RESUMEN
BACKGROUND: While it is presumed that immunosuppressed patients, such as solid organ transplant recipients on immunosuppression, are at greater risk from SARS-CoV-2 infection than the general population, the antibody response to infection in this patient population has not been studied. METHODS: In this report, we follow the anti-SARS-CoV-2 antibody levels in patients with COVID-19 who are undergoing exogenous immunosuppression. Specifically, we studied the antibody response of 3 solid organ transplant recipient patients, 3 patients who take daily inhaled fluticasone, and a patient on etanercept and daily inhaled fluticasone, and compared them to 5 patients not on exogenous immunosuppression. RESULTS: We found that the solid organ transplant patients on full immunosuppression are at risk of having a delayed antibody response and poor outcome. We did not find evidence that inhaled steroids or etanercept predispose patients to delayed immune response to SARS-CoV-2. CONCLUSION: The data presented here suggest that solid organ transplant recipients may be good candidates for early targeted intervention against SARS-CoV-2.
Asunto(s)
Anticuerpos Antivirales/sangre , COVID-19/inmunología , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , SARS-CoV-2/inmunología , Administración por Inhalación , Adulto , Anciano , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/aislamiento & purificación , COVID-19/sangre , COVID-19/diagnóstico , COVID-19/virología , Prueba Serológica para COVID-19/estadística & datos numéricos , Inhibidores de la Calcineurina/efectos adversos , Etanercept/efectos adversos , Femenino , Fluticasona/administración & dosificación , Fluticasona/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Trasplante de Órganos/efectos adversos , SARS-CoV-2/aislamiento & purificación , Glicoproteína de la Espiga del Coronavirus/inmunología , Receptores de Trasplantes/estadística & datos numéricos , Adulto JovenRESUMEN
There have been a number of investigations of the efficacy and safety of etanercept. This study was performed to obtain long-term drug survival data (ie, time to drug discontinuation) for etanercept, and the reasons for its discontinuation. The study population consisted of patients with psoriatic arthritis and psoriasis followed up by our clinic, registered in the Turkish Psoriasis Registry (PSR-TR) and treated with etanercept for at least 4 weeks between January 1, 2005, and January 31, 2020. The efficacy of etanercept was evaluated in terms of the Psoriasis Area and Severity Index (PASI) 75, PASI 90 and PASI 100 response rates at 12, 24, 36, and 48 weeks, and annually thereafter. The behaviors of the patients with respect to the use of etanercept, and the outcomes of those who continued to use it during the COVID-19 pandemic, were also investigated.
Asunto(s)
COVID-19 , Etanercept/uso terapéutico , Psoriasis , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Etanercept/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida , Pandemias , Psoriasis/diagnóstico , Psoriasis/tratamiento farmacológico , Psoriasis/epidemiología , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Tasa de Supervivencia , Resultado del Tratamiento , Adulto JovenRESUMEN
Hydroxychloroquine is an agent used as a treatment but also considered as a prophylaxis for SARS-CoV-2 infection. We report the case of a patient who developed COVID-19 while on hydroxychloroquine for mixed connectivitis associated with spondyloarthritis. Although more work is needed before any conclusions can be drawn, this raises questions about the protective role of this drug against infection. Are they really protected against COVID-19 or will they develop pauci-symptomatic forms?