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COVID-19 与系统性自身免疫性风湿病的发生、病程和治疗的关系。

COVID-19 in Association With Development, Course, and Treatment of Systemic Autoimmune Rheumatic Diseases.

机构信息

Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Faculty of Mathematics, Natural Sciences and Information Technologies (FAMNIT), University of Primorska, Koper, Slovenia.

出版信息

Front Immunol. 2021 Jan 26;11:611318. doi: 10.3389/fimmu.2020.611318. eCollection 2020.


DOI:10.3389/fimmu.2020.611318
PMID:33574819
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7870870/
Abstract

Autoimmune diseases and infections are often closely intertwined. Patients with autoimmune diseases are more susceptible to infections due to either active autoimmune disease or the medications used to treat them. Based on infections as environmental triggers of autoimmunity, an autoimmune response would also be expected in COVID-19. Although some studies have shown the occurance of autoantibodies and the possible development of autoimmune diseases after SARS-CoV-2 infection, current data suggest that the levels of autoantibodies following SARS-CoV-2 infection is comparable to that of some other known infections and that the autoantibodies might only be transient. The risk of SARS-CoV-2 infection in patients with a systemic autoimmune rheumatic disease (SARD) appears slightly higher compared to the general population and the course of COVID-19 disease does not seem to be very different, however, specific therapies such as glucocorticoids and anti-TNF might modulate the risk of hospitalization/death. Cytokine release syndrome is a severe complication in COVID-19. Many drugs used for the treatment of SARD are directly or indirectly targeting cytokines involved in the cytokine release syndrome, therefore it has been suggested that they could also be effective in COVID-19, but more evidence on the use of these medications for the treatment of COVID-19 is currently being collected.

摘要

自身免疫性疾病和感染常常密切相关。由于自身免疫性疾病处于活动期或正在接受治疗,自身免疫性疾病患者更容易受到感染。根据感染是自身免疫的环境触发因素这一理论,COVID-19 也会引发自身免疫反应。尽管一些研究表明,在 SARS-CoV-2 感染后会出现自身抗体和可能发生自身免疫性疾病,但目前的数据表明,SARS-CoV-2 感染后自身抗体的水平与一些已知感染相当,而且这些自身抗体可能只是短暂存在。与普通人群相比,系统性自身免疫性风湿病(SARD)患者感染 SARS-CoV-2 的风险似乎略高,COVID-19 疾病的病程似乎没有太大差异,但是,皮质类固醇和抗 TNF 等特定疗法可能会调节住院/死亡的风险。细胞因子释放综合征是 COVID-19 的严重并发症。许多用于治疗 SARD 的药物直接或间接靶向细胞因子释放综合征中涉及的细胞因子,因此有人认为它们也可能对 COVID-19 有效,但目前正在收集更多关于这些药物用于 COVID-19 治疗的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bec/7870870/4790cf6424a4/fimmu-11-611318-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bec/7870870/bb8be21376eb/fimmu-11-611318-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bec/7870870/5f26900ee573/fimmu-11-611318-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bec/7870870/4790cf6424a4/fimmu-11-611318-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bec/7870870/bb8be21376eb/fimmu-11-611318-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bec/7870870/5f26900ee573/fimmu-11-611318-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bec/7870870/4790cf6424a4/fimmu-11-611318-g003.jpg

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[5]
Factors Related to Severity, Hospitalization, and Mortality of COVID-19 Infection among Patients with Autoimmune Diseases.

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[6]
Longitudinal Analysis of Antiphospholipid Antibody Dynamics after Infection with SARS-CoV-2 or Vaccination with BNT162b2.

Int J Mol Sci. 2022-12-22

[7]
The Risk of Autoimmunity Development following mRNA COVID-19 Vaccination.

Viruses. 2022-11-28

[8]
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[9]
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[10]
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本文引用的文献

[1]
Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome.

Front Immunol. 2020-10-15

[2]
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Chest. 2021-3

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Ann Rheum Dis. 2021-3

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Reality Check on Antiphospholipid Antibodies in COVID-19-Associated Coagulopathy.

Arthritis Rheumatol. 2021-1

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Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis.

JAMA. 2020-10-6

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COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series.

Clin Rheumatol. 2020-8-27

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An inflammatory cytokine signature predicts COVID-19 severity and survival.

Nat Med. 2020-8-24

[10]
COVID-19 in patients with rheumatic diseases in northern Italy: a single-centre observational and case-control study.

Lancet Rheumatol. 2020-9

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