Article Text

Download PDFPDF

LP-068 The challenges in the management of systemic lupus erythematosus during the 3rd wave of COVID19 pandemic in Sri Lanka: a single-centre experience
  1. Chathurika Dandeniya
  1. Department of Medicine, University of Peradeniya, SrLanka


Background COVID19 pandemic likely has had significant influence on the presentation, management and outcome of Systemic Lupus Erythematosus (SLE). A single-centre experience of managing SLE during the 3rd wave of COVID19 pandemic in Sri Lanka is presented.

Methods New and follow up patients with SLE seen at Peradeniya University Teaching Hospital from the 1st of July to the 31st of August 2021 were audited. Those with moderate to severe disease (assessed by British Isles Lupus Assessment Groups 2004/BILAG score1) requiring intensification of immunosuppression, were identified. Possible effects of the pandemic on the clinical presentation, and treatment outcome were assessed.

Results Of 45 patients with SLE seen during this period, eleven had moderate to severe flares (female:male 10:1). Four were new diagnoses during the study period. Of the seven follow-up patients, six had well-controlled disease over the preceding 24 months, while one had intermittent flares.

9 out of 11 patients were BILAG-A in at least one domain and two were BILAG-B. All needed aggressive immunosuppression. Remission was induced in ten patients while one succumbed to severe disease and sepsis.

In 72.7% of patients (n=8), effects of COVID19 were evident. These were possible causal association (n=1), disease flare concomitant with COVID19 infection (n=2), COVID19 complicating immunosuppression (n=1) and delayed presentation leading to requirement of aggressive immunosuppression (n=4).

Conclusions Diagnosing and managing SLE is challenging due to variable clinical presentation, multi-system involvement and complex treatment decisions.2 The on-going pandemic has increased these challenges several-fold. COVID19 probably has a causative relationship with autoimmune disease.3 Delayed presentation can cause unfavourable outcomes during the pandemic.

  • Systemic Lupus Erythematosus
  • COVID19
  • effects of pandemic

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.