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Artículos científicos sobre 
COVID-19 y enfermedades reumatológicas

  • Rheumatologists’ perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets

 

Abstract: The ongoing pandemic coronavirus disease 19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a matter of global concern. Environmental factors such as air pollution and smoking and comorbid conditions (hypertension, diabetes mellitus and underlying cardio-respiratory illness) likely increase the severity of COVID-19. Rheumatic manifestations such as arthralgias and arthritis may be prevalent in about a seventh of individuals. COVID-19 can result in acute interstitial pneumonia, myocarditis, leucopenia (with lymphopenia) and thrombocytopenia, also seen in rheumatic diseases like lupus and Sjogren’s syndrome. Descargar artículo.

  • Are my patients with rheumatic diseases at higher risk of COVID-19?

 

Abstract: According to the last WHO situation report (10 March 2020), the novel Coronavirus disease 2019 (COVID-19) has been confirmed in 113702 patients, most of them in China (71.1%) and the rest in other 109 countries, with a global case-fatality rate (CFR) of 3.5% (4012 deaths among 113702 confirmed cases).1 Most patients have presented with fever, dry cough and fatigue, about 81% of cases reported in China have been classified as mild, 14% severe and 5% critical, the higher CFR has been observed among older patients and with comorbid conditions (cardiovascular disease, diabetes, chronic respiratory disease, hypertension, cancer, etc).2 To our knowledge none of the fatal cases reported has been associated with rheumatic diseases. Descargar artículo.

  • Therapies used in rheumatology with relevance to coronavirus disease 2019 

 

Abstract: With the ongoing coronavirus disease 2019 (COVID-19) pandemic and growing evidence suggesting a role for some drugs commonly used in the context of rheumatic diseases, both colleagues and patients are coming to us with questions about these claims. Despite the fact that evidence is still scarce, it is pertinent to be able to address these queries in light of our previous experience in handling these prescriptions and take part in the multidisciplinary care of COVID-19 patients. Descargar artículo.

  • COVID-19: the new challenge for rheumatologists

 

Abstract: On Saturday, March 21, 2020 two articles on coronavirus disease 2019 (COVID-19) were submitted to Clinical and Experimental Rheumatology: a review by the colleagues from Milan, summarising the current knowledge on this new disease, and a letter on the same topic from Portugal (1, 2). We have given these articles top priority not only because of their topic, but also because the review was submitted by the principal hotspot in Italy (and probably in the world in this moment) where the epidemic is more serious. This article testifes that our colleagues, although on the forefront at the bedside of their patients, also wanted to share their expertise with scientists all over the world to help identify potential solutions. Descargar artículo.

  • COVID-19 infection and rheumatoid arthritis: Faraway, so close!

 

Abstract: The outbreak of the new coronavirus infections COVID-19 in December 2019 in China has quickly become a global health emergency. Given the lack of specific anti-viral therapies, the current management of severe acute respiratory syndrome coronaviruses (SARS-CoV-2) is mainly supportive, even though several compounds are now under investigation for the treatment of this life-threatening disease. COVID-19 pandemic is certainly conditioning the treatment strategy of a complex disorder as rheumatoid arthritis (RA), whose infectious risk is increased compared to the general population because of an overall impairment of immune system typical of autoimmune diseases combined with the iatrogenic effect generated by corticosteroids and immunosuppressive drugs.. Descargar artículo.

  • Associations between immune-suppressive and stimulating drugs and novel COVID-19—a systematic review of current evidence

 

Abstract: The COVID-19 pandemic has led to challenging decision-making about treatment of critically unwell patients. Low-dose prednisolone and tacrolimus may have beneficial impacts on COVID-19. The mycophenolate mofetil picture is less clear, with conflicting data from pre-clinical studies. There is no definitive evidence that specific cytotoxic drugs, low-dose methotrexate for auto-immune disease, NSAIDs, JAK kinase inhibitors or anti-TNFα agents are contraindicated. There is clear evidence that IL-6 peak levels are associated with severity of pulmonary complications. Descargar artículo.

• Base de datos internacional sobre Covid-19 y enfermedades reumáticas: www.rheum-covid.org/langages

  • SARS-CoV-2 antibody response after COVID-19 in patients with rheumatic disease

 

The impacts of rheumatic disease and immunosuppression on the development of antibodies to SARS-CoV-2 are unknown. A study of healthcare workers showed that detectable SARS-CoV-2 antibodies were associated with reduced risk of SARS-CoV-2 reinfection, and the robustness of this neutralising antibody response has implications for seroprevalence studies and vaccine efficacy... Descargar artículo.

