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1.
Clin Immunol ; 239: 109022, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1803761

ABSTRACT

In March 2020, when coronavirus disease 2019 (COVID-19) was just beginning to spread around the world, we presented the potential benefits and controversies of anti-inflammatory therapy in COVID-19 patients based on the limited experience and proposed some types of anti-inflammatory drugs with potential therapeutic value, while without evidence-based data. In the past one more year, many clinical trials or real-world studies have been performed, either confirm or deny the efficacy of certain anti-inflammatory drugs in the treatment of COVID-19. In this review we summarize the progress of anti-inflammatory and immune therapy in COVID-19, including glucocorticoids, IL-6 antagonist, IL-1 inhibitor, kinase inhibitors, non-steroidal anti-inflammatory drugs and chloroquine/hydroxychloroquine.


Subject(s)
COVID-19 , Anti-Inflammatory Agents/therapeutic use , COVID-19/drug therapy , Chloroquine/therapeutic use , Humans , Hydroxychloroquine/therapeutic use , SARS-CoV-2
2.
Front Immunol ; 12: 791348, 2021.
Article in English | MEDLINE | ID: covidwho-1608514

ABSTRACT

Background: Striking similarities have been found between coronavirus disease 2019 (COVID-19) and anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-related dermatomyositis, implying a shared autoinflammatory aberrance. Herein, we aim to investigate whether the anti-MDA5 Ab is present in COVID-19 and correlates with the severity and adverse outcome of COVID-19 patients. Methods and Findings: We retrospectively recruited 274 adult inpatients with COVID-19 in this study, including 48, 164, and 62 cases of deaths, severe, and non-severe patients respectively. The anti-MDA5 Ab was determined by ELISA and verified by Western Blotting, which indicated that the positive rate of anti-MDA5 Ab in COVID-19 patients was 48.2% (132/274). The clinical and laboratory features, as well as outcomes between patients with positive and negative anti-MDA5 Ab were compared and we found that the anti-MDA5 Ab positive patients tended to represent severe disease (88.6% vs 66.9%, P<0.0001). We also demonstrated that the titer of anti-MDA5 Ab was significantly elevated in the non-survivals (5.95 ± 5.16 vs 8.22 ± 6.64, P=0.030) and the positive rate was also higher than that in the survivals (23.5% vs 12.0%, P=0.012). Regarding severe COVID-19 patients, we found that high titer of anti-MDA5 Ab (≥10.0 U/mL) was more prevalent in the non-survivals (31.2% vs 14.0%, P=0.006). Moreover, a dynamic analysis of anti-MDA5 Ab was conducted at different time-points of COVID-19, which revealed that early profiling of anti-MDA5 Ab could distinguish severe patients from those with non-severe ones. Conclusions: Anti-MDA5 Ab was prevalent in the COVID-19 patients and high titer of this antibody is correlated with severe disease and unfavorable outcomes.


Subject(s)
Antibodies/immunology , COVID-19/immunology , Interferon-Induced Helicase, IFIH1/immunology , Severity of Illness Index , Adult , Aged , Antibodies/blood , COVID-19/epidemiology , COVID-19/virology , Disease Progression , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Male , Middle Aged , Pandemics , Prognosis , Retrospective Studies , SARS-CoV-2/physiology
4.
Ann Rheum Dis ; 79(6): 724-726, 2020 06.
Article in English | MEDLINE | ID: covidwho-155085

ABSTRACT

Due to the frequent presence of interstitial lung disease and widespread use of immunosuppressive treatment, systemic sclerosis (SSc) patients may be considered at risk for a more severe disease course and higher mortality when they develop Severe Acute Respiratory Syndrome - Coronavirus - 2 (SARS-CoV-2) virus infection. Therefore, with World Scleroderma Foundation endorsement, experts from different specialties including rheumatology, virology and clinical immunology gathered virtually to answer to the main practical clinical questions regarding SARS-CoV-2 infection coming from both patients and physicians. This preliminary advice is aligned with other national and international recommendations, adapted for SSc patients.


Subject(s)
Coronavirus Infections/drug therapy , Coronavirus Infections/physiopathology , Pneumonia, Viral/drug therapy , Pneumonia, Viral/physiopathology , Scleroderma, Systemic/therapy , Scleroderma, Systemic/virology , Antibodies, Monoclonal, Humanized/therapeutic use , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Lung Diseases, Interstitial/immunology , Lung Diseases, Interstitial/virology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Respiratory Distress Syndrome/drug therapy , Respiratory Distress Syndrome/virology , SARS-CoV-2 , Scleroderma, Systemic/epidemiology , Scleroderma, Systemic/immunology
5.
Clin Immunol ; 214: 108393, 2020 05.
Article in English | MEDLINE | ID: covidwho-41645

ABSTRACT

The pandemic outbreak of coronavirus disease 2019 (COVID-19) is rapidly spreading all over the world. Reports from China showed that about 20% of patients developed severe disease, resulting in a fatality of 4%. In the past two months, we clinical immunologists participated in multi-rounds of MDT (multidiscipline team) discussion on the anti-inflammation management of critical COVID-19 patients, with our colleagues dispatched from Chinese leading PUMC Hospital to Wuhan to admit and treat the most severe patients. Here, from the perspective of clinical immunologists, we will discuss the clinical and immunological characteristics of severe patients, and summarize the current evidence and share our experience in anti-inflammation treatment, including glucocorticoids, IL-6 antagonist, JAK inhibitors and choloroquine/hydrocholoroquine, of patients with severe COVID-19 that may have an impaired immune system.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Betacoronavirus , COVID-19 , Chloroquine/therapeutic use , Cytokines/immunology , Glucocorticoids/therapeutic use , Humans , Hydroxychloroquine/therapeutic use , Inflammation/pathology , Interleukin-6/antagonists & inhibitors , Janus Kinases/antagonists & inhibitors , Pandemics , SARS-CoV-2 , Thrombosis/virology , Vasculitis/virology
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