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COVID-19 and Rheumatic Diseases

Year 2020, Volume: 22 Issue: Special Issue, 14 - 18, 30.11.2020
https://doi.org/10.18678/dtfd.788147

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infectious agent affecting respiratory system the most and spreads rapidly due to large number of ACE2 receptors in the lung. Arthralgia and myalgia are the most common rheumatologic findings, but arthritis is rare. Hyperinflammatory condition called cytokine storm causes acute respiratory distress syndrome (ARDS) leading to death. Although coronavirus disease 2019 (COVID-19) is mild or asymptomatic in most cases, it may progress to pneumonia and ARDS, especially in elderly patients who have comorbidities. Drugs such as tocilizumab which suppress inflammatory response and reduce cytokine storm may be effective on treating COVID-19 pneumonia. Cytokine storm, the cause of which is not fully understood and in which many structures of immune system interact with each other, is quite complex and has different mechanisms contributing to it. Although antimalarial drugs such as hydroxychloroquine are used in the treatment, there is no definite evidence that they are effective. It has been shown that the prevalence and course of COVID-19 in rheumatic diseases is similar to the general population, and that increasing age and additional comorbid conditions increase the risk of mortality. It is recommended that anti-rheumatic drugs used in the treatment of rheumatic diseases should not be stopped unless the patient is infected with COVID-19.

