A Systemic Lupus Erythematosus Incidence Surveillance Report Among DoD Beneficiaries During the COVID-19 Pandemic

Concerns have been raised regarding the potential for COVID-19 infection to precipitate the development of systemic lupus erythematosus (SLE). This surveillance analysis was conducted to determine the incidence of SLE among US Department of Defense (DoD) beneficiaries before and during the COVID-19 pandemic.

Outpatient encounters, private sector care records, and laboratory data from January 1, 2018, through December 31, 2022, were analyzed. Data from 2017 were used to exclude previously diagnosed cases. Inpatient data also were excluded. Positive lupus cases were identified through a combination of laboratory results and relevant International Classification of Diseases, 10th Revision, Clinical Modification diagnostic codes.

A consistent decrease in SLE incidence was observed during the COVID-19 pandemic, with total cases declining from 2866 in 2018 to 1399 in 2022 among DoD health care beneficiaries. The mean annual decline of 16.0% and an overall reduction of 48.2% from 2018 to 2022 displayed consistent patterns across subgroups stratified by sex, age, and beneficiary type.

The results of this study do not show an increase in SLE incidence among DoD beneficiaries during the COVID-19 pandemic. These findings suggest that the mitigation strategies implemented within the DoD to reduce COVID-19 transmission may have contributed to this trend. Further research is warranted to monitor SLE incidence over time, with attention to broader environmental changes and shifting patterns of common infections.