In the WARCOV study, patients with SLE admitted to hospital and those receiving outpatient care were identified by review of medical records and contacted serially for 1–9 weeks between April 13 and June 14, 2020, to prospectively capture symptom onset. Full inclusion criteria are summarised in the appendix (p 1). Patients with SLE from the WARCOV Cohort (outpatients at NYU Langone Health and NYC Health + Hosptials/Bellevue and patients admitted to NYU Langone Health or NYC Health + Hospitals/Bellevue for COVID-19) completed questionnaires approved by the NYU Langone Health institutional review board, which included information about demographic characteristics, comorbidities, SLE medications used, symptoms related to COVID-19, contact exposure, and RT-PCR testing. Immunosuppressant medication use was not associated with risk of hospital admission for COVID-19.Īnd the NYU Lupus Cohort. Previous descriptive studies noted frequent hospital admission in patients with SLE andRT-PCR-confirmed SARS-CoV-2 infection, with risk factors for hospital admission including non-White or Hispanic ethnicity, a higher body-mass index, and having at least one other medical comorbidity. Search terms included “systemic lupus erythematosus,” and “rheumatic disease” in combination with “viral infections,” “vaccination immune response,” “COVID-19,” “SARS-CoV-2 IgG” and “COVID-19 antibodies.” We also reviewed the online dashboard for the New York City COVID-19 case and death numbers between March 1 and June 21, 2020. To evaluate previous research related to the risk of infections, response to vaccinations and COVID-19 in patients with SLE and rheumatic disease, we searched PubMed for articles published from Jan 1, 1980, to March 14, 2021. Patients with systemic lupus erythematosus (SLE) are at an increased risk of developing viral infections due to immunological abnormalities and immunosuppressant use, which might affect humoral immune responses. Seven (70%) of ten patients with confirmed COVID-19 had antibody positivity beyond 30 weeks from disease onset. Among 36 patients who were initially SARS-CoV-2 IgG positive, the majority maintained reactivity serially (88% up to 10 weeks, 83% up to 20 weeks, and 80% up to 30 weeks). Of 83 patients who had no symptoms of COVID-19 and no RT-PCR testing, four (5%) developed an antibody response. Of 26 patients who had COVID-19-related symptoms but did not undergo RT-PCR testing, six (23%) developed an antibody response. Of 17 patients who had symptoms of COVID-19 but negative concurrent RT-PCR testing, one (6%) developed an antibody response. Of the 29 patients with COVID-19 previously confirmed by RT-PCR, 18 (62%) were on immunosuppressants 24 (83%) of 29 patients tested positive for SARS-CoV-2 IgG antibodies. Other demographic variables, SLE-specific factors, and immunosuppressant use were not associated with SARS-CoV-2 positivity. Seropositive patients were more likely than seronegative patients to be Hispanic (24 of 51 vsz 67 of 278). 51 (16%) of 329 patients had a positive SARS-CoV-2 IgG antibody test. 309 (94%) were women and 91 (28%) were of Hispanic ethnicity. The Lancet Regional Health – Western Pacificģ29 patients with SLE were included in this analysis, 146 from the WARCOV study and 183 from the NYU Lupus Cohort, and were tested for SARS-CoV-2 antibodies between April 29, 2020, and Feb 9, 2021.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.