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Autoinflammatory and autoimmune conditions at the crossroad of COVID-19.

Authors
  • Rodríguez, Yhojan1
  • Novelli, Lucia2
  • Rojas, Manuel1
  • De Santis, Maria2
  • Acosta-Ampudia, Yeny1
  • Monsalve, Diana M1
  • Ramírez-Santana, Carolina1
  • Costanzo, Antonio3
  • Ridgway, William M4
  • Ansari, Aftab A4
  • Gershwin, M Eric5
  • Selmi, Carlo6
  • Anaya, Juan-Manuel7
  • 1 Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia. , (Colombia)
  • 2 Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center (IRCCS), Rozzano, Milan, Italy. , (Italy)
  • 3 Dermatology, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy; Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy. , (Italy)
  • 4 Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA, USA.
  • 5 Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA, USA. Electronic address: [email protected]
  • 6 Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center (IRCCS), Rozzano, Milan, Italy; Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy. Electronic address: [email protected] , (Italy)
  • 7 Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia. Electronic address: [email protected] , (Colombia)
Type
Published Article
Journal
Journal of Autoimmunity
Publisher
Elsevier
Publication Date
Nov 01, 2020
Volume
114
Pages
102506–102506
Identifiers
DOI: 10.1016/j.jaut.2020.102506
PMID: 32563547
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Coronavirus disease 2019 (COVID-19) has been categorized as evolving in overlapping phases. First, there is a viral phase that may well be asymptomatic or mild in the majority, perhaps 80% of patients. The pathophysiological mechanisms resulting in minimal disease in this initial phase are not well known. In the remaining 20% of cases, the disease may become severe and/or critical. In most patients of this latter group, there is a phase characterized by the hyperresponsiveness of the immune system. A third phase corresponds to a state of hypercoagulability. Finally, in the fourth stage organ injury and failure occur. Appearance of autoinflammatory/autoimmune phenomena in patients with COVID-19 calls attention for the development of new strategies for the management of life-threatening conditions in critically ill patients. Antiphospholipid syndrome, autoimmune cytopenia, Guillain-Barré syndrome and Kawasaki disease have each been reported in patients with COVID-19. Here we present a scoping review of the relevant immunological findings in COVID-19 as well as the current reports about autoinflammatory/autoimmune conditions associated with the disease. These observations have crucial therapeutic implications since immunomodulatory drugs are at present the most likely best candidates for COVID-19 therapy. Clinicians should be aware of these conditions in patients with COVID-19, and these observations should be considered in the current development of vaccines. Copyright © 2020 Elsevier Ltd. All rights reserved.

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