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Erschienen in: Current Rheumatology Reports 2/2021

29.01.2021 | COVID-19 | Systemic Lupus Erythematosus (G Tsokos, Section Editor) Zur Zeit gratis

SARS-CoV-2 and Systemic Lupus Erythematosus

verfasst von: Aikaterini Thanou, Amr H. Sawalha

Erschienen in: Current Rheumatology Reports | Ausgabe 2/2021

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Abstract

Purpose of Review

To summarize current knowledge of the impact of coronavirus disease 19 (COVID-19) on patients with systemic lupus erythematosus (SLE).

Recent Findings

Several observational studies, including case series, patient surveys, and patient registries, have examined the incidence and severity of COVID-19 in patients with SLE. Due to methodologic limitations (focus on sicker patients, exclusion of asymptomatic or mild cases, limited or inaccurate viral testing), it is difficult to determine the risk and outcomes of COVID-19 in SLE patients. Corticosteroids might be associated with increased hospitalizations from COVID-19 in individuals with autoimmune rheumatic diseases. Some immune suppressive treatments do not appear to significantly increase the risk of contracting COVID-19 or poor subsequent outcomes; however, data on the safety of specific drugs remain scarce. Studies in non-autoimmune cohorts have shown more severe COVID-19 in ethnic and racial minorities, populations also more heavily impacted by SLE. Such results have been attributed to highly prevalent socioeconomic disparities and comorbidities. The complex interplay between SARS-CoV-2 and the host immunologic milieu may have particular implications for patients with SLE that remain to be explored. Concerns have been raised of COVID-19 heightening the risk of thromboembolic events in the presence of an SLE-induced procoagulant state.

