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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".