Cruz-Domínguez María Del Pilar, Morales-Montalvo Susana Isabel, Vera-Lastra Olga Lidia, López-Zamora Berenice, Ordoñez-González Irvin, Medina-García Gabriela, López-Burgos Cinthya Paola, Montes-Cortés Daniel Héctor, Jara-Quezada Luis Javier
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", División de Investigación en Salud. Ciudad de México, México.
Instituto Politécnico Nacional, Escuela Superior de Medicina, Campus Casco de Santo Tomás, Sección de Estudios de Posgrado e Investigación. Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2023 Mar 1;61(2):163-171.
COVID-19 brought with it unknowns related to systemic sclerosis.
To know the clinical evolution and prognosis of COVID-19 in a cohort of patients with systemic sclerosis.
During the pandemic, we had digital contact with a cohort of 197 patients with SSc. If they had any condition that met the suspected definition of COVID-19, they underwent polymerase chain reaction testing for SARS-CoV-2; they were treated on an outpatient or hospital basis without interfering with their treatment. They followed their evolution every 24 hours until they became asymptomatic or died.
Thirteen patients (6.6%), nine diffuse cutaneous (dcSSc), and four limited cutaneous (lcSSc) developed COVID-19 during nine months of follow-up. The immunosuppressants used at the time of the disease were: mycophenolate mofetil, methotrexate, and prednisone, in low doses. Seven patients had interstitial lung disease (ILD). The main symptoms were chest pain, cough, dyspnea, dysgeusia, and anosmia, 1 with mild symptoms without pneumonia, 11 with mild pneumonia, and one with severe pneumonia that required hospital management. Only one (7.7%) presented severe pneumonia, was hospitalized, and died.
COVID-19 disease in patients with SSc can be overcome in most cases, even when they are ILD and were using immunosuppressants at the time of infection with the SARS-CoV-2 virus.
2019冠状病毒病带来了与系统性硬化症相关的未知情况。
了解一组系统性硬化症患者中2019冠状病毒病的临床演变和预后。
在疫情期间，我们与一组197例系统性硬化症患者进行了线上联系。如果他们有任何符合2019冠状病毒病疑似定义的情况，就进行严重急性呼吸综合征冠状病毒2的聚合酶链反应检测；他们在门诊或住院接受治疗，且不干扰其原有治疗。他们每24小时跟踪病情进展，直至症状消失或死亡。
在9个月的随访期间，13例患者（6.6%）感染了2019冠状病毒病，其中9例为弥漫性皮肤型（dcSSc），4例为局限性皮肤型（lcSSc）。发病时使用的免疫抑制剂为：低剂量的霉酚酸酯、甲氨蝶呤和泼尼松。7例患者患有间质性肺病（ILD）。主要症状为胸痛、咳嗽、呼吸困难、味觉障碍和嗅觉丧失，1例症状轻微无肺炎，11例有轻度肺炎，1例有严重肺炎需住院治疗。只有1例（7.7%）出现严重肺炎，住院后死亡。
大多数系统性硬化症患者的2019冠状病毒病可以治愈，即使他们患有间质性肺病且在感染严重急性呼吸综合征冠状病毒2病毒时正在使用免疫抑制剂。
