COVID-19 outbreak is currently being concerned for managing patients with immunological disorders nowadays, including SLE. Lupus is a complex autoimmune disease characterized by the presence of autoantibodies that against cell nucleus involved many organs in the body. Patients with SLE will increase risk of severe infection because the intrinsic respond attack with their immune respond though immunosuppressive drugs consumption, and will potentially damage some organs target associated with their disease. Lupus have multiple clinical manifestations with a fluctuating symptom. Patient who come with the symptom ofbreathlessness will getworse day by day. The symptom could be felt in the same time as fatigue, joint pain, hair loss, malar rash, oral ulcer, pleural effusion and swollen feet. There's a patient with antinuclear antibody positive for anti-smith and anti-Ro/SS-A. She was diagnosed with COVID-19, SLE with nephritis, haemolytic anemia, vasculitis and pleural effusions. The clinical manifestations of this patient indicate a COVID-19 with lupus nephritis that has severe disease. She was being treated with methylprednisolone and hydroxychloroquine for SLE and azithromycin plus oseltamivir as a therapy for COVID-19. The effect of hydroxychloroquine on SARS-CoV-2 was better seen in patients with SLE who gotthe medication regularly. Patients went home after 24 days of hospitalization after negative RT-PCR results and clinical improvement of LES.
COVID-19 in lupus nephritis