Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Department of Medicine, Academic Internal Medicine.
Curr Opin Pulm Med. 2021 Sep 1;27(5):463-471. doi: 10.1097/MCP.0000000000000812.
Patients with sarcoidosis may be at higher risk of coronavirus disease-19 (COVID-19) as over 90% of the patients have pulmonary involvement and many are treated with immunosuppressive agents. This review will summarize the current literature regarding sarcoidosis and COVID-19, with a particular focus on susceptibility, clinical outcomes, management, and approach to vaccination.
Data about COVID-19 and sarcoidosis include a number of case series and reports, cohort studies, and registries. Literature is not conclusive whether patients with sarcoidosis have increased susceptibility to COVID-19. Patients with moderate to severe impaired pulmonary function may be at increased risk of adverse outcomes and mortality. Whether immunosuppressive medication increases risk of COVID-19 severity or affects vaccination response is not yet clear. Novel approaches, such as telemedicine and home monitoring programs, are promising to ensure continuity of care for patients with sarcoidosis during the COVID-19 pandemic.
Current evidence about the risk and clinical outcomes of COVID-19 infection in patient with sarcoidosis, is mainly extrapolated from other immune-mediated diseases. Hence, further research that focuses on the sarcoidosis population is warranted.
超过 90%的结节病患者存在肺部受累,且许多患者接受免疫抑制治疗,因此结节病患者可能具有更高的罹患冠状病毒病 2019(COVID-19)的风险。本文将重点总结目前有关结节病和 COVID-19 的文献,特别关注易感性、临床结局、管理以及疫苗接种方法。
有关 COVID-19 和结节病的数据包括一系列病例系列和报告、队列研究和注册研究。目前尚不能确定结节病患者是否更容易感染 COVID-19。中度至重度肺功能受损的患者发生不良结局和死亡的风险可能增加。免疫抑制药物是否会增加 COVID-19 严重程度或影响疫苗接种反应尚不清楚。在 COVID-19 大流行期间,远程医疗和家庭监测等新方法有望确保结节病患者的医疗服务连续性。
目前关于 COVID-19 感染风险和结节病患者临床结局的证据主要是从其他免疫介导性疾病中推断而来。因此,有必要针对结节病患者开展进一步研究。