Summary

Limitations in epidemiologic data available to date do not allow for assessing the risk and severity of COVID-19 in patients with SLE. Other than corticosteroids, prior use of some immune suppressive medications does not appear to increase the risk for infection with SARS-CoV-2 however, more comprehensive studies are needed.
Literatur
20.
Zurück zum Zitat Mantovani Cardoso E, Hundal J, Feterman D, Magaldi J. Concomitant new diagnosis of systemic lupus erythematosus and COVID-19 with possible antiphospholipid syndrome. Just a coincidence? A case report and review of intertwining pathophysiology. Clin Rheumatol. 2020. https://doi.org/10.1007/s10067-020-05310-1. Mantovani Cardoso E, Hundal J, Feterman D, Magaldi J. Concomitant new diagnosis of systemic lupus erythematosus and COVID-19 with possible antiphospholipid syndrome. Just a coincidence? A case report and review of intertwining pathophysiology. Clin Rheumatol. 2020. https://​doi.​org/​10.​1007/​s10067-020-05310-1.
30.
Zurück zum Zitat Gendebien Z, von Frenckell C, Ribbens C, Andre B, Thys M, Gangolf M, et al. Systematic analysis of COVID-19 infection and symptoms in a systemic lupus erythematosus population: correlation with disease characteristics, hydroxychloroquine use and immunosuppressive treatments. Ann Rheum Dis. 2020:annrheumdis-2020-218244. https://doi.org/10.1136/annrheumdis-2020-218244. Gendebien Z, von Frenckell C, Ribbens C, Andre B, Thys M, Gangolf M, et al. Systematic analysis of COVID-19 infection and symptoms in a systemic lupus erythematosus population: correlation with disease characteristics, hydroxychloroquine use and immunosuppressive treatments. Ann Rheum Dis. 2020:annrheumdis-2020-218244. https://​doi.​org/​10.​1136/​annrheumdis-2020-218244.
35.
Zurück zum Zitat • Fernandez-Ruiz R, Masson M, Kim MY, Myers B, Haberman RH, Castillo R, et al. Leveraging the United States epicenter to provide insights on COVID-19 in patients with systemic lupus erythematosus. Arthritis Rheumatol. 2020. https://doi.org/10.1002/art.41450Prospective cohort study of systematically collected patients with SLE and confirmed or suspected COVID-19 from New York City. • Fernandez-Ruiz R, Masson M, Kim MY, Myers B, Haberman RH, Castillo R, et al. Leveraging the United States epicenter to provide insights on COVID-19 in patients with systemic lupus erythematosus. Arthritis Rheumatol. 2020. https://​doi.​org/​10.​1002/​art.​41450Prospective cohort study of systematically collected patients with SLE and confirmed or suspected COVID-19 from New York City.
36.
Zurück zum Zitat • Gianfrancesco M, Hyrich KL, Al-Adely S, Carmona L, Danila MI, Gossec L, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2020;79(7):859–66. https://doi.org/10.1136/annrheumdis-2020-217871Compreheinsive report of 600 patients with AIRDs and confirmed or suspected COVID-19 from the Global Rheumatology Alliance Registry.CrossRefPubMed • Gianfrancesco M, Hyrich KL, Al-Adely S, Carmona L, Danila MI, Gossec L, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2020;79(7):859–66. https://​doi.​org/​10.​1136/​annrheumdis-2020-217871Compreheinsive report of 600 patients with AIRDs and confirmed or suspected COVID-19 from the Global Rheumatology Alliance Registry.CrossRefPubMed
40.
Zurück zum Zitat Favalli EG, Monti S, Ingegnoli F, Balduzzi S, Caporali R, Montecucco C. Incidence of COVID-19 in patients with rheumatic diseases treated with targeted immunosuppressive drugs: what can we learn from observational data? Arthritis Rheum. 2020;72:1600–6. https://doi.org/10.1002/art.41388.CrossRef Favalli EG, Monti S, Ingegnoli F, Balduzzi S, Caporali R, Montecucco C. Incidence of COVID-19 in patients with rheumatic diseases treated with targeted immunosuppressive drugs: what can we learn from observational data? Arthritis Rheum. 2020;72:1600–6. https://​doi.​org/​10.​1002/​art.​41388.CrossRef
45.
Zurück zum Zitat Haberman RH, Castillo R, Chen A, Yan D, Ramirez D, Sekar V, et al. COVID-19 in patients with inflammatory arthritis: a prospective study on the effects of comorbidities and DMARDs on clinical outcomes. Arthritis Rheum. 2020;72:1981–9. https://doi.org/10.1002/art.41456.CrossRef Haberman RH, Castillo R, Chen A, Yan D, Ramirez D, Sekar V, et al. COVID-19 in patients with inflammatory arthritis: a prospective study on the effects of comorbidities and DMARDs on clinical outcomes. Arthritis Rheum. 2020;72:1981–9. https://​doi.​org/​10.​1002/​art.​41456.CrossRef
47.
Zurück zum Zitat • D'Silva KM, Serling-Boyd N, Wallwork R, Hsu T, Fu X, Gravallese EM, et al. Clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) and rheumatic disease: a comparative cohort study from a US 'hot spot'. Ann Rheum Dis. 2020. https://doi.org/10.1136/annrheumdis-2020-217888Cohort study of patients with AIRD and COVID-19 matched to non-AIRD comparators from a large heathcare system in the greater Boston area. • D'Silva KM, Serling-Boyd N, Wallwork R, Hsu T, Fu X, Gravallese EM, et al. Clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) and rheumatic disease: a comparative cohort study from a US 'hot spot'. Ann Rheum Dis. 2020. https://​doi.​org/​10.​1136/​annrheumdis-2020-217888Cohort study of patients with AIRD and COVID-19 matched to non-AIRD comparators from a large heathcare system in the greater Boston area.
