RESUMEN
Herbal medicines made from the bark of the Cinchona tree, and later quinine, have been widely used for centuries to treat medical conditions such as tropical malaria. More recently, chloroquine (CQ) and its synthetic derivatives have been used as antimalarials and to treat systemic lupus erythematosus, rheumatoid arthritis, and in the past 14 months or so, COVID-19 pneumonia. Anecdotal evidence and the erratic covering through social media of its potential efficacy in the treatment of COVID-19 pneumonia have resulted in the widespread off-label use of CQ in South Africa and worldwide. This study aimed to show that access to CQ as a chronic medication for rheumatic and musculoskeletal diseases was limited during the COVID-19 pandemic, and that this resulted in an increased incidence of flares in these patients, affecting their morbidity and potentially leading to mortality.
Asunto(s)
Cloroquina/farmacología , Reumatología/normas , Instituciones de Atención Ambulatoria/organización & administración , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Antirreumáticos/farmacología , Antirreumáticos/uso terapéutico , Cloroquina/uso terapéutico , Humanos , Enfermedades Musculoesqueléticas/tratamiento farmacológico , Enfermedades Reumáticas/tratamiento farmacológico , Reumatología/métodos , Reumatología/estadística & datos numéricos , Tratamiento Farmacológico de COVID-19RESUMEN
COVID-19 has been associated with lymphopaenia secondary to direct effects of SARS-CoV-2 virus on lymphocytes. We report on a case of an elderly patient with previous pulmonary tuberculosis (TB), recently diagnosed with COVID-19 complicated by lymphopaenia and TB reactivation. Our intention is to raise the awareness of clinicians to be alert to the high level of suspected TB infections during the COVID-19 pandemic, especially in TB-endemic regions such as South Africa. We further review the mechanism by which SARS-CoV-2 infection may lead to TB reactivation.