El inicio del nuevo coronavirus humano del síndrome respiratorio agudo grave (SARS-CoV-2) en Wuhan, China, ha desencadenado un brote respiratorio mundial (COVID-19). El síndrome de insuficiencia respiratoria agua, el fallo multiorgánico y los eventos trombóticos están entre las causas que llevan a la muerte en pacientes críticamente enfermos con COVID-19. Las citocinas inflamatorias elevadas sugieren que una «tormenta de citocinas», también conocida como síndrome de liberación de citocinas, puede desempeñar un papel principal en la patología de la COVID-19. Adicionalmente al tratamiento antiviral y la terapia de apoyo respiratorio en pacientes críticamente enfermos, están en investigación medicamentos únicos para esta condición. En esta revisión sintetizamos la evidencia más actual de opciones terapéuticas, incluyendo anticuerpos anticitocinas como una estrategia intermedia para la terapia de SARS-CoV-2.
The novel SARS-CoV-2 human coronavirus in Wuhan, China, has triggered a worldwide respiratory disease outbreak (COVID-19). Acute respiratory distress syndrome (ARDS), multiorgan dysfunction and thrombotic events are among the leading causes of death in critically ill patients with COVID-19. The elevated inflammatory cytokines suggest that a “cytokine storm”, also known as cytokine release syndrome (CRS), may play a major role in the pathology of COVID-19. In addition to anti-viral therapy and supportive treatment in critically ill patients, unique medications for this condition are also under investigation. Here we reviewed therapeutic options, including the antibody therapy that might be an immediate strategy for SARS-CoV-2 therapy.
BackgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystemic involvement. Gastrointestinal (GI) manifestations are frequent in patients with SLE, but functional gastrointestinal disorders (FGIDs), a heterogeneous group of GI diseases have hardly been evaluated in SLE patients.ObjectivesWe evaluated the prevalence of FGIDs in SLE patients compared with age-matched controls and the role of potential risk factors for FGIDs.MethodsSLE patients who met the ACR classification criteria for SLE and age-matched controls completed the Rome III questionnaire to assess the prevalence of FGIDs. Exclusion criteria were organic gastrointestinal disorders. Patients completed a structured interview to assess sociodemographic, clinical and treatment variables. Logistic multivariate analysis was performed to determine potential clinical factors (alcohol ingestion and medications) for FGIDS.ResultsThe study responders included 116 SLE patients and 122 controls. The prevalence of FGIDs was higher in SLE patients than in controls (74.1% vs. 54.1%; p= 0.01). The most frequent FGIDs were nausea and vomiting disorders, belching disorders and globus pharyngeus. Anorectal disorders, mainly anorectal pain, were more frequent in SLE patients than controls (14.7% vs. 5.7%). After adjusting for confounding variables, SLE was associated with globus pharyngeus (OR: 3.5, 95%CI: 1.3-9.3), functional heartburn (OR: 2.5, 95% CI: 1.5-4.4), nausea and vomiting disorders (OR 7.1, 95% CI 2.7-19.1) and anorectal disorders (OR: 3.4, 95% CI 1.4-8.4). Overlap symptoms were present in 69.8% of patients vs. 31.8% of controls. When only SLE patients were evaluated, glucocorticoid therapy and non-steroidal anti-inflammatory drugs (NSAIDs) were associated with any FGID and functional bowel disorders, while alcohol ingestion was associated with gallbladder and sphincter of Oddi disorders.ConclusionThere is a higher prevalence of FGIDs in patients with SLE and a wider distribution of various GI tract symptoms compared with controls. Medication that may alter gastrointestinal homeostasis, such as NSAIDs and protein pump inhibitors, were associated with FGIDs in SLE patients. Disclosure of InterestsNone declared
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