Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa Cerrahpaşa School of Medicine, İstanbul, Turkey
Balkan Med J. 2020 Jun 1;37(4):184-188. doi: 10.4274/balkanmedj.galenos.2020.2020.4.43. Epub 2020 Apr 8.
As it is known, we are all in a pandemic situation due to a novel coronavirus, officially named “Severe Acute Respiratory Syndrome Coronavirus 2” and the disease caused by the virus named “Coronavirus disease-2019”. The virus seems to has propensity to infect older male individuals with underlying disease. The clinical features were on a large scale that varies from being an asymptomatic carrier to acute respiratory distress syndrome and multiorgan dysfunction. Fever, dry cough and fatigue are the most common symptoms. Not only, the disease seems to be rare and have a milder course in pediatric age but also respiratory failure, multiorgan dysfunction, and death are extremely rare. Although several comorbidities such as hypertension, diabetes and cardiovascular diseases are defined as a risk factor for developing the acute respiratory syndrome and need for intensive care; immune-compromised situations such as rheumatic disease which require immunosuppressive treatment strikingly are not found to be a risk factor for more severe disease course. However, there is a lack of data regarding the effects of “Coronavirus disease-2019” on pediatric patients with rheumatic diseases. Additionally, there are three controversial circumstances that patients with rheumatic diseases are believed to be more likely to have viral infections like “Severe Acute Respiratory Syndrome Coronavirus 2”, on the other hand, antirheumatic drugs may have a protective and therapeutic role in Coronavirus disease-2019 and children are more unlikely to have serious disease course. Therefore, we aimed to have a contributor role for explaining this conundrum and present a bird’s eye view regarding this equivocal issue in this review.
众所周知,由于一种新型冠状病毒,我们都处于大流行状态,该病毒正式命名为“严重急性呼吸系统综合症冠状病毒 2”,由该病毒引起的疾病命名为“2019 年冠状病毒病”。该病毒似乎倾向于感染有基础疾病的老年男性。其临床特征大规模变化,从无症状携带者到急性呼吸窘迫综合征和多器官功能障碍。发热、干咳和疲劳是最常见的症状。不仅如此,该疾病在儿科年龄似乎罕见且病程较轻,而且呼吸衰竭、多器官功能障碍和死亡极为罕见。尽管高血压、糖尿病和心血管疾病等几种合并症被定义为发生急性呼吸窘迫综合征和需要重症监护的危险因素;但免疫抑制情况,如需要免疫抑制治疗的风湿性疾病,并未被发现是疾病加重的危险因素。然而,关于“2019 年冠状病毒病”对患有风湿性疾病的儿科患者的影响,数据仍然缺乏。此外,存在三种有争议的情况,人们认为患有风湿性疾病的患者更有可能感染像“严重急性呼吸系统综合症冠状病毒 2”这样的病毒,另一方面,抗风湿药物可能在 2019 年冠状病毒病中具有保护和治疗作用,且儿童不太可能出现严重的疾病过程。因此,我们旨在为解释这一难题做出贡献,并在本篇综述中提供关于这一有争议问题的鸟瞰图。