Augmentation of COVID-19’s Neurological Impact in Patients with Subacute Cutaneous Lupus Erythematosus

Summary: Introduction: SARS-CoV-2 infection has a well-documented history of inducing various neurologic impairments including disorientation, memory loss, and psychosis. Subacute cutaneous lupus erythematosus (SCLE) is an autoimmune disease associated with similar manifestations, often triggered by exogenous stress factors. An increased frequency of SCLE neurological reports may be accounted for by assessing infection with COVID-19. This study examines whether a history of SCLE can exacerbate the neuropsychological outcomes associated with COVID-19 infection. Methodology/Design: We utilized the TriNetX national database to access contemporaneous, multi-institutional patient data. Patients diagnosed with COVID-19, identified using ICD-10 codes, were stratified into cohorts based on the presence or absence of a documented history of SCLE. To control for demographic and comorbidity confounders, we employed a 1:1 propensity score matching (PSM) algorithm. The relative risk (RR) of developing psychiatric complications within one year following a COVID-19 diagnosis was evaluated in both cohorts, with 95% confidence intervals (CI). Summary: The initial query of COVID-19 yielded 3,738,010 patients: SCLE was noted in 939. Following PSM, 854 patients were assessed for major depression, substance abuse, insomnia, anxiety, psychosis, disorientation and amnesia. The results revealed a risk difference of 23.468% ([20.323%, 26.613%]), risk ratio of 2.347 ([2.173,2.534]), and odds ratio of 3.278 (2.878,3.734), indicating that SCLE patients, when exposed to COVID-19, have an increased risk of experiencing at least one of the aforementioned neuropsychological complications. Limitations of study: This study is based on the assumption that every case of SCLE was accurately reported. Given the diagnostic difficulty of SCLE and its similarities to other ailments, this limitation could slightly alter the statistical power of the study; however, given the sample size, effects would be minimal. Conclusion: Patients with a history of SCLE are at significantly heightened risk of developing neuropsychological complications within one year following COVID-19 infection.