The COVID-19 pandemic has spread across New York City, NY, USA, affecting more than 150 000 of its 8· 5 million inhabitants as of April 26, 2020. 1 Severe illness resulting in hypoxemic respiratory failure, believed to be the result of uncontrolled inflammation coupled with a reduced and dysfunctional lymphocyte response, occurs in 5% of cases. 2 Systemic lupus erythematosus (SLE) is an autoimmune disease characterised by autoantibodies, inflammation, and lymphopenia. The condition is frequently treated with hydroxychloroquine or chloroquine, both of which are being tested in the treatment of COVID-19. 3 It remains unclear whether patients with SLE are at increased risk of COVID-19 or if there is a paradoxical protective effect due to, in part, hydroxychloroquine use. Patients with SLE comprise

17% of the COVID-19 Global Rheumatology Alliance registry as of April 1, 2020. 4 Although two series5, 6 reported that patients with chronic arthritis receiving immunosuppressants had low rates of severe disease from COVID-19 (0–2%), another series by Mathian and colleagues7 described 17 patients with SLE, of whom 7 (35%) required mechanical methods of ventilation or extracorporeal membrane oxygenation. To our knowledge, this is the first case series to report the characteristics and clinical course of COVID-19 in patients with SLE in the USA. 18 patients diagnosed with SLE on the basis of the revised classification criteria by the American College of Rheumatology8 had confirmed or clinically suspected COVID-19 infection. 16 of these patients were identified from the Columbia Lupus