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本文引用的文献

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[Updated recommendations of the German Society for Rheumatology for the care of patients with inflammatory rheumatic diseases in the context of the SARS-CoV‑2/COVID‑19 pandemic, including recommendations for COVID‑19 vaccination].[德国风湿病学会关于在SARS-CoV-2/COVID-19大流行背景下照顾炎性风湿性疾病患者的最新建议,包括COVID-19疫苗接种建议]
Z Rheumatol. 2021 Aug;80(6):570-587. doi: 10.1007/s00393-021-01056-6.
2
Anti-SARS-CoV-2 mRNA vaccine in patients with rheumatoid arthritis.类风湿关节炎患者使用抗SARS-CoV-2 mRNA疫苗。
Lancet Rheumatol. 2021 Jul;3(7):e470-e472. doi: 10.1016/S2665-9913(21)00186-7. Epub 2021 Jun 8.
3
SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases.未治疗、常规治疗和抗细胞因子治疗的免疫介导性炎症性疾病患者的 SARS-CoV-2 疫苗反应。
Ann Rheum Dis. 2021 Oct;80(10):1312-1316. doi: 10.1136/annrheumdis-2021-220461. Epub 2021 May 6.
4
National registry for patients with inflammatory rheumatic diseases (IRD) infected with SARS-CoV-2 in Germany (ReCoVery): a valuable mean to gain rapid and reliable knowledge of the clinical course of SARS-CoV-2 infections in patients with IRD.德国炎症性风湿病(IRD)患者感染 SARS-CoV-2 的国家登记处(ReCoVery):了解 IRD 患者 SARS-CoV-2 感染临床病程的快速可靠知识的宝贵手段。
RMD Open. 2020 Sep;6(2). doi: 10.1136/rmdopen-2020-001332.
5
Patients with immune-mediated inflammatory diseases receiving cytokine inhibitors have low prevalence of SARS-CoV-2 seroconversion.接受细胞因子抑制剂治疗的免疫介导性炎症性疾病患者 SARS-CoV-2 血清转化发生率较低。
Nat Commun. 2020 Jul 24;11(1):3774. doi: 10.1038/s41467-020-17703-6.
6
EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2.EULAR 临时推荐意见:在 SARS-CoV-2 背景下管理风湿和肌肉骨骼疾病。
Ann Rheum Dis. 2020 Jul;79(7):851-858. doi: 10.1136/annrheumdis-2020-217877. Epub 2020 Jun 5.
7
Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry.风湿性疾病患者因 COVID-19 住院的相关特征:来自 COVID-19 全球风湿病联盟医生报告登记处的数据。
Ann Rheum Dis. 2020 Jul;79(7):859-866. doi: 10.1136/annrheumdis-2020-217871. Epub 2020 May 29.
8
[Current guidance of the German Society of Rheumatology for the care of patients with rheumatic diseases during the SARS-CoV-2/Covid 19 pandemic].[德国风湿病学会关于SARS-CoV-2/新冠疫情期间风湿病患者护理的当前指南]
Z Rheumatol. 2020 May;79(4):385-388. doi: 10.1007/s00393-020-00799-y.
9
COVID-19: risk for cytokine targeting in chronic inflammatory diseases?COVID-19:慢性炎症性疾病中细胞因子靶向治疗的风险?
Nat Rev Immunol. 2020 May;20(5):271-272. doi: 10.1038/s41577-020-0312-7.

[常规风湿病护理中的新型冠状病毒肺炎]

[COVID-19 in Routine Rheumatologic Care].

作者信息

Werner S G, Langer H-E, Chatelain R

机构信息

RHIO (Rheumatologie, Immunologie und Osteologie) Düsseldorf und RHIO Forschungsinstitut Düsseldorf, Reichsstr. 59, 40217 Düsseldorf, Deutschland.

Fakultät für Gesundheit, Department für Humanmedizin, Universität Witten/Herdecke, Witten, Deutschland.

出版信息

Rheuma Plus. 2021;20(6):267-271. doi: 10.1007/s12688-021-00474-3. Epub 2021 Nov 1.

DOI:10.1007/s12688-021-00474-3
PMID:34745375
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8558759/
Abstract

Since the first case of coronavirus infection with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and the associated COVID-19 (corona virus disease 2019) it has become a worldwide pandemic. This leads to persistent and far-reaching consequences for the health system and society as a whole. Our patients with inflammatory rheumatic diseases were initially considered to be at high risk of contracting SARS-CoV‑2, especially if they were on immunosuppressive and/or immunomodulatory therapy (DMARD). It was assumed that a severe COVID-19 course could occur in case of infection. Although PCR diagnosis is generally considered the gold standard for early diagnosis of active infection with SARS-CoV‑2, it has been shown that it should not always be used to confirm the diagnosis of COVID-19. Therefore, complementary antibody testing for SARS-CoV‑2 could be useful in cases of clinical suspicion and negative PCR for diagnostic confirmation of COVID-19, even retrospectively. Apparently, patients with inflammatory rheumatic disease and under DMARD therapy are not particularly at risk in case of SARS-CoV‑2 infection. Whether this is due to better hygiene measures or increased contact restrictions of patients with underlying inflammatory rheumatic disease, or whether ongoing DMARD therapy offers some protection against a severe course of COVID-19, is still to be clarified. The important questions about the tolerability and efficacy of COVID-19 vaccination have yet to be answered. In summary, there is still a clear need for research to better advise our patients.

摘要

自首例新型冠状病毒(SARS-CoV-2,严重急性呼吸综合征冠状病毒2)感染及相关的2019冠状病毒病(COVID-19)出现以来,它已成为一场全球大流行疾病。这给整个卫生系统和社会带来了持续且影响深远的后果。我们的炎性风湿性疾病患者最初被认为感染SARS-CoV-2的风险很高,尤其是那些正在接受免疫抑制和/或免疫调节治疗(传统改善病情抗风湿药)的患者。人们认为一旦感染,可能会出现严重的COVID-19病程。尽管PCR诊断通常被认为是早期诊断SARS-CoV-2活跃感染的金标准,但事实表明,它并不总是适用于确诊COVID-19。因此,即使是回顾性地,针对SARS-CoV-2的补充抗体检测在临床怀疑但PCR结果为阴性的情况下,对于确诊COVID-19可能会有帮助。显然,炎性风湿性疾病患者及正在接受传统改善病情抗风湿药治疗的患者在感染SARS-CoV-2时并非特别高危。这是由于更好的卫生措施、炎性风湿性疾病患者增加的接触限制,还是持续的传统改善病情抗风湿药治疗对预防COVID-19的严重病程提供了某种保护,仍有待阐明。关于COVID-19疫苗接种的耐受性和有效性的重要问题尚未得到解答。总之,仍迫切需要开展研究,以便为我们的患者提供更好的建议。