COVID-19 in a patient with a flare of systemic lupus erythematosus: A rare case-report

Abdulrahman Alharthy; Fahad Faqihi; Nasir Nasim; Alfateh Noor; Saima Akhtar; Ahmed Balshi; Abdullah Balhamar; Saleh A Alqahtani; Ziad A Memish; Dimitrios Karakitsos

doi:10.1016/j.rmcr.2020.101252

COVID-19 in a patient with a flare of systemic lupus erythematosus: A rare case-report

Respir Med Case Rep. 2020:31:101252. doi: 10.1016/j.rmcr.2020.101252. Epub 2020 Oct 15.

Authors

Affiliations

¹ Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
² Department of Medicine, The Johns Hopkins University Hospital, Baltimore, MD, USA.
³ Research & Innovation Centre, King Saud Medical City, Riyadh, Saudi Arabia.
⁴ Department of Internal Medicine, South Carolina University, School of Medicine, Columbia, SC, USA.

Abstract

This is a rare case-report of a young female with systemic lupus erythematosus and end-stage kidney disease (on maintenance hemodialysis) who was admitted to our intensive care unit due to life-threatening COVID-19. The patient was diagnosed with a flare of lupus; while being on maintenance hydroxychloroquine therapy. However, after the administration of steroids she made an uneventful recovery and was discharged home. In this report, the diagnostic dilemmas and the therapeutic challenges due to the overlapping clinical, imaging, and laboratory findings between lupus and COVID-19 pneumonitis are outlined. In conclusion, patients with lupus may be affected by COVID-19 despite the administration of hydroxychloroquine. The administration of steroids may have a beneficial effect on mitigating both the flare of SLE and the COVID-19 associated hyperinflammation.

Keywords: Acute respiratory failure; COVID-19; End-stage kidney disease; Hydroxychloroquine; Steroid therapy; Systemic lupus erythematosus.

Publication types

Case Reports