symptoms were improved, and the nephropathy was completely reversed. The disease condition was stable during follow-up. LP is a specific pathological change in the spectrum of LN, with nephrotic syndrome (NS) as its primary clinical manifestation. Patients may also have severe lupus-associated injuries affecting multiple systems. Immunosuppressive agents combined with steroids can improve clinical symptoms.
