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10.1016/j.semarthrit.2020.05.010

http://scihub22266oqcxt.onion/10.1016/j.semarthrit.2020.05.010
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32512263!7245236!32512263
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suck abstract from ncbi


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pmid32512263      Semin+Arthritis+Rheum 2020 ; 50 (4): 680-686
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  • COVID-19 in rheumatic disease patients on immunosuppressive agents #MMPMID32512263
  • Sharmeen S; Elghawy A; Zarlasht F; Yao Q
  • Semin Arthritis Rheum 2020[Aug]; 50 (4): 680-686 PMID32512263show ga
  • OBJECTIVE: To analyze clinical characteristics and outcome of COVID-19 patients with underlying rheumatic diseases (RD) on immunosuppressive agents. METHOD: A case series of COVID-19 patients with RD on disease modifying anti-rheumatic drugs (DMARDs) were studied by a retrospective chart review. A literature search identified 9 similar studies of single cases and case series, which were also included. RESULTS: There were 4 COVID-19 inpatients with RD from our hospital, and the mean age was 57 +/- 21 years. Two patients had a mild infection, and 2 developed severe COVID-19 related respiratory complications, including 1 patient on secukinumab requiring mechanical ventilation and 1 patient on rituximab developing viral pneumonia requiring supplemental oxygenation. All 4 patients had elevated acute phase reactants, 2 patients had mild COVID-19 with lymphopenia, and 2 patients had severe COVID-19 with normal lymphocyte counts, and high levels of IL-6. None of the patients exhibited an exacerbation of their underlying RD. In the literature, there were 9 studies of COVID-19 involving 197 cases of various inflammatory RD. Most patients were on DMARDs or biologics, of which TNFalpha inhibitors were most frequently used. Two tocilizumab users had a mild infection. Two patients were on rituximab with 1 severe COVID-19 requiring mechanical ventilation. Six patients were on secukinumab with 1 hospitalization. Of the total 201 cases, 12 died, with an estimated mortality of 5.9% CONCLUSION: Patients with RD are susceptible to COVID-19. Various DMARDs or biologics may affect the viral disease course differently. Patients on hydroxychloroquine, TNFalpha antagonists or tocilizumab may have a mild viral illness. Rituximab or secukinumab could worsen the viral disease. Further study is warranted.
  • |*Antirheumatic Agents/classification/therapeutic use[MESH]
  • |*Coronavirus Infections/immunology/mortality/therapy[MESH]
  • |*Pandemics[MESH]
  • |*Pneumonia, Viral/immunology/mortality/therapy[MESH]
  • |*Rheumatic Diseases/drug therapy/epidemiology/immunology[MESH]
  • |Betacoronavirus/isolation & purification[MESH]
  • |Biological Products/*therapeutic use[MESH]
  • |COVID-19[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Immunosuppressive Agents/therapeutic use[MESH]
  • |Lymphocyte Count/methods/statistics & numerical data[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Mortality[MESH]
  • |Outcome and Process Assessment, Health Care[MESH]
  • |Respiration, Artificial/methods/statistics & numerical data[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |Severity of Illness Index[MESH]


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