Increased rates of idiopathic inflammatory myopathies during the COVID-19 pandemic: a single-centre experience.

OBJECTIVES: Higher-level evidence is required to discern whether the incidence of idiopathic inflammatory myopathies (IIM) has increased during the COVID-19 pandemic and whether the disease pattern and course have changed. We aimed to analyse patients who were diagnosed with IIM at our tertiary care centre during the pandemic and compare them with IIM patients diagnosed before COVID-19. METHODS: We retrospectively analysed the medical records of adult patients (>18 years) who were diagnosed with IIM during COVID-19 versus a control group of patients diagnosed before the outbreak. Included were patients whose diagnosis was made at the Department of Medicine and Rheumatology Unit of Hadassah Medical Center, Jerusalem, Israel. We also conducted a comprehensive review of the literature regarding SARS-CoV-2 infection and vaccine-induced IIM. RESULTS: Our study yielded 18 and 16 diagnosed IIM patients over periods of 27 and 56 months in the COVID-19 and pre-pandemic cohorts, respectively. These constitute incidence rates of 0.66 and 0.28 patients/month, respectively, marking an increased rate in the COVID-19 group. Unique features were noted in IIM patients who were diagnosed during the pandemic. This includes male predominance (M:F ratio of 12:6), higher hospitalisation rate (0.77 vs. 0.43 admitted/total patients) and increased number of patients with CPK >10,000 U/L (3 vs. 1 patient). Despite the more severe presentation and course in the pandemic group, survival was comparable between the groups. CONCLUSIONS: The incidence of IIM increased during the COVID-19 pandemic. These patients display unique features and a more severe presentation. Fortunately, the prognosis remains unchanged.

A Novel Tool for Nasal Polyp Investigation: An Ex vivo Organ Culture System.

BACKGROUND: Nasal polyps are three-dimensional structures arising from the mucosa of the upper airway. Due to their complexity, the reliability of single-layer cell cultures and animal systems as research models is limited. OBJECTIVES: To evaluate the feasibility of an ex vivo organ culture of human polyps, preserving tissue structure and function. METHODS: Nasal polyps were excised during routine endoscopic sinus surgery for chronic rhinosinusitis and polyposis. Fresh tissue samples were used for pathological evaluation and for the preparation of 250-500 µm sections, which were incubated in culture media. Tissue viability was assessed by visualisation of cilia motility, measurement of glucose uptake, and an infectivity assay. Cytokine secretion was evaluated by enzyme-linked immunosorbent assay and real-time polymerase chain reaction before and after the introduction of steroids. RESULTS: Polyp tissue viability was retained for 2-3 days as demonstrated by cilia motility, glucose uptake and preserved cellular composition. Tissue samples maintained their capacity to respond to infection by herpes simplex virus 1 and adenovirus. Introduction of dexamethasone to cultured tissue samples led to suppression of interferon-g production. CONCLUSIONS: The ex vivo nasal polyp organ culture reproduces the physiological, metabolic, and cellular features of nasal polyps. Furthermore, it shows a preserved capacity for viral infection and response to drugs. This system is a useful tool for the investigation nasal-polyps and for the development of novel therapies.