References

  • Ge H, Wang X, Yuan X, Xiao G, Wang C, Deng T, et al. The epidemiology and clinical information about COVID-19. Eur J Clin Microbiol Infect Dis. 2020;39(6):1011-9.
  • Schett G, Manger B, Simon D, Caporali R. COVID-19 revisiting inflammatory pathways of arthritis. Nat Rev Rheumatol. 2020:16(8):465-70.
  • Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet. 2020;395(10229):1014-5.
  • Pope JE. What does the COVID-19 pandemic mean for rheumatology patients? Curr Treatm Opt Rheumatol. 2020;[Epub ahead of print]. doi: 10.1007/s40674-020-00145-y.
  • Landewé RB, Machado PM, Kroon F, Biljsma HW, Burmester GR, Carmona L, et al. EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in context of SARS-CoV-2. Ann Rheum Dis. 2020;79(7):851-8.
  • Zhou D, Dai SM, Tong Q. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression. J Antimicrob Chemother. 2020;75(7):1667-70.
  • Misra DP, Agarwal V, Gasparyan AY, Zimba O. Rheumatologists’ perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets. Clin Rheumatol. 2020;39(7):2055-62.
  • Figueroa-Parra G, Aguirre-Garcia GM, Gambao-Alonso CM, Camacho-Ortiz A, Galarza-Delgado DA. Are my patients with rheumatic diseases at higher risk of COVID-19? Ann Rheum Dis. 2020;79(6):839-40.
  • Pablos JL, Abasolo L, Alvaro-Gracia JM, Blanco FJ, Blanco R, Castrejón I, et al. Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rhemuatic diseases. Ann Rheum Dis. 2020;79(9):1170-3.
  • Michelena X, Borrell H, López-Corbeto M, López-Lasanta M, Moreno E, Pascual-Pastor M, et al. Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic diseases-modifying anti-rheumatic drugs. Semin Arthritis Rheum. 2020;50(4):564-70.
  • Quartuccio L, Valent F, Pasut E, Tascini C, De Vita S. Prevalence of COVID-19 among patients with chronic inflammatory rheumatic diseases treated with biologic agents or small molecules: A population-based study in the first two months of COVID-19 outbreak in Italy. Joint Bone Spine. 2020;87(5):439-43.
  • Shah S, Danda D, Kavadichanda C, Das S, Adarsh MB, Negi VS. Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment. Rheumatol Int. 2020;40(10):1539-54.
  • López-González MD, Peral-Garrido ML, Calabuig I, Tovar-Sugrañes E, Jovani V, Bernabeu P, et al. Case series of acute arthritis during COVID-19 admission. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-217914.
  • Saricaoglu EM, Hasanoglu I, Guner R. The first reactive arthritis case associated with COVID-19. J Med Virol. 2020;[Epub ahead of print]. doi: 10.1002/jmv.26296.
  • Yokogawa N, Minematsu N, Katano H, Suzuki T. Case of acute arthritis following SARS-CoV-2 infection. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218281.
  • Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020;39(7):2085-94.
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
  • Blanco- Melo D, Nilsson-Payant BE, Liu WC, Uhl S, Hoagland D, Møller R, et al. Imbalanced host response to SARS-CoV-2 drives development of COVID 19. Cell. 2020;181(5):1036-45.
  • Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1):620-32.
  • Siddiqi HK, Mehra MR. COVID-19 illness in native and immunsuppressed states: A clinical-therapeutic stating proposal. J Heart Lung Transplant. 2020;39(5):405-7.
  • Joavani V, Calabuig I, Peral-Garrido ML, Tovar-Sugrañes E, López-González MD, Bernabeu P, et al. Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218152.
  • D’Silva KM, Serling-Boyd N, Wallwork R, Hsu T, Sparks JA, Wallace ZS. Response to: ‘Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors’ by Jovani et al. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218179.
  • Sangelli C, Gentile V, Tirri R, Macera M, Cappabianca S, Ciccia F, et al. Chronic conventional disease-modifying anti-rheumatic drugs masking severe SARS-CoV-2 manifestations in an elderly rheumatic patient. J Infect. 2020;[Epub ahead of print]. doi: 10.1016/j.jinf.2020.05.043.
  • Vakil-Gilani K, O’Rourke K. Are patients with rheumatologic diseases on chronic immunosuppressive therapy at lower risk of developing severe symptoms when infected with COVID-19? Clin Rheumatol. 2020;39(7):2067-8.
  • Gao ZW, Wang X, Lin F, Dong K. The correlation between SARS-CoV-2 infection and rheumatic diseases. Autoimmun Rev. 2020;19(7):102557.
  • Mikuls TR, Johnson SR, Fraenkel L, Arasaratnam JR, Baden LR, Bermas BL, et al. American College of Rheumatology Guidance for the management of rheumatic disease in adult patients during the COVID-19 pandemic: version 1. Arhtritis Rheumatol. 2020;[Epub ahead of print]. doi: 10.1002/art.41301.
  • Avouac J, Airó P, Carlier N, Matucci-Cerinic M, Allanore Y. Severe COVID-19-associated pneumonia in 3 patients with systemic sclerosis treated with rituximab. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-217864.
  • Sharmeen S, Elghawy A, Zarlasht F, Yao Q. COVID-19 in rheumatic disease patients on immunsuppressive agents. Semin Arthritis Rheum. 2020;50(4):680-6.
  • Fragoulis GE, Evangelatos G, Arida A, Bournia VK, Fragiadaki K, Karamanakos A, et al. Treatment adherence of patients with systemic rheumatic diseases in COVID-19 pandemic. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-217935.
  • Georgiev T. Coronavirus disease 2019 (COVID-19) and anti-rheumatic drugs. Rheumatol Int. 2020;40(5):825-6.
  • Favalli EG, De Lucia O, Biggioggero M, Del Papa N, Caporali R. Role of antimalarials in COVID-19: observational data from a cohort of rheumatic patients. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218068.
  • Ferner RE, Aronson JK. Chloroquine and hydroxychloroquine in COVID-19. BMJ. 2020;369:m1432. doi: 10.1136/bmj.m1432.
  • Toniati P, Piva S, Cattalini M, Garrafa E, Regola F, Castelli F, et al. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy. Autoimmun Rev. 2020;19(7):102568.
  • Pontali E, Volpi S, Antonucci G, Castellaneta M, Buzzi D, Tricerri F, et al. Safety and efficacy of early high-dose IV anakinra in severe COVID-19 lung disease. J Allergy Clin Immunol. 2020;146(1):213-5.
  • Russell B, Moss C, George G, Santaolalla A, Cope A, Papa S, et al. Associations between immune-suppressive and stimulating drugs and novel COVID-19-a systematic review of current evidence. Ecancermedicalscience. 2020;14:1022.
  • Prete M, Favoino E, Catacchio G, Racanelli V, Perosa F. SARS-CoV-2 infection complicated by inflammatory syndrome. Could high-dose human immunoglobulin for intravenous use (IVIG) be beneficial? Autoimmun Rev. 2020;19(7):102559.

