Mild Clinical Presentation of COVID-19 in Childhood FMF Patients Treated with Colchicine

Abstract

Aim: Clinical trials continue for several medical protocols for COVID-19. Colchicine is an anti-inflammatory agent that is highly used medicament for autoimmune disorders, including Familial Mediterranean Fever (FMF). Based on immunity disrupting the pathogenesis of SARS-CoV-2, we aimed to describe the clinical course of SARS-CoV-2 infection in patients with childhood-onset FMF on colchicine treatment. Material and Methods: We prepared a survey investigating contact histories, and clinical presentation of childhood-onset FMF patients treated with colchicine and questioned their parents via phone calls or during outpatient visits. In addition, medical record history, treatment, and medication history were obtained from the hospital database. Results: A total of 171 patients, 99 (57.9%) male and 72 (42.1%) female, diagnosed with FMF and who have been under colchicine treatment for at least one month were included in the study. Among patients, 56 (32.7%) have contact with a confirmed COVID-19 case; 43 (25.1%) have suspected family member contact and 13 (7.6%) have non-family contact. Only 15 (8.8%) FMF patients treated with colchicine were PCR diagnosed with COVID-19 disease; all had mild symptoms, none required antiviral treatment, and none were hospitalized. The dose and duration of colchicine use did not significantly differ between the patients with confirmed COVID or not (p=0.112, and p=0.344, respectively). Conclusion: We concluded that pediatric patients with FMF receiving colchicine treatment may not be at increased risk for being infected with SARS-CoV-2 or the severe symptoms of COVID-19.

Keywords

• Children
• COVID-19
• Familial Mediterranean Fever
• Colchicine
• Treatment

Kolşisin ile Tedavi Edilen Çocukluk Çağı FMF Hastalarında COVID-19'un Hafif Klinik Seyri

Abstract

Amaç: Etkin COVID-19 tedavisi için çeşitli tıbbi protokoller oluşturmak adına klinik çalışmalar devam etmektedir. Kolşisin, Ailevi Akdeniz Ateşi (AAA) de dahil olmak üzere otoimmün hastalıklar için yüksek oranda kullanılan bir anti-enflamatuar ajandır. SARS-CoV-2'nin bağışıklığı bozan patogenezine dayanarak, amacımız kolşisin tedavisi gören çocukluk çağı başlangıçlı AAA hastalarında SARS-CoV-2 enfeksiyonunun klinik seyrini tanımlamaktır. Gereç ve Yöntemler: Kolşisin ile tedavi edilen çocukluk çağı başlangıçlı AAA hastalarının temas öykülerini ve klinik tablolarını araştıran bir anket hazırlandı ve ebeveynlerini telefon görüşmeleri veya poliklinik ziyaretleri sırasında sorgulandı. Ayrıca hastane veri tabanından tıbbi kayıt geçmişi, tedavi ve ilaç geçmişi elde edildi. Bulgular: AAA tanısı konmuş ve en az bir aydır kolşisin tedavisi altında olan, 99 (%57,9) erkek ve 72 (%42,1) kadın olmak üzere toplam 171 hasta bu çalışmaya dahil edilmiştir. Hastaların 43'ünün (%25,1) şüpheli aile üyesi teması ve 13'ünün (%7,6) aile dışı teması olmak üzere 56'sının (%32,7) doğrulanmış bir COVID-19 vakası ile teması vardı. Kolşisin ile tedavi edilen AAA hastalarının sadece 15'ine (%8,8) PCR ile COVID-19 hastalığı tanısı konmuştur; hepsinde hafif semptomlar görülmüş, hiçbiri antiviral tedavi gerektirmemiş ve hiçbiri hastaneye yatırılmamıştır. Kolşisin kullanım dozu ve süresi, COVID tanısı olan ve olmayan hastalar arasında anlamlı farklılık göstermedi (sırasıyla p=0,112 ve p=0,344). Sonuç: Kolşisin tedavisi alan AAA'lı pediatrik hastaların SARS-CoV-2 ile enfekte olması veya bu hastalarda COVID-19'un şiddetli semptomlarının görülebilmesi açısından yüksek riskte olmadığını düşünebiliriz.

Keywords

• Ailevi Akdeniz Ateşi
• COVID-19
• Çocuklar
• Kolşisin
• Tedavi

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