Your browser doesn't support javascript.
[COVID-19: treatment strategies of German-speaking pediatric rheumatologists : Results of an online survey]. / COVID-19: Behandlungsstrategien der deutschsprachigen Kinderrheumatologen : Ergebnisse einer Online-Umfrage.
Janda, A; Schuetz, C; Heeg, M; Minden, K; Hedrich, C M; Kallinich, T; Hinze, C; Schulz, A; Speth, F.
  • Janda A; Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Eythstr. 24, 89075, Ulm, Deutschland. ales.janda@uniklinik-ulm.de.
  • Schuetz C; Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland.
  • Heeg M; Institut für Immundefizienz und Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg, Freiburg, Deutschland.
  • Minden K; Charité Universitätsmedizin Berlin und Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Deutschland.
  • Hedrich CM; Department of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool & Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, Großbritannien.
  • Kallinich T; Charité Universitätsmedizin Berlin und Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Deutschland.
  • Hinze C; Klinik für Pädiatrische Rheumatologie und Immunologie, Universitätsklinikum Münster, Münster, Deutschland.
  • Schulz A; Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Eythstr. 24, 89075, Ulm, Deutschland.
  • Speth F; Zentrum für Geburtshilfe, Kinder- und Jugendmedizin, Sektion Pädiatrische Stammzelltransplantation und Immunologie, Abteilung Kinderrheumatologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Z Rheumatol ; 79(7): 710-717, 2020 Sep.
Artículo en Alemán | MEDLINE | ID: covidwho-720358
ABSTRACT

BACKGROUND:

Reliable data on the course and treatment of pediatric COVID-19 ("corona virus disease 2019") in immunosuppressed patients with rheumatic diseases are missing.

AIM:

Delineation of individual strategies of the members of the Society for Pediatric Rheumatology (GKJR) in cases of COVID-19.

METHODS:

In May 2020 all GKJR members were invited to take part in an online survey. Opinion data regarding an approach using disease-modifying anti-rheumatic drugs (DMARD) in cases of COVID-19 as well as the readiness to use new therapeutic agents in patients in different stages of the disease were collected.

RESULTS:

A total of 71 respondents (27.3% of all contacted pediatric rheumatologists) took part in the survey. Of these 28.2% had treated patients with COVID-19. Over 95% of the respondents did not support a preventive adaptation of the anti-rheumatic treatment during the SARS-CoV­2 pandemic. In the case of outpatients under immunosuppression with proven COVID-19 more than 50% of the respondents would refrain from administering intravenous high-dose steroids, cyclophosphamide, anti-CD20 antibodies as well as BAFF, CTLA­4 and TNF-alpha blockades. Conversely, >70% of the respondents would continue the treatment with nonsteroidal anti-inflammatory drugs, hydroxychloroquine (HCQ), oral steroids, mycophenolate, IL­1 blockade and immunoglobulins (Ig). In the case of inpatients 74.6% of respondents would consider targeted COVID-19 treatment. In stable patients with oxygen treatment (stage I) HCQ (18.3%), azithromycin (16.9%) and Ig (9.9%) were most frequently used. In cases of early signs (stage II) or a manifest cytokine storm (stage III) anakinra (40.8% for stage II and 46.5% for stage III), tocilizumab (26.8% and 40.8%, respectively), steroids (25.4% and 33.8%, respectively) and remdesivir (29.6% and 38.0%, respectively) were most frequently used. The need for a personalized approach based on the current clinical situation was emphasized by many respondents.

CONCLUSION:

The currently low prevalence of COVID-19 in Germany limits the general clinical experience. Therefore, the presented results have to be interpreted with caution and mostly as hypothetical treatment considerations. It is to be expected that there will always be a limited amount of evidence on pediatric COVID-19; therefore, a continuous and critical exchange of expert opinions on the treatment strategies is important.
Asunto(s)
Palabras clave

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Reumatólogos Tipo de estudio: Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Límite: Niño / Humanos País/Región como asunto: Europa Idioma: Alemán Revista: Z Rheumatol Año: 2020 Tipo del documento: Artículo

Similares

MEDLINE

...
LILACS

LIS


Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Reumatólogos Tipo de estudio: Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Límite: Niño / Humanos País/Región como asunto: Europa Idioma: Alemán Revista: Z Rheumatol Año: 2020 Tipo del documento: Artículo