COVID-19 ve Romatizmal Hastalıklar

Year 2020, Volume: 22 Issue: Special Issue, 14 - 18, 30.11.2020
https://doi.org/10.18678/dtfd.788147

Abstract

Şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) solunum sistemini en çok etkileyen ve akciğerdeki çok sayıda ACE2 reseptörü nedeniyle hızla yayılan bulaşıcı bir ajandır. Artralji ve miyalji en sık görülen romatolojik bulgulardır, ancak artrit nadirdir. Sitokin fırtınası adı verilen hiperinflamatuar durum, akut solunum sıkıntısı sendromu (acute respiratory distress syndrome, ARDS)’na neden olarak ölüme neden olur. Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) çoğu durumda hafif veya asemptomatik olmasına rağmen, özellikle ileri yaş ve komorbiditeleri olan hastalarda pnömoni ve ARDS'ye ilerleyebilir. Enflamatuar yanıtı baskılayan ve sitokin fırtınasını azaltan tosiluzumab gibi ilaçlar, COVID-19 pnömonisinin tedavisinde etkili olabilir. Nedeni tam olarak anlaşılamayan ve bağışıklık sistemindeki birçok yapının birbiriyle etkileşime girdiği sitokin fırtınası oldukça karmaşıktır ve buna katkıda bulunan farklı mekanizmalara sahiptir. Tedavide hidroksiklorokin gibi antimalaryal ilaçlar kullanılsa da etkili olduklarına dair kesin bir kanıt yoktur. Romatizmal hastalıklarda COVID-19 sıklığının ve seyrinin genel popülasyona benzer olduğu, artan yaş ve ek komorbid durumların mortalite riskini artırdığı gösterilmiştir. Romatizmal hastalıkların tedavisinde kullanılan anti-romatizmal ilaçların, hasta COVID-19 ile enfekte olmadıkça kesilmemesi önerilmektedir.

