Werner S G, Langer H-E, Chatelain R
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.
Rheuma Plus. 2021;20(6):267-271. doi: 10.1007/s12688-021-00474-3. Epub 2021 Nov 1.
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.
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。