{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:22:29Z","timestamp":1783689749664,"version":"3.55.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002915","name":"Fondation pour la Recherche M\u00e9dicale","doi-asserted-by":"publisher","award":["FDM202106013488"],"award-info":[{"award-number":["FDM202106013488"]}],"id":[{"id":"10.13039\/501100002915","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["ANR-21-COVR-0034 COVALUS"],"award-info":[{"award-number":["ANR-21-COVR-0034 COVALUS"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To analyze the risk of systemic lupus erythematosus (SLE) flare after admission for COVID-19.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed a matched cohort study using the Assistance Publique\u2014H\u00f4pitaux de Paris Clinical Data Warehouse which collects structured medical, biological and administrative information from 11 million patients in Paris area, France. Each SLE patient hospitalized with a COVID-19 diagnosis code between March 2020 and December 2021 was matched to one SLE control patient with an exact matching procedure using age \u00b13 years, gender, chronic kidney disease, end-stage renal disease, and serological activity. The main outcome was a lupus flare during the 6 months follow-up. A flare was considered if a) documented by the treating physician in the patient\u2019s EHR and b) justifying a change in SLE treatment. The electronic health records (EHRs) were individually checked for data accuracy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among 4,533 SLE patients retrieved from the database, 81 (2.8%) have been admitted for COVID-19 between March 2020 and December 31, 2021, and 79 (n = 79\/81,97.5%) were matched to a unique unexposed SLE. During follow-up, a flare occurred in 14 (17.7%) patients from the COVID-19 group as compared to 5 (6.3%) in the unexposed control group, including 4 lupus nephritis in the exposed group and 1 in the control group. After adjusting for HCQ use at index date and history of lupus nephritis, the risk of flare was higher in exposed SLE patients (hazard ratio [95% confidence interval] of 3.79 [1.49\u20139.65]).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>COVID-19 hospitalization is associated with an increased risk of flare in SLE.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0309316","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T17:22:15Z","timestamp":1728580935000},"page":"e0309316","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk of systemic lupus erythematosus flare after COVID-19 hospitalization: A matched cohort study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2995-767X","authenticated-orcid":true,"given":"Arthur","family":"Mageau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"G\u00e9radin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanko\u00e9","family":"Sallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Papo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6544-234X","authenticated-orcid":true,"given":"Karim","family":"Sacre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Timsit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"pone.0309316.ref001","first-page":"5459","article-title":"Type I interferon in the pathogenesis of lupus","volume":"192","author":"MK Crow","year":"2014","journal-title":"J Immunol Baltim Md 1950"},{"key":"pone.0309316.ref002","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1002\/art.39607","article-title":"Distinct Functions of Anti-interferon Autoantibodies in Systemic Lupus Erythematosus: A Comprehensive Analysis of Anticytokine Autoantibodies in Common Rheumatologic Diseases","volume":"68","author":"S Gupta","year":"2016","journal-title":"Arthritis Rheumatol Hoboken NJ"},{"key":"pone.0309316.ref003","doi-asserted-by":"crossref","DOI":"10.1126\/science.abd4585","article-title":"Autoantibodies against type I IFNs in patients with life-threatening COVID-19","volume":"370","author":"P Bastard","year":"2020","journal-title":"Science"},{"key":"pone.0309316.ref004","doi-asserted-by":"crossref","DOI":"10.1126\/science.abd4570","article-title":"Inborn errors of type I IFN immunity in patients with life-threatening COVID-19","volume":"370","author":"Q Zhang","year":"2020","journal-title":"Science"},{"key":"pone.0309316.ref005","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1136\/ard-2022-222549","article-title":"Lower disease activity but higher risk of severe COVID-19 and herpes zoster in patients with systemic lupus erythematosus with pre-existing autoantibodies neutralising IFN-\u03b1","volume":"81","author":"A Mathian","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"pone.0309316.ref006","first-page":"1450","article-title":"Systemic lupus erythematosus flare following SARS-CoV2 infection: the implication of IFN\u03b1 and anti-IFN\u03b1 autoantibodies","volume":"40","author":"A Mageau","year":"2022","journal-title":"Clin Exp Rheumatol"},{"key":"pone.0309316.ref007","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1136\/annrheumdis-2021-221599","article-title":"Survival after COVID-19-associated organ failure among inpatients with systemic lupus erythematosus in France: a nationwide study","volume":"81","author":"A Mageau","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"pone.0309316.ref008","article-title":"SARS-CoV-2 infection among inpatients with systemic lupus erythematosus in France: a nationwide epidemiological study","author":"A Mageau","year":"2021","journal-title":"Ann Rheum Dis"},{"key":"pone.0309316.ref009","first-page":"101252","article-title":"COVID-19 in a patient with a flare of systemic lupus erythematosus: A rare case-report","volume":"31","author":"A Alharthy","year":"2020","journal-title":"Respir Med Case Rep"},{"key":"pone.0309316.ref010","article-title":"Systemic lupus erythematosus flare during SARS-CoV-2 infection: Report of 3 cases presented during the fourth wave of the pandemic in Colombia","author":"JA Naranjo-Mill\u00e1n","year":"2023","journal-title":"Int J Rheum Dis"},{"key":"pone.0309316.ref011","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1007\/s00296-021-04825-3","article-title":"Plasmacytoid dendritic cells and type I interferons in flares of systemic lupus erythematosus triggered by COVID-19","volume":"41","author":"N Nasser","year":"2021","journal-title":"Rheumatol Int"},{"key":"pone.0309316.ref012","unstructured":"ATIH. International Classification of Disease, 10th revision. Official reference document defining the coding used in the APHP data warehouse database. 