References

  • Ge H, Wang X, Yuan X, Xiao G, Wang C, Deng T, et al. The epidemiology and clinical information about COVID-19. Eur J Clin Microbiol Infect Dis. 2020;39(6):1011-9.
  • Schett G, Manger B, Simon D, Caporali R. COVID-19 revisiting inflammatory pathways of arthritis. Nat Rev Rheumatol. 2020:16(8):465-70.
  • Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet. 2020;395(10229):1014-5.
  • Pope JE. What does the COVID-19 pandemic mean for rheumatology patients? Curr Treatm Opt Rheumatol. 2020;[Epub ahead of print]. doi: 10.1007/s40674-020-00145-y.
  • Landewé RB, Machado PM, Kroon F, Biljsma HW, Burmester GR, Carmona L, et al. EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in context of SARS-CoV-2. Ann Rheum Dis. 2020;79(7):851-8.
  • Zhou D, Dai SM, Tong Q. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression. J Antimicrob Chemother. 2020;75(7):1667-70.
  • Misra DP, Agarwal V, Gasparyan AY, Zimba O. Rheumatologists’ perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets. Clin Rheumatol. 2020;39(7):2055-62.
  • Figueroa-Parra G, Aguirre-Garcia GM, Gambao-Alonso CM, Camacho-Ortiz A, Galarza-Delgado DA. Are my patients with rheumatic diseases at higher risk of COVID-19? Ann Rheum Dis. 2020;79(6):839-40.
  • Pablos JL, Abasolo L, Alvaro-Gracia JM, Blanco FJ, Blanco R, Castrejón I, et al. Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rhemuatic diseases. Ann Rheum Dis. 2020;79(9):1170-3.
  • Michelena X, Borrell H, López-Corbeto M, López-Lasanta M, Moreno E, Pascual-Pastor M, et al. Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic diseases-modifying anti-rheumatic drugs. Semin Arthritis Rheum. 2020;50(4):564-70.
  • Quartuccio L, Valent F, Pasut E, Tascini C, De Vita S. Prevalence of COVID-19 among patients with chronic inflammatory rheumatic diseases treated with biologic agents or small molecules: A population-based study in the first two months of COVID-19 outbreak in Italy. Joint Bone Spine. 2020;87(5):439-43.
  • Shah S, Danda D, Kavadichanda C, Das S, Adarsh MB, Negi VS. Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment. Rheumatol Int. 2020;40(10):1539-54.
  • López-González MD, Peral-Garrido ML, Calabuig I, Tovar-Sugrañes E, Jovani V, Bernabeu P, et al. Case series of acute arthritis during COVID-19 admission. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-217914.
  • Saricaoglu EM, Hasanoglu I, Guner R. The first reactive arthritis case associated with COVID-19. J Med Virol. 2020;[Epub ahead of print]. doi: 10.1002/jmv.26296.
  • Yokogawa N, Minematsu N, Katano H, Suzuki T. Case of acute arthritis following SARS-CoV-2 infection. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218281.
  • Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020;39(7):2085-94.
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
  • Blanco- Melo D, Nilsson-Payant BE, Liu WC, Uhl S, Hoagland D, Møller R, et al. Imbalanced host response to SARS-CoV-2 drives development of COVID 19. Cell. 2020;181(5):1036-45.
  • Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1):620-32.
  • Siddiqi HK, Mehra MR. COVID-19 illness in native and immunsuppressed states: A clinical-therapeutic stating proposal. J Heart Lung Transplant. 2020;39(5):405-7.
  • Joavani V, Calabuig I, Peral-Garrido ML, Tovar-Sugrañes E, López-González MD, Bernabeu P, et al. Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218152.
  • D’Silva KM, Serling-Boyd N, Wallwork R, Hsu T, Sparks JA, Wallace ZS. Response to: ‘Incidence of severe COVID-19 in a Spanish cohort of 1037 patients with rheumatic diseases treated with biologics and JAK-inhibitors’ by Jovani et al. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218179.
  • Sangelli C, Gentile V, Tirri R, Macera M, Cappabianca S, Ciccia F, et al. Chronic conventional disease-modifying anti-rheumatic drugs masking severe SARS-CoV-2 manifestations in an elderly rheumatic patient. J Infect. 2020;[Epub ahead of print]. doi: 10.1016/j.jinf.2020.05.043.
  • Vakil-Gilani K, O’Rourke K. Are patients with rheumatologic diseases on chronic immunosuppressive therapy at lower risk of developing severe symptoms when infected with COVID-19? Clin Rheumatol. 2020;39(7):2067-8.
  • Gao ZW, Wang X, Lin F, Dong K. The correlation between SARS-CoV-2 infection and rheumatic diseases. Autoimmun Rev. 2020;19(7):102557.
  • Mikuls TR, Johnson SR, Fraenkel L, Arasaratnam JR, Baden LR, Bermas BL, et al. American College of Rheumatology Guidance for the management of rheumatic disease in adult patients during the COVID-19 pandemic: version 1. Arhtritis Rheumatol. 2020;[Epub ahead of print]. doi: 10.1002/art.41301.
  • Avouac J, Airó P, Carlier N, Matucci-Cerinic M, Allanore Y. Severe COVID-19-associated pneumonia in 3 patients with systemic sclerosis treated with rituximab. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-217864.
  • Sharmeen S, Elghawy A, Zarlasht F, Yao Q. COVID-19 in rheumatic disease patients on immunsuppressive agents. Semin Arthritis Rheum. 2020;50(4):680-6.
  • Fragoulis GE, Evangelatos G, Arida A, Bournia VK, Fragiadaki K, Karamanakos A, et al. Treatment adherence of patients with systemic rheumatic diseases in COVID-19 pandemic. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-217935.
  • Georgiev T. Coronavirus disease 2019 (COVID-19) and anti-rheumatic drugs. Rheumatol Int. 2020;40(5):825-6.
  • Favalli EG, De Lucia O, Biggioggero M, Del Papa N, Caporali R. Role of antimalarials in COVID-19: observational data from a cohort of rheumatic patients. Ann Rheum Dis. 2020;[Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218068.
  • Ferner RE, Aronson JK. Chloroquine and hydroxychloroquine in COVID-19. BMJ. 2020;369:m1432. doi: 10.1136/bmj.m1432.
  • Toniati P, Piva S, Cattalini M, Garrafa E, Regola F, Castelli F, et al. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy. Autoimmun Rev. 2020;19(7):102568.
  • Pontali E, Volpi S, Antonucci G, Castellaneta M, Buzzi D, Tricerri F, et al. Safety and efficacy of early high-dose IV anakinra in severe COVID-19 lung disease. J Allergy Clin Immunol. 2020;146(1):213-5.
  • Russell B, Moss C, George G, Santaolalla A, Cope A, Papa S, et al. Associations between immune-suppressive and stimulating drugs and novel COVID-19-a systematic review of current evidence. Ecancermedicalscience. 2020;14:1022.
  • Prete M, Favoino E, Catacchio G, Racanelli V, Perosa F. SARS-CoV-2 infection complicated by inflammatory syndrome. Could high-dose human immunoglobulin for intravenous use (IVIG) be beneficial? Autoimmun Rev. 2020;19(7):102559.
There are 36 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Invited Review
Authors

