Rheumatology and COVID-19 at 1 year: facing the unknowns

Calabrese, Leonard H.; Winthrop, Kevin

doi:10.1136/annrheumdis-2021-219957

Cited by 13 publications

(8 citation statements)

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“…For example the time needed for the full panel of symptoms to arise (1-2 weeks), coincides with the time needed for the production of autoantibodies (220,221). Persistence of these autoantibodies and/or the accompanying inflammation after the resolution of the acute phase of COVID-19 has also been proposed as a possible mechanism leading to the so-called "long-COVID" (222)(223)(224). On the other hand, it is of interest, that, some of the main drugs used in patients hospitalized with COVID-19 (like corticosteroids, IL6 inhibitors, Jak inhibitors etc.)…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Immunobiology: Lessons Learned, New Questions Arise

et al. 2021

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There is strong evidence that COVID-19 pathophysiology is mainly driven by a spatiotemporal immune deregulation. Both its phenotypic heterogeneity, spanning from asymptomatic to severe disease/death, and its associated mortality, are dictated by and linked to maladaptive innate and adaptive immune responses against SARS-CoV-2, the etiologic factor of the disease. Deregulated interferon and cytokine responses, with the contribution of immune and cellular stress-response mediators (like cellular senescence or uncontrolled inflammatory cell death), result in innate and adaptive immune system malfunction, endothelial activation and inflammation (endothelitis), as well as immunothrombosis (with enhanced platelet activation, NET production/release and complement hyper-activation). All these factors play key roles in the development of severe COVID-19. Interestingly, another consequence of this immune deregulation, is the production of autoantibodies and the subsequent development of autoimmune phenomena observed in some COVID-19 patients with severe disease. These new aspects of the disease that are now emerging (like autoimmunity and cellular senescence), could offer us new opportunities in the field of disease prevention and treatment. Simultaneously, lessons already learned from the immunobiology of COVID-19 could offer new insights, not only for this disease, but also for a variety of chronic inflammatory responses observed in autoimmune and (auto)inflammatory diseases.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Immunobiology: Lessons Learned, New Questions Arise

et al. 2021

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“…Очевидно, что для более глубокого понимания эффективности и безопасности вакцинации больных ИВРЗ против SARS-CoV-2 необходимы специальные исследования [161,162]. Существенный вклад могут внести материалы международного регистра EULAR COVAX database (https://www.eular.org/eular_covid19_database.cfm), целью которого является сбор данных об эффективности и переносимости вакцинации у пациентов с ИВРЗ.…”

Section: Discussionunclassified

Coronavirus Disease 2019 (COVID-19) and Immune-mediated Rheumatic Diseases. Recommendations of the Association of Rheumatologists of Russia

Насонов

Лила

Мазуров

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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In mid-2021, the SARS-CoV-2 (Severe Acute Respiratory coronavirus 2) infection, which caused the coronavirus disease (COVID-19) pandemic, affected more than 157 million people in all regions of the world and led to more than 3.2 million deaths. It is assumed that elderly age, uncontrolled inflammation, anti-inflammatory therapy, comorbid pathology, genetic and other factors can potentially lead to an increase in “sensitivity” to viral and bacterial infections, including SARS-CoV-2. The new version of the recommendations of the Association of Rheumatologists of Russia formulates the main provisions concerning the tactics of managing patients with Immune-mediated Rheumatic Diseases during the ongoing COVID-19 pandemic.

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“…In early 2020, at the onset of the COVID-19 pandemic, many concerns have been raised regarding COVID-19 in patients with immune-mediated inflammatory diseases, which affect an estimated 4-5% of the global population (14,15). These patients are known to be at higher risk of severe infections, not only due to their underlying immune dysfunction but also as a consequence of immunosuppressant therapy (14,16,17).…”

Section: Are Chronic Inflammatory Rheumatic Diseases Associated With An Increased Risk Of Covid-19 Infection?mentioning

confidence: 99%

“…The immune dysregulation that has been asso ci a ted with the pathogenesis of immune-inflammatory rheumatic diseases together with the medications used in their management impact both innate immune responses (which play a critical role in viral in fec tions), as well as the adaptive immune responses through intricate mechanisms (18). In the early stages of COVID-19, failure to reduce the viral load may result in an exaggerated inflammatory reaction leading to tissue damage and multiple organ involvement (15,18).…”

Section: Are Chronic Inflammatory Rheumatic Diseases Associated With An Increased Risk Of Covid-19 Infection?mentioning

confidence: 99%

“…During the progression of the COVID-19 pan demic, numerous questions were raised regarding patients with autoimmune diseases under certain me dica tions (disease-modifying or symptomatic treat ment), with a need for further investigation if they were found to be more likely to contract the virus and develop COVID-19. Some questions have also arisen about the disease form these patients would develop, more spe ci fically if they could have a more aggressive form of the disease compared to the general population (14,15,19).…”

Section: Are Chronic Inflammatory Rheumatic Diseases Associated With An Increased Risk Of Covid-19 Infection?mentioning

confidence: 99%

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2021

Ro J Rheumatol.

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Since the first case was reported to the World Health Organization (in late December 2019 in Wuhan, Hubei Province, China), by mid-June 2021, there have been 175,541,600 confirmed cases of COVID-19 globally, including 3,798,361 reported deaths. Many of those infected with SARS-CoV-2 have an asymptomatic form of the disease or mild flu-like symptoms. In another category of patients, the disease may be more aggressive, with a severe form that can lead to acute respiratory distress syndrome (ARDS), respiratory failure, and even death with a negative impact on patients. The COVID-19 pandemic has arisen serious concerns in the rheumatology community regarding the management of immunosuppressed patients diagnosed with inflammatory rheumatic diseases. It has been stated that severe forms of COVID-19 occur as a result of exacerbated inflammation status and cytokine production. Nevertheless, it remains unclear whether the use of biological agents subjects the patient to a higher risk, or rather protects them against severe forms of the disease. According to the American College of Rheumatology, rheumatic diseases were not identified as a risk factor that predicted poor outcome in patients with COVID-19. However, various studies have certified that corticosteroid treatment in patients with chronic rheumatic diseases at a dose >10 mg/day is associated with an increased risk of infection as well as the possibility of developing more severe COVID-19 symptoms.

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Rheumatology and COVID-19 at 1 year: facing the unknowns

Cited by 13 publications

References 25 publications

COVID-19 Immunobiology: Lessons Learned, New Questions Arise

COVID-19 Immunobiology: Lessons Learned, New Questions Arise

Coronavirus Disease 2019 (COVID-19) and Immune-mediated Rheumatic Diseases. Recommendations of the Association of Rheumatologists of Russia

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