COVID-19 in a patient with severe asthma using mepolizumab

Aksu, Kurtuluş; Yeşilkaya, Selma; Topel, Musa; Türkyılmaz, Süleyman; Erçelebi, Dilek Çuhadar; Öncül, Ali; Kalkan, İlkay Koca; Ateş, Hale

doi:10.2500/aap.2021.42.200125

Cited by 26 publications

(19 citation statements)

References 10 publications

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“…However, a study conducted in the Netherlands revealed a poor outcome of COVID-19 in asthma patients treated with biologicals ( 51 ). Single case reports for asthma patients treated with Omalizumab ( 81 ), Mepolizumab ( 82 ) and Benralizumab ( 83 ) have been reported with a good outcome of COVID-19. Noticeably, a severe asthma patient treated with dupilumab presented with modest antibody response against SARS-CoV-2 ( 84 ), suggesting that further studies are needed to elucidate the safety of dupilumab during COVID-19.…”

Section: Asthma and Covid-19mentioning

confidence: 99%

The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19

Gao

Agache

Akdiş

et al. 2021

International Immunology

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The coronavirus disease 2019 (COVID-19) pandemic causes an overwhelming number of hospitalization and deaths with a significant socioeconomic impact. The vast majority of studies indicate that asthma and allergic diseases do not represent a risk factor for COVID-19 susceptibility nor cause a more severe course of disease. This raises the opportunity to investigate the underlying mechanisms of the interaction between an allergic background and SARS-CoV-2 infection. The majority of patients with asthma, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, food and drug allergies exhibit an overexpression of type 2 immune and inflammatory pathways with the contribution of epithelial cells, innate lymphoid cells (ILC), dendritic cells, T cells, eosinophils, mast cells, basophils and the type 2 cytokines interleukin (IL)-4, IL-5, IL-9, IL-13, and IL-31. The potential impact of type 2 inflammation-related allergic diseases on susceptibility to COVID-19 and severity of its course have been reported. In this review, the prevalence of asthma and other common allergic diseases in COVID-19 patients is addressed. Moreover, the impact of allergic and non-allergic asthma with different severity and control status, currently available asthma treatments such as inhaled and oral corticosteroids, short- and long-acting β2 agonists, leukotriene receptor antagonists and biologicals on the outcome of COVID-19 patients is reviewed. In addition, possible protective mechanisms of asthma and type 2 inflammation on COVID-19 infection, such as the expression of SARS-CoV-2 entry receptors, antiviral activity of eosinophils, cross-reactive T cell epitopes are discussed. Potential interactions of other allergic diseases with COVID-19 are postulated, including recommendations for their management.

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Section: Asthma and Covid-19mentioning

confidence: 99%

The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19

Gao

Agache

Akdiş

et al. 2021

International Immunology

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“… 59 Aksu et al also reported the case of a COVID-19 severe asthma patient on mepolizumab who had mild disease. 60 Bhalla et al reported the case of a patient on dupilumab who had mild COVID-19. 61 …”

Section: Resultsmentioning

confidence: 99%

Understanding and Managing Severe Asthma in the Context of COVID-19

Cardoso¹,

Ribeiro²,

Aguiar³

et al. 2021

ITT

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Coronavirus disease 2019 (COVID-19) continues to spread across the world. Since the beginning of the pandemic, the question of whether asthma is a risk factor for getting the infection or for poor outcomes motivated a great debate. In the field of severe asthma and its treatment during COVID-19 pandemic, several issues are also pending. A literature review focused on the management of severe asthma patients in the context of COVID-19 is performed. The available evidence suggests that severe asthma patients do not have an increased risk of poor COVID-19 outcomes and that it is safe to treat asthmatic patients with inhaled corticosteroids (ICS) and biologics during the pandemic, even though some studies indicate that high doses of ICS may predispose to COVID-19. The chronic use of oral corticosteroid (OCS) might be associated with poor COVID-19 outcomes, although there is no complete agreement. There is very limited evidence concerning the use of triple therapy for asthma in the context of this pandemic. Ultimately, severe asthma patients should maintain their medication during the COVID-19 pandemic, including biologic agents. More studies are needed to address the role of asthma medications and asthma’s different phenotypes on the incidence and course of COVID-19.

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“…However, the results of some experimental infection models are difficult to align with observations of controlled studies of eosinophil-depleting anti-IL-5/5R biologics in humans, which do not appear to show increased rates of viral, bacterial, or helminth infections [5,6]. Moreover, although eosinopenia has been frequently observed in hospitalised patients with coronavirus disease 2019 (COVID-19) and has been linked to patient outcomes [32], emerging data indicate no increase in hospital admissions for COVID-19 amongst patients with asthma receiving eosinophil-depleting biologic therapies [33][34][35][36][37]. In fact, a potential beneficial effect in terms of a milder course of disease has been postulated for some patients.…”

Section: Physiologic Roles Of Eosinophilsmentioning

confidence: 99%

Eosinophils and eosinophilic immune dysfunction in health and disease

2022

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The functions ascribed to eosinophils have classically been limited to host defence against certain parasitic infections and potentially deleterious effects in the setting of specific diseases that are associated with elevated eosinophil counts in blood and/or tissue. The ability to induce eosinophil depletion either experimentally in animal models or through targeted therapies in humans has extended our understanding of the roles played by eosinophils in health and homeostasis as well as in disease pathogenesis. When associated with human disease aetiology, the eosinophil takes on a pathogenic rather than a protective role. This maladaptive response, called “eosinophilic immune dysfunction” herein, appears central to exacerbation pathogenesis and disease control in severe asthma and may be involved in the aetiology of other eosinophil-related conditions ranging from organ-system-limited diseases such as phenotypic subsets of chronic obstructive pulmonary disease and chronic rhinosinusitis with nasal polyposis to more broadly systemic diseases such as eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome. In this review, we describe the evidence supporting eosinophilic functions related to health and homeostasis and explore the contribution of eosinophilic immune dysfunction to human disease.

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COVID-19 in a patient with severe asthma using mepolizumab

Cited by 26 publications

References 10 publications

The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19

The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19

Understanding and Managing Severe Asthma in the Context of COVID-19

Eosinophils and eosinophilic immune dysfunction in health and disease

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