Official websites use. Share sensitive information only on official, secure websites. Correspondence to: Edward R. E-mail: edr. For commercial re-use, please contact journals. We conducted a systematic review and meta-analysis to determine the magnitude of infection risk in patients with SLE and evaluate the effect of general and SLE-related factors on infection risk.
Random-effects models were used to calculate pooled risk ratios RRs for each type of infection. Sensitivity analysis assessed the impact of removing studies with high risk of bias.
Heterogeneity and evidence of publication bias were present for all analyses, except herpes zoster. Sensitivity analyses confirmed robustness of the results. Efforts to strengthen strategies aimed at preventing infections in SLE are needed. Pooled risk for overall severe infections is 3. SLE is a chronic autoimmune disease that affects multiple organ systems, leading to a variety of clinical manifestations [ 1 ]. Increased disease activity, characterized by recurrent and unpredictable flares, can occur in patients with SLE and may be associated with organ damage and increased mortality [ 2 ].
SLE is associated with increased comorbidities [ 3 ], which may result from disease activity and CS use [ 4 ]. Infections are the leading cause of morbidity and mortality in patients with SLE [ 5 , 6 ].
One-third of SLE-related deaths are attributable to an infectious organism [ 5 , 9 ]. Bacterial infections are the most common aetiological agent in SLE. In the same study, the most frequent infection sites were the respiratory tract Although many bacterial infections are more prevalent in patients with SLE than in healthy people, the causal organisms do not vary from the general population and include pathogens such as Staphylococcus aureus , Streptococcus pneumonia and Escherichia coli [ 12 ].