52.
Zurück zum Zitat Gómez-Puerta JA, Barbhaiya M, Guan H, Feldman CH, Alarcón GS, Costenbader KH. Racial/ethnic variation in all-cause mortality among United States Medicaid recipients with systemic lupus erythematosus: a Hispanic and Asian paradox. Arthritis Rheum. 2015;67(3):752–60. https://doi.org/10.1002/art.38981.CrossRef Gómez-Puerta JA, Barbhaiya M, Guan H, Feldman CH, Alarcón GS, Costenbader KH. Racial/ethnic variation in all-cause mortality among United States Medicaid recipients with systemic lupus erythematosus: a Hispanic and Asian paradox. Arthritis Rheum. 2015;67(3):752–60. https://​doi.​org/​10.​1002/​art.​38981.CrossRef
55.
Zurück zum Zitat Scheetz MH, Konig MF, Robinson PC, Sparks JA, Kim AHJ. A pharmacokinetics-informed approach to navigating hydroxychloroquine shortages in patients with rheumatic disease during the COVID-19 pandemic. ACR Open Rheumatol. 2020. https://doi.org/10.1002/acr2.11164. Scheetz MH, Konig MF, Robinson PC, Sparks JA, Kim AHJ. A pharmacokinetics-informed approach to navigating hydroxychloroquine shortages in patients with rheumatic disease during the COVID-19 pandemic. ACR Open Rheumatol. 2020. https://​doi.​org/​10.​1002/​acr2.​11164.
56.
Zurück zum Zitat Mendel A, Bernatsky S, Askanase A, Bae SC, Clarke AE, Costedoat-Chalumeau N, et al. Hydroxychloroquine shortages among patients with systemic lupus erythematosus during the COVID-19 pandemic: experience of the Systemic Lupus International Collaborating Clinics. Ann Rheum Dis. 2020:annrheumdis-2020-218164. https://doi.org/10.1136/annrheumdis-2020-218164. Mendel A, Bernatsky S, Askanase A, Bae SC, Clarke AE, Costedoat-Chalumeau N, et al. Hydroxychloroquine shortages among patients with systemic lupus erythematosus during the COVID-19 pandemic: experience of the Systemic Lupus International Collaborating Clinics. Ann Rheum Dis. 2020:annrheumdis-2020-218164. https://​doi.​org/​10.​1136/​annrheumdis-2020-218164.
60.
Zurück zum Zitat Konig MF, Gianfrancesco M, Yazdany J, Robinson PC. Patients with systemic lupus erythematosus using hydroxychloroquine or chloroquine develop severe COVID-19 at similar frequency as patients not on antimalarials: need to explore antithrombotic benefits for COVID-19 coagulopathy. Response to: 'Clinical course of COVID-19 in patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine' by Carbillon et al. Ann Rheum Dis. 2020. https://doi.org/10.1136/annrheumdis-2020-217990. Konig MF, Gianfrancesco M, Yazdany J, Robinson PC. Patients with systemic lupus erythematosus using hydroxychloroquine or chloroquine develop severe COVID-19 at similar frequency as patients not on antimalarials: need to explore antithrombotic benefits for COVID-19 coagulopathy. Response to: 'Clinical course of COVID-19 in patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine' by Carbillon et al. Ann Rheum Dis. 2020. https://​doi.​org/​10.​1136/​annrheumdis-2020-217990.
63.
Zurück zum Zitat • Mikuls TR, Johnson SR, Fraenkel L, Arasaratnam RJ, 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 2. Arthritis Rheumatol. 2020. https://doi.org/10.1002/art.41437Guidelines by the ACR on the management of patients with AIRDs during COVID-19. • Mikuls TR, Johnson SR, Fraenkel L, Arasaratnam RJ, 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 2. Arthritis Rheumatol. 2020. https://​doi.​org/​10.​1002/​art.​41437Guidelines by the ACR on the management of patients with AIRDs during COVID-19.
66.
Zurück zum Zitat Pereira MR, Mohan S, Cohen DJ, Husain SA, Dube GK, Ratner LE, et al. COVID-19 in solid organ transplant recipients: initial report from the US epicenter. Am J Transplant Off J Am Soc Transplant Am Soc Transplant Surg. 2020;20(7):1800–8. https://doi.org/10.1111/ajt.15941.CrossRef Pereira MR, Mohan S, Cohen DJ, Husain SA, Dube GK, Ratner LE, et al. COVID-19 in solid organ transplant recipients: initial report from the US epicenter. Am J Transplant Off J Am Soc Transplant Am Soc Transplant Surg. 2020;20(7):1800–8. https://​doi.​org/​10.​1111/​ajt.​15941.CrossRef
67.
Zurück zum Zitat Wallace DJ, Ginzler EM, Merrill JT, Furie RA, Stohl W, Chatham WW, et al. Safety and efficacy of belimumab plus standard therapy for up to thirteen years in patients with systemic lupus erythematosus. Arthritis Rheum. 2019;71(7):1125–34. https://doi.org/10.1002/art.40861.CrossRef Wallace DJ, Ginzler EM, Merrill JT, Furie RA, Stohl W, Chatham WW, et al. Safety and efficacy of belimumab plus standard therapy for up to thirteen years in patients with systemic lupus erythematosus. Arthritis Rheum. 2019;71(7):1125–34. https://​doi.​org/​10.​1002/​art.​40861.CrossRef
Metadaten
Titel
SARS-CoV-2 and Systemic Lupus Erythematosus
verfasst von
Aikaterini Thanou
Amr H. Sawalha
Publikationsdatum
29.01.2021
Verlag
Springer US
Schlagwort
COVID-19
Erschienen in
Current Rheumatology Reports / Ausgabe 2/2021
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-020-00973-w

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