Department of Dermatology, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.
Am J Clin Dermatol. 2020 Jun;21(3):307-311. doi: 10.1007/s40257-020-00514-2.
Coronavirus disease 2019 (COVID-19) is a clinical syndrome caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has spread rapidly worldwide and has been shown to have a wide spectrum of severity. COVID-19 has become a public health emergency of relevant international concern, and it was declared a pandemic by the World Health Organization on 11 March, 2020. SARS-CoV-2 infection in severe cases involves the host response as an important contributor to the disease process and tissue damage, mainly due to dysregulated and excessive innate immune responses. The primary immune response leads to viral clearance in the majority of cases. However, in a subgroup of patients, the secondary immune response may be exaggerated, leading to inflammatory-induced lung injury and other complications including pneumonitis, acute respiratory distress syndrome, respiratory failure, shock, organ failure, and potentially death. Several cutaneous immune-mediated diseases, including psoriasis, atopic dermatitis, and hidradenitis suppurativa, are therapeutically managed with biologic and non-biologic immunosuppressive and immunomodulatory drugs. The outbreak of COVID-19 affects the management of these chronic conditions, not only for those who are already receiving treatment but also for those who are about to start a new treatment to control their disease. In this article, the management of cutaneous immune-mediated diseases during the COVID-19 pandemic is discussed.
新型冠状病毒病（COVID-19）是由一种新型冠状病毒引起的临床综合征，称为严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）。COVID-19 在全球范围内迅速传播，其严重程度广泛。COVID-19 已成为国际关注的公共卫生紧急事件，世界卫生组织于 2020 年 3 月 11 日宣布其为大流行。严重的 SARS-CoV-2 感染涉及宿主反应，这是疾病过程和组织损伤的重要因素，主要是由于失调和过度的固有免疫反应。在大多数情况下，原发性免疫反应可清除病毒。然而，在一小部分患者中，二次免疫反应可能会被夸大，导致炎症诱导的肺损伤和其他并发症，包括肺炎、急性呼吸窘迫综合征、呼吸衰竭、休克、多器官功能衰竭，以及潜在的死亡。几种皮肤免疫介导性疾病，包括银屑病、特应性皮炎和化脓性汗腺炎，可通过生物制剂和非生物制剂的免疫抑制和免疫调节药物进行治疗。COVID-19 的爆发影响了这些慢性疾病的管理，不仅对那些已经接受治疗的患者，而且对那些即将开始新的治疗来控制疾病的患者。本文讨论了 COVID-19 大流行期间皮肤免疫介导性疾病的管理。
