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2.
Ann Rheum Dis ; 79(9): 1170-1173, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-597162

RESUMEN

BACKGROUND: The susceptibility of patients with rheumatic diseases and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown. METHODS: We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with severe acute respiratory syndrome coronavirus 2-positive PCR tests performed in the hospital to the same reference populations. Rates of PCR+ confirmed COVID-19 were compared among groups. RESULTS: Patients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Patients with systemic autoimmune or immune-mediated disease (AI/IMID) showed a significant increase, whereas patients with inflammatory arthritis (IA) or systemic lupus erythematosus did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. Patients with IA on targeted-synthetic or biological disease-modifying antirheumatic drugs (DMARDs), but not those on conventional-synthetic DMARDs, had a greater prevalence despite a similar age distribution. CONCLUSION: Patients with AI/IMID show a variable risk of hospital-diagnosed COVID-19. Interplay of ageing, therapies and disease-specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyse the specific factors involved in COVID-19 susceptibility.


Asunto(s)
Enfermedades Autoinmunes/epidemiología , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Enfermedades Reumáticas/epidemiología , Adulto , Distribución por Edad , Anciano , Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/epidemiología , Artritis Reumatoide/virología , Enfermedades Autoinmunes/tratamiento farmacológico , Enfermedades Autoinmunes/virología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Femenino , Humanos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Sistémico/epidemiología , Lupus Eritematoso Sistémico/virología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Reacción en Cadena de la Polimerasa , Prevalencia , Estudios Retrospectivos , Enfermedades Reumáticas/tratamiento farmacológico , Enfermedades Reumáticas/virología , España/epidemiología
3.
Arthritis Care Res (Hoboken) ; 72(9): 1189-1195, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-593679

RESUMEN

OBJECTIVE: To determine health perceptions of patients with rheumatic diseases in the early phase of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Rheumatology patients at a single center received via text message the Australian Rheumatology Association COVID-19 information sheet and an invitation to participate in a deidentified survey. Patient concerns regarding risks conferred by their rheumatologic disease or medications, impact of receiving the information sheet on the likelihood of staying on medication, and acceptance of telehealth were ascertained. RESULTS: A total of 2,630 patients received the text message, and the survey response rate was 21% (n = 550). The mean ± SD age of the participants was 52 ± 15.2 years, and 75.3% were female. Participants' highest ranked concern was that their medications would increase the severity of their COVID-19 symptoms (76.1%). The highest levels of concern were seen in patients taking combination conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and/or a biologic/targeted synthetic DMARD. There was no association between prednisolone dose and concern. While 63% of patients planned to continue their antirheumatic medications, a further 30% were more likely to continue taking their medications because of receiving the information. Telehealth was acceptable to 98.4% of patients, but 28.1% felt this was only appropriate while infection control measures were in place. CONCLUSION: Concerns regarding the risk of COVID-19 among patients taking antirheumatic drugs are common. Proactive dissemination of information is needed to address misconceptions related to medication risk, improve medication adherence, and minimize the risk of flares. Telehealth is acceptable to most patients during the COVID-19 pandemic.


Asunto(s)
Antirreumáticos/efectos adversos , Betacoronavirus , Infecciones por Coronavirus/psicología , Aceptación de la Atención de Salud/psicología , Neumonía Viral/psicología , Enfermedades Reumáticas/psicología , Actitud Frente a la Salud , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Enfermedades Reumáticas/tratamiento farmacológico , Enfermedades Reumáticas/virología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios
6.
Medicina (B Aires) ; 80(3): 271-274, 2020.
Artículo en Español | MEDLINE | ID: covidwho-344356

RESUMEN

Due to the coronavirus disease 2019 (COVID-19) pandemic, a wide number of compounds are under scrutiny regarding their antiviral activity, one of them being hydroxychloroquine. Cardiac aspects of the use of chloroquine and hydroxychloroquine are reviewed in this manuscript. A non-systematic review of the medical literature was performed. Information about their safety and efficacy as antimalarials, antivirals, as well as in the long-term treatment of rheumatic diseases was collected. We found an anti-inflammatory effect with reduction of longterm cardiovascular events, a very infrequent heart disease due to a lysosomal effect of the drug, and at the hemodynamic level hypotension, tachycardia, and QT interval prolongation, exacerbated when combined with azithromycin. However, the rate of adverse cardiac events of hydroxychloroquine (and chloroquine) was low.


