Department of Internal Medicine I, Division of Haematology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.
Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, Mich.
J Allergy Clin Immunol. 2020 Aug;146(2):300-306. doi: 10.1016/j.jaci.2020.06.009. Epub 2020 Jun 17.
The coronavirus disease 2019 (COVID-19) (caused by severe acute respiratory syndrome coronavirus 2) pandemic has massively distorted our health care systems and caused catastrophic consequences in our affected communities. The number of victims continues to increase, and patients at risk can only be protected to a degree, because the virulent state may be asymptomatic. Risk factors concerning COVID-19-induced morbidity and mortality include advanced age, an impaired immune system, cardiovascular or pulmonary diseases, obesity, diabetes mellitus, and cancer treated with chemotherapy. Here, we discuss the risk and impact of COVID-19 in patients with mastocytosis and mast cell activation syndromes. Because no published data are yet available, expert opinions are, by necessity, based on case experience and reports from patients. Although the overall risk to acquire the severe acute respiratory syndrome coronavirus 2 may not be elevated in mast cell disease, certain conditions may increase the risk of infected patients to develop severe COVID-19. These factors include certain comorbidities, mast cell activation-related events affecting the cardiovascular or bronchopulmonary system, and chemotherapy or immunosuppressive drugs. Therefore, such treatments should be carefully evaluated on a case-by-case basis during a COVID-19 infection. In contrast, other therapies, such as anti-mediator-type drugs, venom immunotherapy, or vitamin D, should be continued. Overall, patients with mast cell disorders should follow the general and local guidelines in the COVID-19 pandemic and advice from their medical provider.
2019 年冠状病毒病（COVID-19）（由严重急性呼吸综合征冠状病毒 2 引起）大流行极大地扭曲了我们的医疗体系，并在我们受影响的社区造成了灾难性的后果。受害者人数持续增加，而处于危险中的患者只能在一定程度上得到保护，因为这种毒力状态可能是无症状的。与 COVID-19 引起的发病率和死亡率相关的危险因素包括年龄较大、免疫系统受损、心血管或肺部疾病、肥胖、糖尿病和接受化疗的癌症。在这里，我们讨论肥大细胞增多症和肥大细胞激活综合征患者 COVID-19 的风险和影响。由于目前尚无发表的数据，因此专家意见必然基于病例经验和患者报告。尽管在肥大细胞疾病中获得严重急性呼吸综合征冠状病毒 2 的总体风险可能不会增加，但某些情况可能会增加感染患者发展为严重 COVID-19 的风险。这些因素包括某些合并症、影响心血管或支气管肺系统的肥大细胞激活相关事件，以及化疗或免疫抑制药物。因此，在 COVID-19 感染期间，应根据具体情况仔细评估此类治疗方法。相比之下，其他治疗方法，如抗介质型药物、毒液免疫疗法或维生素 D，应继续使用。总体而言，肥大细胞疾病患者应遵循 COVID-19 大流行期间的一般和当地指南以及他们的医疗提供者的建议。
