ANALYSIS OF PULMONARY COMPLICATIONS IN SLE PATIENTS WITH AND WITHOUT COVID-19: A NATIONAL INPATIENT STUDY
Bibliographic record
Abstract
PV051 / #529 Poster Topic: AS06 - Comorbidities Background/Purpose While respiratory failure in Systemic Lupus Erythematosus (SLE) patients with Coronavirus Disease 2019 (COVID-19) is well-documented, the spectrum of acute pulmonary complications compared to SLE patients without COVID-19 remains incompletely characterized. We aimed to analyze rates and predictors of acute pulmonary complications between these groups. Methods Using the 2021 National Inpatient Sample, we identified adult SLE patients (n=170,085) and stratified by COVID-19 status. Primary outcomes included pulmonary embolism (PE) and mechanical ventilation. We employed survey-weighted logistic regression to calculate adjusted odds ratios (aOR) comparing SLE patients with vs without COVID-19. Results Of 170,085 hospitalized SLE patients, 12,710 (7.47%) had COVID-19 and 157,375 (92.53%) did not. PE rates were higher in SLE patients with COVID-19 vs those without (9.52% vs 8.64%, p = 0.0013). After adjustment, COVID-19 remained associated with increased PE risk (aOR 1.12, 95% CI 0.97-1.30, p = 0.126). Mechanical ventilation rates were substantially higher in the COVID-19 group (11.25% vs 2.76%, p < 0.001), with an aOR of 4.87 (95% CI 4.22-5.62, p < 0.001). Within the COVID-19 group, risk factors for PE included African American vs Caucasian race (29.50% vs 48.03%, aOR 1.37, 95% CI 1.24-1.51, p < 0.001), obesity (31.94% vs 22.23%, aOR 1.32, 95% CI 1.09-1.51, p = 0.015), and severe comorbidity burden (41.03% vs 9.87%, aOR 4.20, 95% CI 3.51-5.03, p < 0.001). Among SLE patients with COVID-19 who developed PE, intensive care admission rates were higher (42.8% vs 28.3%, p < 0.001), and hospital length of stay was longer (11.2 vs 8.1 days, p < 0.001) compared to those without PE. Conclusions This analysis demonstrates significantly higher rates of acute pulmonary complications in SLE patients with COVID-19 compared to those without, particularly regarding mechanical ventilation needs. The increased PE risk in COVID-19 patients, especially in certain demographic groups, suggests the need for enhanced thromboprophylaxis protocols in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".