Nelson Meghan Corrigan, Manos Cynthia K, Flanagan Elaine, Prahalad Sampath
Nelson Department of Pediatrics, Emory University School of Medicine, 1400 Tullie Rd, Atlanta, GA 30329, USAChildren's Healthcare of Atlanta, Atlanta, GA, USA.
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USAChildren's Healthcare of Atlanta, Atlanta, GA, USA.
Ther Adv Vaccines Immunother. 2023 Jun 21;11:25151355231181242. doi: 10.1177/25151355231181242. eCollection 2023.
Childhood-onset systemic lupus erythematosus (cSLE) is an autoimmune disease associated with significant morbidity and mortality. Rituximab is a B-cell depleting therapy utilized in the treatment of SLE. In adults, rituximab has been associated with increased risk of adverse outcomes in patients who develop coronavirus disease 2019 (COVID-19). We aimed to assess the impact of prior rituximab treatment on clinical outcomes from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in children with SLE. To describe the impact of rituximab on outcomes from SARS-CoV-2 infection, we conducted a retrospective study of pediatric SLE patients in our center diagnosed with COVID-19 who had previously received rituximab between February 2019 and October 2022. Patients' clinical characteristics, disease activity, and outcomes were assessed. Of the eight subjects assessed, five required hospitalizations for COVID-19, four required ICU admission, and two were seen in the emergency department for their symptoms. One patient ultimately expired from her illness. The median time between rituximab administration and COVID-19 diagnosis was 3 months. We assessed the clinical outcomes, including the need of ICU admission and fatal outcome, of COVID-19 in our cSLE patient population after rituximab administration. Approximately 60% of our patients required hospitalization for their illness, and seven out of eight patients required healthcare utilization to include hospitalization and/or emergency department visits.
儿童期起病的系统性红斑狼疮（cSLE）是一种自身免疫性疾病，与较高的发病率和死亡率相关。利妥昔单抗是一种用于治疗系统性红斑狼疮的B细胞清除疗法。在成人中，利妥昔单抗与感染2019冠状病毒病（COVID-19）的患者不良结局风险增加有关。我们旨在评估先前使用利妥昔单抗治疗对患有系统性红斑狼疮的儿童感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）临床结局的影响。为了描述利妥昔单抗对SARS-CoV-2感染结局的影响，我们对2019年2月至2022年10月期间在我们中心诊断为COVID-19且先前接受过利妥昔单抗治疗的儿童系统性红斑狼疮患者进行了一项回顾性研究。评估了患者的临床特征、疾病活动度和结局。在评估的8名受试者中，5名因COVID-19需要住院治疗，4名需要入住重症监护病房（ICU），2名因症状在急诊科就诊。1名患者最终因病死亡。利妥昔单抗给药与COVID-19诊断之间的中位时间为3个月。我们评估了利妥昔单抗给药后我们的cSLE患者群体中COVID-19的临床结局，包括入住ICU的需求和致命结局。我们大约60%的患者因病需要住院治疗，8名患者中有7名需要医疗护理，包括住院和/或急诊科就诊。