Asunto(s)
Antivirales/efectos adversos , Betacoronavirus , Enfermedades Cardiovasculares/inducido químicamente , Cloroquina/efectos adversos , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/efectos adversos , Neumonía Viral/tratamiento farmacológico , Antiinflamatorios/efectos adversos , Antirreumáticos/efectos adversos , Corazón/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Humanos , Pandemias , Factores de Riesgo
9.
Emerg Microbes Infect ; 9(1): 830-832, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-125318

RESUMEN

The current pandemic coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) calls urgently for effective therapies. Anti-malarial medicine chloroquine (CQ) and particularly its chemical analogue hydroxychloroquine (HCQ) have been recommended as promising candidate therapeutics that are now under either compassionate off-label use or clinical trials for the treatment of COVID-19 patients. However, there are public concerns and disputes about both the safety and efficacy of CQ and HCQ for this new application. Given the fact that for decades HCQ has been approved as an immunomodulatory drug for the long term treatment of chronic rheumatic diseases, as experienced rheumatologists, we would like to share our thoughts in this regard and trigger a brainstorm among clinical care providers for exchanging their diverse opinions on this urgent topic.


Asunto(s)
Antimaláricos , Antirreumáticos , Antivirales , Betacoronavirus/efectos de los fármacos , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina , Neumonía Viral/tratamiento farmacológico , Antimaláricos/administración & dosificación , Antimaláricos/efectos adversos , Antimaláricos/uso terapéutico , Antirreumáticos/administración & dosificación , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Antivirales/administración & dosificación , Antivirales/efectos adversos , Antivirales/uso terapéutico , Ensayos Clínicos como Asunto , Infecciones por Coronavirus/epidemiología , Humanos , Hidroxicloroquina/administración & dosificación , Hidroxicloroquina/efectos adversos , Hidroxicloroquina/uso terapéutico , Comunicación Interdisciplinaria , Pandemias , Neumonía Viral/epidemiología , Reumatólogos
10.
Z Rheumatol ; 79(4): 379-384, 2020 May.
Artículo en Alemán | MEDLINE | ID: covidwho-95158

RESUMEN

The current COVID-19 pandemic inherits an unprecedented challenge for the treating rheumatologists. On the one hand, antirheumatic drugs can increase the risk of infection and potentially deteriorate the course of an infection. On the other hand, an active inflammatory rheumatic disease can also increase the risk for an infection. In the recommendations of the German Society for Rheumatology (www.dgrh.de), it is recommended that our patients continue the antirheumatic therapy to maintain remission or low state of activity despite the pandemic. In this study, patients with inflammatory rheumatic disease were asked in the first weeks of the pandemic on their opinion of their immunomodulating therapy. The result shows that over 90% of the patients followed the recommendation of the rheumatologist to continue the antirheumatic therapy, and only a small percentage of the patients terminated the therapy on their own. This result was independent of the individual anti-rheumatic therapy. Taken together, the results of this study illustrate not only the trustful patient-physician partnership in a threatening situation but also the high impact of state-of-the art recommendations by the respective scientific society.


Asunto(s)
Infecciones por Coronavirus , Huésped Inmunocomprometido , Cumplimiento de la Medicación , Pandemias , Neumonía Viral , Enfermedades Reumáticas/inmunología , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Estudios Transversales , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Enfermedades Reumáticas/complicaciones , Enfermedades Reumáticas/tratamiento farmacológico
11.
Rheumatol Int ; 40(6): 991-995, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-88672

RESUMEN

In December 2019, numerous coronavirus disease 2019 (COVID-19) cases were reported in Wuhan, China, which has since spread throughout the world. However, its impact on rheumatoid arthritis (RA) patients is unknown. Herein, we report a case of COVID-19 pneumonia in a 61-year-old female RA patient who was receiving conventional disease-modifying antirheumatic drugs (cDMARDs). The patient presented with a 4-day history of myalgia and febrile sensation. COVID-19 was confirmed by real-time polymerase chain reaction (PCR). Chest X-ray showed increased opacity on the right lower lung area, and C-reactive protein level was slightly elevated. The patient was treated with antiviral agents (lopinavir/ritonavir), and treatment with cDMARDs was discontinued except hydroxychloroquine. Her symptoms and laboratory results gradually improved. Three weeks later, real-time PCR for COVID-19 showed negative conversion, and the patient was discharged without any complications.