Gezmiş Kimyon 0000-0003-3775-639X

Taşkın Duman 0000-0002-6552-4193

Publication Date November 30, 2020
Submission Date August 31, 2020
Published in Issue Year 2020 Volume: 22 Issue: Special Issue

Cite

APA Kimyon, G., & Duman, T. (2020). COVID-19 and Rheumatic Diseases. Duzce Medical Journal, 22(Special Issue), 14-18. https://doi.org/10.18678/dtfd.788147
AMA Kimyon G, Duman T. COVID-19 and Rheumatic Diseases. Duzce Med J. November 2020;22(Special Issue):14-18. doi:10.18678/dtfd.788147
Chicago Kimyon, Gezmiş, and Taşkın Duman. “COVID-19 and Rheumatic Diseases”. Duzce Medical Journal 22, no. Special Issue (November 2020): 14-18. https://doi.org/10.18678/dtfd.788147.
EndNote Kimyon G, Duman T (November 1, 2020) COVID-19 and Rheumatic Diseases. Duzce Medical Journal 22 Special Issue 14–18.
IEEE G. Kimyon and T. Duman, “COVID-19 and Rheumatic Diseases”, Duzce Med J, vol. 22, no. Special Issue, pp. 14–18, 2020, doi: 10.18678/dtfd.788147.
ISNAD Kimyon, Gezmiş - Duman, Taşkın. “COVID-19 and Rheumatic Diseases”. Duzce Medical Journal 22/Special Issue (November 2020), 14-18. https://doi.org/10.18678/dtfd.788147.
JAMA Kimyon G, Duman T. COVID-19 and Rheumatic Diseases. Duzce Med J. 2020;22:14–18.
MLA Kimyon, Gezmiş and Taşkın Duman. “COVID-19 and Rheumatic Diseases”. Duzce Medical Journal, vol. 22, no. Special Issue, 2020, pp. 14-18, doi:10.18678/dtfd.788147.
Vancouver Kimyon G, Duman T. COVID-19 and Rheumatic Diseases. Duzce Med J. 2020;22(Special Issue):14-8.