Introduction/objectives To evaluate the impact of BA.5.2/BF.7 infections on the severity of systemic lupus erythematosus (SLE) and to identify associated risk factors. Methods A cross-sectional study was conducted from January 6 to February 19, 2023. The study population included SLE patients and healthy controls infected with the BA.5.2/BF.7 variants. Odds ratios (ORs), risk differences (RDs), and their corresponding 95% confidence intervals (CIs) were calculated to assess the effects of infection on SLE severity and to explore related risk factors. Results A total of 1,013 SLE patients and 2,125 healthy controls who were infected with BA.5.3/BF.7 were enrolled in the study. After adjusting for age, sex, comorbidities, and vaccination status, SLE was significantly associated with an increased risk of COVID-19 hospitalization (adjusted OR [aOR] 6.13, 95% confidence interval [CI] 3.06 to 12.27, p < 0.001). Among SLE patients, COVID-19 infection was associated with an increased risk of rash (risk difference [RD] 4.0%, 95% CI 1.5 to 6.6; p = 0.002), alopecia (RD 4.2%, 95% CI 0.9 to 7.6; p = 0.016), and mucosal ulcers (RD 3.3%, 95% CI 0.8 to 5.7; p = 0.012). Among SLE patients, the use of mycophenolate mofetil (MMF) was significantly associated with an increased risk of COVID-19 hospitalization (aOR 1.99, 95% CI 1.06 to 3.74; p = 0.033). Conclusions These findings highlight the importance of a nuanced approach in managing SLE patients with COVID-19. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="justify" colname="c1" colnum="1" /> <colspec align="justify" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> Key Points • The COVID-19 pandemic spread widely across China. However, the impact of systemic lupus erythematosus (SLE) medications on COVID-19-related hospitalization remains unclear. • Our study found that treatment with mycophenolate mofetil in SLE patients was associated with a higher risk of hospitalization for COVID-19. • These findings should alert policymakers and clinicians to the need for a more nuanced and cautious approach when managing SLE patients infected with the Omicron BA.5.2 or BF.7 subvariants. </entry> </row> </tbody> </tgroup> </Table>

Mycophenolate mofetil associates with COVID-19 hospitalization in patients with systemic lupus erythematosus: a nationwide population-based study from China

期刊论文
发表日期：

2026年4月6日

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Sitian Zang,
Ruihe Liu,
Liang Luo,
Yi Li,
Yan Wang,
Jing Li,
Bo Huang,
Ranran Yao,
Yipeng Han,
Chun Li,
Zhanguo Li

摘要

Introduction/objectives

To evaluate the impact of BA.5.2/BF.7 infections on the severity of systemic lupus erythematosus (SLE) and to identify associated risk factors.

Methods

A cross-sectional study was conducted from January 6 to February 19, 2023. The study population included SLE patients and healthy controls infected with the BA.5.2/BF.7 variants. Odds ratios (ORs), risk differences (RDs), and their corresponding 95% confidence intervals (CIs) were calculated to assess the effects of infection on SLE severity and to explore related risk factors.

Results

A total of 1,013 SLE patients and 2,125 healthy controls who were infected with BA.5.3/BF.7 were enrolled in the study. After adjusting for age, sex, comorbidities, and vaccination status, SLE was significantly associated with an increased risk of COVID-19 hospitalization (adjusted OR [aOR] 6.13, 95% confidence interval [CI] 3.06 to 12.27, p < 0.001). Among SLE patients, COVID-19 infection was associated with an increased risk of rash (risk difference [RD] 4.0%, 95% CI 1.5 to 6.6; p = 0.002), alopecia (RD 4.2%, 95% CI 0.9 to 7.6; p = 0.016), and mucosal ulcers (RD 3.3%, 95% CI 0.8 to 5.7; p = 0.012). Among SLE patients, the use of mycophenolate mofetil (MMF) was significantly associated with an increased risk of COVID-19 hospitalization (aOR 1.99, 95% CI 1.06 to 3.74; p = 0.033).

Conclusions

These findings highlight the importance of a nuanced approach in managing SLE patients with COVID-19.

Key Points

• The COVID-19 pandemic spread widely across China. However, the impact of systemic lupus erythematosus (SLE) medications on COVID-19-related hospitalization remains unclear.

• Our study found that treatment with mycophenolate mofetil in SLE patients was associated with a higher risk of hospitalization for COVID-19.

• These findings should alert policymakers and clinicians to the need for a more nuanced and cautious approach when managing SLE patients infected with the Omicron BA.5.2 or BF.7 subvariants.