ABSTRACT
Introduction: Mixed connective tissue disease (MCTD) is a rare autoimmune condition characterized by Scleroderma, Polymyositis, and Systemic Lupus Erythematous (SLE). Though a possible relationship between COVID-19 and autoimmune diseases has been recently reported, its pathophysiological mechanism behind flares in Lupus Nephritis (LN), a complication of SLE, remains unknown. Case presentation: A 22-year-old COVID-19 positive female presented with anemia, bilateral pitting edema, periorbital swelling, and posterior cervical lymphadenitis. Further inspection revealed lower abdominal striae, hepatosplenomegaly, and hyperpigmented skin nodules. Complete blood counts showed elevated inflammatory markers and excessively high protein creatinine ratio. Antinuclear antibody titers were elevated (anti-smith and U1 small nuclear ribonucleoprotein) and Rheumatoid Factor was positive. She was diagnosed with MCTD associated with a flare of LN. To control her lupus flare, a lower dose of steroids was initially administered, in addition to oral hydroxychloroquine and intravenous cyclophosphamide. Her condition steadily improved and was discharged on oral steroid maintenance medication. Discussion: We present a rare phenomenon of newly diagnosed LN, a complication of SLE, with MCTD in a PCR-confirmed COVID-19 patient. The diagnostic conundrum and treatment hurdles should be carefully addressed when patients present with lupus and COVID-19 pneumonia, with further exploration of the immuno-pathophysiology of COVID-19 infection in multi-systemic organ dysfunction in autoimmune disorders. Conclusion: In COVID-19 patients with LN and acute renal injury, it is critical to promptly and cautiously treat symptomatic flares associated with autoimmune disorders such as SLE and MCTD that may have gone unnoticed to prevent morbidity from an additional respiratory infection.
ABSTRACT
Coronavirus disease 2019 (COVID-19) originated in Wuhan, China, and subsequently spread to 215 countries and territories. Due to the high transmission rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the disease has been declared as a pandemic by the World Health Organization (WHO). Scientists are striving to investigate and contribute new findings of the disease to the literature, especially related to the treatments and preventive measures that can be undertaken to curb its transmission. Multiple studies regarding medical interventions such as antivirals use, mesenchymal stem cell therapy, and convalescent plasma therapy have been published to date. Furthermore, non-pharmacological measures including the usage of personal protective equipment, undertaking proper hand hygiene, and social distancing has been reported to suppress the spread of this infection. However, a definite cure has not been discovered yet. In this review, we have summarized the effectiveness, potential risks, and side effects of all pharmacological agents and non-pharmacological preventive strategies as well as the prospects of possible vaccine for COVID-19. [ABSTRACT FROM AUTHOR] Copyright of Professional Medical Journal is the property of Professional Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)