Full Papers
Association of influenza infection with hospitalisation-related systemic lupus erythematosus flares: a time series analysis
Y.B. Joo1, Y.-H. Lim2, K.-J. Kim3, K.-S. Park4, Y.-J. Park5
- Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Denmark.
- Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. jwas@catholic.ac.kr
CER13618
2021 Vol.39, N°5
PI 1056, PF 1062
Full Papers
PMID: 33124567 [PubMed]
Received: 27/05/2020
Accepted : 14/09/2020
In Press: 27/10/2020
Published: 31/08/2021
Abstract
OBJECTIVES:
This study aimed to investigate whether the influenza annual outbreak in Korea is related to hospitalisation-related flares in systemic lupus erythematosus (SLE) patients.
METHODS:
The weekly frequency of hospitalisation-related SLE flares (2012-2015) was collected from the Korean National Health Insurance claim database. The weekly laboratory-confirmed detection rate of influenza infection was obtained from the Korea Centers for Disease Control and Prevention database. A generalised linear model was used to examine the relative risks (RRs) of hospitalisation-related SLE flares associated with influenza infection, after adjusting for time trends and meteorological data.
RESULTS:
A total of 2,223 hospitalisation-related SLE flares were analysed. An interquartile range (24.5%) increase in influenza infection was associated with a 14.0% increase in hospitalisation-related SLE flares (RR, 1.14; 95% confidence interval [CI]: 1.04–1.25; p=0.006). In addition, influenza infections at lag 0–1 (over 2 weeks including concurrent and 1 previous week) and lag 0–2 (over 3 weeks including concurrent and 2 previous weeks) were associated with increase in hospitalisation-related SLE flares (RR, 1.14; 95% confidence interval [CI]: 1.03–1.26; p=0.014 and RR, 1.13; 95% CI: 1.02–1.26; p=0.023). Significant associations were especially observed in women (RR, 1.15; 95% CI: 1.15–1.16; p=0.006) and immunosuppressant (RR, 1.26; 95% CI: 1.26–1.27; p<0.001) or glucocorticoid recipients (RR, 1.17, 95% CI: 1.16–1.17; p=0.004).
CONCLUSIONS:
This study shows a significant association between seasonal influenza infection and flares in SLE patients, which suggests influenza can be a novel environmental risk factor for SLE flares.