COVID-19, Rheumatic Diseases and Immune Dysregulation-a Perspective

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2021 Jan 7

PMID 33411143

Citations 9

Authors

Shahna Tariq

Charmaine van Eeden

Jan Willem Cohen Tervaert

Mohammed S Osman

Affiliations

Soon will be listed here.

Abstract

The COVID-19 pandemic has resulted in widespread hospitalisations and deaths around the world. As patients with rheumatic diseases generally have increased risk of infections and complications, understandably, there is significant concern of the impact of SARS-CoV-2 on these patients. However, there is a paucity of data in rheumatic patients. We review mechanisms through which SARS-CoV-2 results in infection, including ACE2 receptor, and complications (including immune dysregulation, thrombosis and complement activation). We assess these pathways in patients with rheumatic disease and those on immune modulating therapy. Although data thus far does not appear to show worse outcomes in rheumatic patients as a whole, given alterations in the underlying immune pathways in certain diseases (such as systemic lupus erythematosus), we posit that the risk is not equal in all rheumatic patients. We also discuss the benefit of underlying disease control with respect to COVID-19 risk reduction and potential increased risk of disease flares following viral infection from an immune standpoint.

Citing Articles

Clinical characteristics and outcomes of COVID-19 in pediatric patients with rheumatic diseases.

Wang Y, Su S, Ma M, Weng R, Zhang Z, Liu D Pediatr Res. 2024; .

PMID: 39375504 DOI: 10.1038/s41390-024-03561-1.

Polymyalgia Rheumatica Post-SARS-CoV-2 Infection.

Duarte-Salazar C, Vazquez-Meraz J, Ventura-Rios L, Hernandez-Diaz C, Arellano-Galindo J Case Reports Immunol. 2024; 2024:6662652.

PMID: 38516555 PMC: 10957256. DOI: 10.1155/2024/6662652.

Paxlovid use is associated with lower risk of cardiovascular diseases in COVID-19 patients with autoimmune rheumatic diseases: a retrospective cohort study.

Wang W, Wang Y, Huang C, Hsieh T, Ibarburu G, Cheng-Chung Wei J BMC Med. 2024; 22(1):117.

PMID: 38481216 PMC: 10938827. DOI: 10.1186/s12916-024-03331-0.

Risk of COVID-19 among unvaccinated and vaccinated patients with systemic lupus erythematosus: a general population study.

Jiang X, Sparks J, Wallace Z, Deng X, Li H, Lu N RMD Open. 2023; 9(1).

PMID: 36889799 PMC: 10008206. DOI: 10.1136/rmdopen-2022-002839.

Dysregulation of immunity in COVID-19 and SLE.

Hejazian S, Hejazian S, Farnood F, Azar S Inflammopharmacology. 2022; 30(5):1517-1531.

PMID: 36028612 PMC: 9417079. DOI: 10.1007/s10787-022-01047-2.

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