Ning Ruoqi, Meng Silu, Tang Fangxu, Yu Chong, Xu Dong, Luo Xiaofang, Sun Haiying
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Open Med (Wars). 2020 Oct 14;15(1):1054-1060. doi: 10.1515/med-2020-0238. eCollection 2020.
The coronavirus disease 2019 (COVID-19) has become a global pandemic, which is induced by infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with systemic lupus erythematosus (SLE) are susceptible to infections due to the chronic use of immunosuppressive drugs and the autoimmune disorders. Now we report a case of SLE infected with SARS-CoV-2, influenza A virus and concurrently. The patient used hydroxychloroquine and prednisone chronically to control the SLE. After infection of SARS-CoV-2, she was given higher dose of prednisone than before and the same dosage of hydroxychloroquine. Besides, some empirical treatments such as antiviral, antibiotic and immunity regulating therapies were also given. The patient finally recovered from COVID-19. This case indicated that hydroxychloroquine may not be able to fully protect SLE patient form SARS-CoV-2. Intravenous immunoglobulin therapies and increased dose of corticosteroids might be adoptable for patient with both COVID-19 and SLE. Physicians should consider SARS-CoV-2 virus test when SLE patient presented with suspected infection or SLE flare under the epidemic of COVID-19.
2019冠状病毒病(COVID-19)已成为全球大流行疾病,它由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染所致。系统性红斑狼疮(SLE)患者由于长期使用免疫抑制药物以及自身免疫紊乱而易于感染。现将1例同时感染SARS-CoV-2和甲型流感病毒的SLE患者报告如下。该患者长期使用羟氯喹和泼尼松来控制SLE。感染SARS-CoV-2后,给予她比之前更高剂量的泼尼松以及相同剂量的羟氯喹。此外,还给予了一些经验性治疗,如抗病毒、抗生素及免疫调节治疗。该患者最终从COVID-19中康复。此病例表明羟氯喹可能无法完全保护SLE患者免受SARS-CoV-2感染。对于同时患有COVID-19和SLE的患者,静脉注射免疫球蛋白治疗及增加糖皮质激素剂量可能是可行的。在COVID-19流行期间,当SLE患者出现疑似感染或SLE病情加重时,医生应考虑进行SARS-CoV-2病毒检测。