COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine

5/12 Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Cassione et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217717 (Letter)
COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine

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Survey of 165 SLE patients, 127 on HCQ. 8 patients with suspected COVID-19 and 4 confirmed cases. No mortality, one ICU case. 7 patients had no symptoms despite contact with a COVID-19 patient.

No adjustment for concomitant medications or severity of SLE. Confounding by indication.

Cassione et al., 5/12/2020, retrospective, Italy, Europe, preprint, survey, median age 52.5, 6 authors.

risk of COVID-19 case, 49.6% higher, RR 1.50, p = 0.59, treatment 10 of 127 (7.9%), control 2 of 38 (5.3%).

This study is excluded in meta analysis: not fully adjusting for the different baseline risk of systemic autoimmune patients.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.

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