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Estimation of the burden of shielding among a cross-section of patients attending rheumatology clinics with SLE-data from the BSR audit of systemic lupus erythematosus

Rutter, Megan; Lanyon, Peter C; Sandhu, Ravinder; Batten, Rebecca L; Garner, Rozeena; Little, Jayne; Narayan, Nehal; Sharp, Charlotte A; Bruce, Ian N; Erb, Nicola; Griffiths, Bridget; Guest, Hannah; Macphie, Elizabeth; Packham, Jon; Hiley, Chris; Obrenovic, Karen; Rivett, Ali; Gordon, Caroline; Pearce, Fiona A.

Estimation of the burden of shielding among a cross-section of patients attending rheumatology clinics with SLE-data from the BSR audit of systemic lupus erythematosus Thumbnail


Authors

Megan Rutter

Peter C Lanyon

Ravinder Sandhu

Rebecca L Batten

Rozeena Garner

Jayne Little

Nehal Narayan

Charlotte A Sharp

Ian N Bruce

Nicola Erb

Bridget Griffiths

Hannah Guest

Elizabeth Macphie

Jon Packham

Chris Hiley

Karen Obrenovic

Ali Rivett

Caroline Gordon

FIONA PEARCE Fiona.Pearce@nottingham.ac.uk
Clinical Associate Professor



Abstract

Objectives: We aimed to estimate what proportion of people with SLE attending UK rheumatology clinics would be categorized as being at high risk from coronavirus disease 2019 (COVID-19) and therefore asked to shield, and explore what implications this has for rheumatology clinical practice. Methods: We used data from the British Society for Rheumatology multicentre audit of SLE, which included a large, representative cross-sectional sample of patients attending UK Rheumatology clinics with SLE. We calculated who would receive shielding advice using the British Society for Rheumatology's risk stratification guidance and accompanying scoring grid, and assessed whether ethnicity and history of nephritis were over-represented in the shielding group. Results: The audit included 1003 patients from 51 centres across all 4 nations of the UK. Overall 344 (34.3%) patients had a shielding score ≥3 and would have been advised to shield. People with previous or current LN were 2.6 (1.9-3.4) times more likely to be in the shielding group than people with no previous LN (P < 0.001). Ethnicity was not evenly distributed between the groups (chi-squared P < 0.001). Compared with White people, people of Black ethnicity were 1.9 (1.3-2.8) and Asian 1.9 (1.3-2.7) times more likely to be in the shielding group. Increased risk persisted after controlling for LN. Conclusion: Our study demonstrates the large number of people with SLE who are likely to be shielding. Implications for clinical practice include considering communication across language and cultural differences, and ways to conduct renal assessment including urinalysis, during telephone and video consultations for patients who are shielding.

Citation

Rutter, M., Lanyon, P. C., Sandhu, R., Batten, R. L., Garner, R., Little, J., …Pearce, F. A. (2021). Estimation of the burden of shielding among a cross-section of patients attending rheumatology clinics with SLE-data from the BSR audit of systemic lupus erythematosus. Rheumatology, 60(3), 1474-1479. https://doi.org/10.1093/rheumatology/keaa620

Journal Article Type Article
Acceptance Date Jul 31, 2020
Online Publication Date Oct 14, 2020
Publication Date Mar 1, 2021
Deposit Date Nov 25, 2020
Publicly Available Date Oct 15, 2021
Journal Rheumatology
Print ISSN 1462-0324
Electronic ISSN 1462-0332
Peer Reviewed Peer Reviewed
Volume 60
Issue 3
Pages 1474-1479
DOI https://doi.org/10.1093/rheumatology/keaa620
Keywords systemic lupus erythematosus, infection, COVID-19, coronavirus, health services, epidemiology, shielding
Public URL https://nottingham-repository.worktribe.com/output/4974264
Publisher URL https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaa620/5923176
Additional Information This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Rutter, M., Lanyon, P. C., Sandhu, R., Batten, R. L., Garner, R., Little, J., …Pearce, F. A. (2020). Estimation of the burden of shielding among a cross-section of patients attending rheumatology clinics with SLE—data from the BSR audit of systemic lupus erythematosus. Rheumatology, https://doi.org/10.1093/rheumatology/keaa620 is available online at: https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaa620/5923176.

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