2023. https:\/\/sante.gouv.fr\/fichiers\/bos\/2022\/2022.9bis.BOS.pdf"},{"key":"pone.0309316.ref013","unstructured":"ATIH. Classification commune des actes m\u00e9dicaux (CCAM). Official document defining the codes used in the APHP clinical data warehouse. 2023. https:\/\/www.atih.sante.fr\/sites\/default\/files\/public\/content\/4441\/ccam_descriptive_a_usage_pmsi_2023_version_provisoire.pdf"},{"key":"pone.0309316.ref014","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1002\/art.40930","article-title":"2019 EULAR\/ACR Classification Criteria for Systemic Lupus Erythematosus","volume":"71","author":"M Aringer","year":"2019","journal-title":"Arthritis Rheumatol Hoboken NJ"},{"key":"pone.0309316.ref015","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1080\/01621459.1989.10478874","article-title":"The Robust Inference for the Cox Proportional Hazards Model","volume":"84","author":"DY Lin","year":"1989","journal-title":"J Am Stat Assoc"},{"key":"pone.0309316.ref016","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A Proportional Hazards Model for the Subdistribution of a Competing Risk","volume":"94","author":"JP Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"key":"pone.0309316.ref017","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1111\/j.1523-1755.2004.00443.x","article-title":"The classification of glomerulonephritis in systemic lupus erythematosus revisited","volume":"65","author":"JJ Weening","year":"2004","journal-title":"Kidney Int"},{"key":"pone.0309316.ref018","doi-asserted-by":"crossref","first-page":"e452","DOI":"10.1016\/S2665-9913(20)30161-2","article-title":"COVID-19 and systemic lupus erythematosus: a case series","volume":"2","author":"Y Gartshteyn","year":"2020","journal-title":"Lancet Rheumatol"},{"key":"pone.0309316.ref019","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s13256-020-02582-8","article-title":"Systemic lupus erythematosus manifestation following COVID-19: a case report","volume":"15","author":"B Zamani","year":"2021","journal-title":"J Med Case Reports"},{"key":"pone.0309316.ref020","doi-asserted-by":"crossref","first-page":"4630","DOI":"10.1038\/s41598-021-84153-5","article-title":"Influenza infection as a trigger for systemic lupus erythematosus flares resulting in hospitalization","volume":"11","author":"YB Joo","year":"2021","journal-title":"Sci Rep"},{"key":"pone.0309316.ref021","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1002\/1529-0131(200105)44:5<1122::AID-ANR193>3.0.CO;2-D","article-title":"Systemic lupus erythematosus in adults is associated with previous Epstein-Barr virus exposure","volume":"44","author":"JA James","year":"2001","journal-title":"Arthritis Rheum"},{"key":"pone.0309316.ref022","doi-asserted-by":"crossref","first-page":"277","DOI":"10.3390\/v13020277","article-title":"Viral Infections and Systemic Lupus Erythematosus: New Players in an Old Story","volume":"13","author":"M Quaglia","year":"2021","journal-title":"Viruses"},{"key":"pone.0309316.ref023","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1038\/s41590-020-00814-z","article-title":"Extrafollicular B cell responses correlate with neutralizing antibodies and morbidity in COVID-19","volume":"21","author":"MC Woodruff","year":"2020","journal-title":"Nat Immunol"},{"key":"pone.0309316.ref024","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.immuni.2018.08.015","article-title":"Distinct Effector B Cells Induced by Unregulated Toll-like Receptor 7 Contribute to Pathogenic Responses in Systemic Lupus Erythematosus","volume":"49","author":"SA Jenks","year":"2018","journal-title":"Immunity"},{"key":"pone.0309316.ref025","doi-asserted-by":"crossref","first-page":"e582","DOI":"10.1016\/S2665-9913(22)00190-4","article-title":"Breakthrough SARS-CoV-2 infections, morbidity, and seroreactivity following initial COVID-19 vaccination series and additional dose in patients with SLE in New York City","volume":"4","author":"A Saxena","year":"2022","journal-title":"Lancet Rheumatol"},{"key":"pone.0309316.ref026","article-title":"Severely impaired humoral response against SARS-CoV-2 variants of concern following two doses of BNT162b2 vaccine in patients with systemic lupus erythematosus (SLE)","author":"A Mageau","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"pone.0309316.ref027","doi-asserted-by":"crossref","first-page":"102987","DOI":"10.1016\/j.jaut.2022.102987","article-title":"Impact of BNT162b2 mRNA anti-SARS-CoV-2 vaccine on interferon-alpha production by plasmacytoid dendritic cells and autoreactive T cells in patients with systemic lupus erythematosus: The COVALUS project","volume":"134","author":"A Mageau","year":"2023","journal-title":"J Autoimmun"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0309316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T17:22:27Z","timestamp":1728580947000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0309316"}},"subtitle":[],"editor":[{"given":"Sham","family":"Santhanam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,10,10]]},"references-count":27,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0309316","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,10]]}}}