Department of Rheumatology, St. James's Hospital, Dublin, Ireland.
Division of Rheumatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Transl Res. 2021 Jun;232:49-59. doi: 10.1016/j.trsl.2021.02.010. Epub 2021 Feb 21.
Patients with inflammatory arthritis represent a possible high-risk group to COVID-19 due to their immunosuppressive regimen designed to maintain low disease activity. Thus, substantial effort has been put forth to understand the impact of COVID-19 on these patients. Patients with rheumatic diseases as a whole do not appear to be more susceptible to acquiring COVID-19. Furthermore, immunosuppression generally did not increase the likelihood of developing severe COVID-19, with the important exception of medium and high-dose glucocorticoid use. In addition, a small number of COVID-19 patients have developed new inflammatory arthritis; whether this represents an unmasking of previous subclinical disease or a bone fide virus-induced arthritis is unclear. Nevertheless, it appears that inflammatory arthritis patients currently on immunosuppression should continue their medication to prevent future flares and limit glucocorticoid usage. While this continues to be a rapidly evolving field, these data are reassuring to both patients with and providers treating inflammatory arthritides.
由于炎症性关节炎患者的免疫抑制方案旨在维持低疾病活动度，因此他们可能是 COVID-19 的高危人群。因此，人们付出了大量努力来了解 COVID-19 对这些患者的影响。一般来说，风湿性疾病患者似乎不容易感染 COVID-19。此外，免疫抑制通常不会增加发展为重症 COVID-19 的可能性，只有中高剂量糖皮质激素的使用是一个重要的例外。此外，少数 COVID-19 患者出现了新的炎症性关节炎；这是否代表以前亚临床疾病的显露还是真正的病毒诱导关节炎尚不清楚。然而，目前正在接受免疫抑制治疗的炎症性关节炎患者似乎应该继续服用药物以预防未来的发作并限制糖皮质激素的使用。虽然这仍然是一个快速发展的领域，但这些数据令炎症性关节炎患者和治疗医生都感到放心。