  • A multidisciplinary registry of patients with autoimmune and immune-mediated diseases with symptomatic COVID-19 from a single center

 

Abstract: Background and aim: There is increasing interest regarding SARS-CoV-2 infection in patients with autoimmune and immune-mediated inflammatory diseases (AI/IMID) with some discrepancies in different cohorts about their risk and outcomes. The aim was to describe a multidisciplinary cohort of patients with AI/IMID and symptomatic SARS-CoV-2 infection in a single tertiary center and analyze sociodemographic, clinical, and therapeutic factors associated with poor outcomes.... Descargar artículo.

  • Recommendations for coronavirus infection in rheumatic diseases treated with biologic therapy

 

Abstract: The Coronavirus-associated disease, that was first identified in 2019 in China (CoViD-19), is a pandemic caused by a bat-derived beta-coronavirus, named SARS-CoV2. It shares homology with SARS and MERS-CoV, responsible for past outbreaks in China and in Middle East. SARS-CoV2 spread from China where the first infections were described in December 2019 and is responsible for the respiratory symptoms that can lead to acute respiratory distress syndrome. A cytokine storm has been shown in patients who develop fatal complications, as observed in past coronavirus infections...Descargar artículo.

  • Characteristics associated with Covid-19 in patients with Rheumatic Disease in Latin America

 

Objectivo: Comparar las características de los pacientes con enfermedades reumáticas y COVID-19 reportados en América Latina con aquellos del resto del mundo.

 

Método: Los pacientes del COVID-19 Global Rheumatology Alliance Physician-Reported Registry fueron incluidos. Se examinaron las características demográficas, características de las enfermedades reumáticas, comorbilidades, diagnóstico de COVID-19 y tratamiento, así como desenlaces...Descargar artículo.

  • High levels of immunosuppression are related to unfavourable outcomes in hospitalised patients with rheumatic diseases and COVID-19: first results of ReumaCoV Brasil registry

 

Abstract: Objectives: To evaluate risk factors associated with unfavourable outcomes: emergency care, hospitalisation, admission to intensive care unit (ICU), mechanical ventilation and death in patients with immune-mediated rheumatic disease (IMRD) and COVID-19.

 

Methods: Analysis of the first 8weeks of observational multicentre prospective cohort study (ReumaCoV Brasil register). Patients with IMRD and COVID-19 according to the Ministry of Health criteria were classified as...Descargar artículo.

  • Recommendations for coronavirus infection in rheumatic diseases treated with biologic therapy

​

Abstract: The Coronavirus-associated disease, that was first identified in 2019 in China (CoViD-19), is a pandemic caused by a bat-derived beta-coronavirus, named SARS-CoV2. It shares homology with SARS and MERS-CoV, responsible for past outbreaks in China and in Middle East. SARS-CoV2 spread from China where the first infections were described in December 2019 and is responsible for the respiratory symptoms that can lead to acute respiratory distress syndrome Descargar artículo.

  • Epigenetic dysregulation of ACE2 and interferon-regulated genes might suggest increased COVID-19 susceptibility and severity in lupus patients

 

Abstract: Infection caused by SARS-CoV-2 can result in severe respiratory complications and death. Patients with a compromised immune system are expected to be more susceptible to a severe disease course. In this report we suggest that patients with systemic lupus erythematous might be especially prone to severe COVID-19 independent of their immunosuppressed state from lupus treatment. Specially, we provide evidence in lupus to suggest hypomethylation and overexpression of ACE2, which is located on the X chromosome and encodes a functional receptor for the SARS-CoV-2 spike glycoprotein. Oxidative stress induced by viral infections exacerbates the DNA methylation defect in lupus, possibly resulting in further ACE2 hypomethylation and enhanced viremia. Descargar artículo.

  • Potential of chloroquine and hydroxychloroquine to treat COVID-19 causes fears of shortages among people with systemic lupus erythematosus

 

Abstract: In March 2020, in the midst of the COVID-19 pandemic1 , reports that chloroquine (CQ) can inhibit the growth of severe acute respiratory syndrome coronavirus (SARS-CoV-2)2,3 have brought this molecule into the spotlight. Hydroxychloroquine (HCQS), which is typically used in dermatology clinics for the management of systemic lupus erythematosus (SLE) and has a better clinical safety profile and fewer drug–drug interactions than CQ, has also been demonstrated to have anti-SARSCoV activity in vitro2,4 . Now, amid the speculation regarding the beneficial roles of these molecules in COVID-19 treatment, shortages of CQ and HCQS are feared Descargar artículo.

  • Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies

 

Abstract: Different viral agents are associated with an increased risk of more severe disease course and respiratory complications in immunocompromised patients.1–3 The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) responsible for a severe acute respiratory syndrome (SARS) represents a source of concern for the management of patients with inflammatory rheumatic diseases.. Descargar artículo.

  • The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The experience of clinical immunologists from China

 

Abstract: The pandemic outbreak of coronavirus disease 2019 (COVID-19) is rapidly spreading all over the world. Reports from China showed that about 20% of patients developed severe disease, resulting in a fatality of 4%. In the past two months, we clinical immunologists participated in multi-rounds of MDT (multidiscipline team) discussion on the anti-inflammation management of critical ill COVID-19 patients, with our colleagues dispatched from Chinese leading PUMC Hospital to Wuhan to admit and treat the most severe patients. Here, from the perspective of clinical immunologists, we will discuss the clinical and immunological characteristics of severe patients, and summarize the current evidence and share our experience in anti-inflammation treatment, including glucocorticoids, IL-6 antagonist, JAK inhibitors and choloroquine/hydrocholoroquine, of patients with severe COVID-19 that may have an impaired immune system. Descargar artículo.

  • American College of Rheumatology Guidance for the Management of Adult Patients with Rheumatic Disease During the COVID-19 Pandemic

 

Abstract: The task force approved 77 initial guidance statements, 36 with moderate and 41 with high consensus. These were combined, resulting in 25 final guidance statements. These guidance statements are provided to promote optimal care during the current pandemic. However, given the low level of available evidence and the rapidly evolving literature, this guidance is presented as a “living document” and future updates are anticipated. Descargar artículo.

  • COVID-19 and Systemic Lupus Erythematosus: Focus on Immune Response and Therapeutics

 

The SARS-CoV-2 novel coronavirus has caused the COVID-19 pandemic with over 35 million cases and over a million deaths worldwide as of early October 2020. The populations most affected are the elderly and especially those with underlying comorbidities. In terms of race and ethnicity, black and hispanic populations are affected at disproportionately higher rates. Individuals with underlying conditions that cause an immune-compromised state are considered vulnerable to this infection. The immune response is an important determinant in viral infections including coronaviruses, not only in the antiviral defense but also in the disease progression, severity, and clinical outcomes of COVID-19... Descargar artículo.

  • Managing rheumatic diseases during COVID-19

 

Abstract: Rheumatology practice, during Coronavirus Disease 2019 (COVID-19) pandemic, has faced multifaceted challenges. Rheumatologists routinely prescribe immunosuppressant medications to their patients with multisystem autoimmune rheumatic diseases who are concerned about the increased risk of acquiring COVID-19 infection and are anxious to know if they should continue or hold these medications. Rheumatologists are often inundated by calls from their patients and physician colleagues caring for COVID-19 patients in hospitals, about how to manage the immunosuppression... Descargar artículo.

  • What is the true incidence of COVID-19 in patients with rheumatic diseases?

 

After its emergence in December 2019 in Wuhan, China, the COVID-19 outbreak has now one of its main epicentres in Lombardy (Italy), with more than 50000 confirmed cases and 9000 deaths. As rheumatologists operating in the same pandemic area (Milan), we read with great interest the letter published by Monti and colleagues about the description of COVID-19 among patients with rheumatic diseases treated with biologic disease-modifying drugs (bDMARDs)...Descargar artículo.

  • Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry

 

Abstract: Objectives: COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease. Methods:  Case series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed...Descargar artículo.

  • Public interest in rheumatic diseases and rheumatologist in the United States during the COVID‑19 pandemic: evidence from Google Trends

 

Abstract: To evaluate the public interest in rheumatic diseases during the coronavirus disease 2019 (COVID-19) pandemic. Google Trends was queried to analyze search trends in the United States for numerous rheumatic diseases and also the interest in a rheumatologist. Three 8-week periods in 2020 ((March 15–May 9), (May 10–July 4), and (July 5–August 29)) were compared to similar periods of the prior 4 years (2016–2019)...Descargar artículo.

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