Asunto(s)
Artritis Reumatoide/inmunología , Infecciones por Coronavirus/tratamiento farmacológico , Lopinavir/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Ritonavir/uso terapéutico , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/virología , China , Infecciones por Coronavirus/complicaciones , Combinación de Medicamentos , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Huésped Inmunocomprometido , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Reacción en Cadena en Tiempo Real de la Polimerasa , Resultado del Tratamiento
12.
Z Rheumatol ; 79(4): 379-384, 2020 May.
Artículo en Alemán | MEDLINE | ID: covidwho-71799

RESUMEN

The current COVID-19 pandemic inherits an unprecedented challenge for the treating rheumatologists. On the one hand, antirheumatic drugs can increase the risk of infection and potentially deteriorate the course of an infection. On the other hand, an active inflammatory rheumatic disease can also increase the risk for an infection. In the recommendations of the German Society for Rheumatology (www.dgrh.de), it is recommended that our patients continue the antirheumatic therapy to maintain remission or low state of activity despite the pandemic. In this study, patients with inflammatory rheumatic disease were asked in the first weeks of the pandemic on their opinion of their immunomodulating therapy. The result shows that over 90% of the patients followed the recommendation of the rheumatologist to continue the antirheumatic therapy, and only a small percentage of the patients terminated the therapy on their own. This result was independent of the individual anti-rheumatic therapy. Taken together, the results of this study illustrate not only the trustful patient-physician partnership in a threatening situation but also the high impact of state-of-the art recommendations by the respective scientific society.


Asunto(s)
Infecciones por Coronavirus , Huésped Inmunocomprometido , Cumplimiento de la Medicación , Pandemias , Neumonía Viral , Enfermedades Reumáticas/inmunología , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Estudios Transversales , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Enfermedades Reumáticas/complicaciones , Enfermedades Reumáticas/tratamiento farmacológico
13.
J Toxicol Environ Health B Crit Rev ; 23(4): 177-181, 2020 05 18.
Artículo en Inglés | MEDLINE | ID: covidwho-46381

RESUMEN

As a result of the 2019 coronavirus disease pandemic (COVID-19), there has been an urgent worldwide demand for treatments. Due to factors such as history of prescription for other infectious diseases, availability, and relatively low cost, the use of chloroquine (CQ) and hydroxychloroquine (HCQ) has been tested in vivo and in vitro for the ability to inhibit the causative virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, even though investigators noted the therapeutic potential of these drugs, it is important to consider the toxicological risks and necessary care for rational use of CQ and HCQ. This study provides information on the main toxicological and epidemiological aspects to be considered for prophylaxis or treatment of COVID-19 using CQ but mainly HCQ, which is a less toxic derivative than CQ, and was shown to produce better results in inhibiting proliferation of SARS-CoV-2 based upon preliminary tests.


Asunto(s)
Antimaláricos/uso terapéutico , Antirreumáticos/uso terapéutico , Antivirales , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Antimaláricos/efectos adversos , Antirreumáticos/efectos adversos , Antivirales/efectos adversos , Antivirales/uso terapéutico , Betacoronavirus/efectos de los fármacos , Humanos , Hidroxicloroquina/efectos adversos , Pandemias
14.
Hellenic J Cardiol ; 61(1): 42-45, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-40673

RESUMEN

OBJECTIVE: Colchicine has been utilized safely in a variety of cardiovascular clinical conditions. Among its potential mechanisms of action is the non-selective inhibition of NLRP3 inflammasome which is thought to be a major pathophysiologic component in the clinical course of patients with COVID-19. GRECCO-19 will be a prospective, randomized, open-labeled, controlled study to assess the effects of colchicine in COVID-19 complications prevention. METHODS: Patients with laboratory confirmed SARS-CoV-2 infection (under RT PCR) and clinical picture that involves temperature >37.5 oC and at least two out of the: i. sustained coughing, ii. sustained throat pain, iii. Anosmia and/or ageusia, iv. fatigue/tiredness, v. PaO2<95 mmHg will be included. Patients will be randomised (1:1) in colchicine or control group. RESULTS: Trial results will be disseminated through peer-reviewed publications and conference presentations. CONCLUSION: GRECCO-19 trial aims to identify whether colchicine may positively intervene in the clinical course of COVID-19. (ClinicalTrials.gov Identifier: NCT04326790).


Asunto(s)
Colchicina , Infecciones por Coronavirus , Cardiopatías , Pandemias , Neumonía Viral , Antirreumáticos/administración & dosificación , Antirreumáticos/efectos adversos , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Colchicina/administración & dosificación , Colchicina/efectos adversos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Cardiopatías/sangre , Cardiopatías/etiología , Cardiopatías/prevención & control , Humanos , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Ensayos Clínicos Controlados Aleatorios como Asunto , Evaluación de Síntomas/métodos , Troponina/análisis
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