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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence

There are no seroprevalence terms in the subcorpus

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    Chloroquine, but not hydroxychlorquine, prolongs the QT interval HP in a primary care population

    Authors: Jonas L Isaksen; Anders Gaarsdal Holst; Adrian Pietersen; Jonas Bille Nielsen; Claus Graff; Jorgen K Kanters

    doi:10.1101/2020.06.19.20135475 Date: 2020-06-20 Source: medRxiv

    Background: Chloroquine (CQ) and Hydroxychloroquine (HCQ) have recently been suggested as treatment for the current Corona Virus Disease MESHD 2019 (COVID-19) pandemic. However, despite their long-term use and only few case reports on adverse effects, CQ and HCQ are listed as a known risk of the lethal ventricular arrhythmia HP Torsade de Pointes MESHD Torsade de Pointes HP and their cardiac safety profile is being questioned. Thus, we aimed to investigate the electrocardiographic and mortality effects of CQ and HCQ in a primary care population. Methods: We used Danish health care registers and electrocardiograms (ECGs) from primary care to define three studies. 1) A paired study of subjects with ECGs before and during use of CQ/HCQ, 2) a matched ECG study of subjects taking CQ/HCQ compared to controls, and 3) a mortality study on people taking HCQ matched to control. In both matched studies, we adjusted for connective tissue diseases MESHD, use of QT-prolonging drugs, and cardiac disease MESHD. We used the QTc interval as the marker for electrocardiographic safety. In the mortality study, cases were followed from first claimed prescription until 300 days after estimated completion of the last prescription. 95% confidence intervals follow estimates in parenthesis. Results: Use of CQ was associated with a 5.5 (0.7;10) ms increase in QTc in the paired study (n=10). In the matched study (n=28, controls=280), QTc was insignificantly increased in subjects taking CQ by 4.7 (-3.4;13) ms. With a {Delta}QTc of 1.0 (-5.6;7.5), use of HCQ was not associated with an increased QTc in the paired study (n=32). In the matched study (n=172, controls=1,720), QTc also was not different between groups (p=0.5). In the mortality study (n=3,368), use of HCQ was associated with a hazard ratio of 0.67 (0.43;1.05). Conclusions: In subjects free of COVID-19, we found a small increase in QTc associated with use of chloroquine, but not hydroxychloroquine. We found no increased mortality associated with use of hydroxychloroquine.

    The impact of COVID-19 pandemic on pediatric rheumatology patients under immunosuppressive therapy: A single-center experience

    Authors: Oya Koker; Fatma Gul Demirkan; Gulsah Kayaalp; Figen Cakmak; Ayse Tanatar; Serife Gul Karadag; Emine Sonmez; Rukiye Omeroglu; Nuray Aktay Ayaz

    doi:10.21203/rs.3.rs-36583/v1 Date: 2020-06-19 Source: ResearchSquare

    Objective: The aim of the research was to further broaden current knowledge of whether severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) disease MESHD 2019 (COVID-19) entails a risk for children TRANS with rheumatic diseases MESHD regarding immunosuppressive treatment.Methods: Telephone-survey was administered by conducting interviews with the parents TRANS. A message containing a link to the actual questionnaire was sent to their phones simultaneously. The medical records of the patients were reviewed for gathering information about demographic data, clinical follow-up, and treatments.Results: Patients who were followed up with immunosuppressive treatment (n=439) were attempted to be contacted between 1 May 2020 and 15 May 2020. The diagnostic distribution of patients who were accessible and eligible for the study was as follows; juvenile idiopathic arthritis MESHD arthritis HP (JIA) (n=243, 58.7%), autoinflammatory diseases MESHD (n=109, 26.3%), autoimmune connective tissue diseases MESHD (n=51, 12.3%) and vasculitis MESHD vasculitis HP (n=11, 2.7%). In the entire cohort, the mean age TRANS was 12 ± 4.7 years, and 54.1% (n=224) of the patients were female TRANS. One patient with seronegative polyarticular JIA, previously prescribed methotrexate and receiving leflunomide during pandemic has been identified to be diagnosed with COVID-19. None of the patients, including the patient diagnosed with COVID-19, had any severe symptoms. More than half of the patients with household contacts TRANS required hospitalization as they were asymptomatic TRANS.Conclusion: Although circumstances such as compliance in social distancing policy, transmission TRANS patterns, attitude following contact may influence the results, immunosuppressive treatment does not seem to pose additional risk in terms of COVID-19.

    COVID-19-induced acute respiratory failure HP: an exacerbation of organ-specific autoimmunity HP?

    Authors: Daniel Gagiannis; Julie Steinestel; Carsten Hackenbroch; Michael Hannemann; Vincent G Umathum; Niklas Gebauer; Marcel Stahl; Hanno M Witte; Konrad Steinestel

    doi:10.1101/2020.04.27.20077180 Date: 2020-05-01 Source: medRxiv

    Background: Understanding the pathophysiology of respiratory failure HP (ARDS) in coronavirus disease MESHD 2019 (COVID-19) patients is of utmost importance for the development of therapeutic strategies and identification of risk factors. Since we observed clinical and histopathological similarities between COVID-19 and lung manifestations of connective tissue disease MESHD (CTD-ILD) in our clinical practice, aim of the present study is to analyze a possible role of autoimmunity HP in SARS-CoV-2-associated respiratory failure HP. Methods: In this prospective, single-center trial, we enrolled 22 consecutive patients with RT-PCR-confirmed SARS-CoV-2 infection MESHD hospitalized in March and April, 2020. We performed high-resolution computed tomography (HR-CT) and full laboratory testing including autoantibody (AAB) screening (anti-ANA, SS-B/La, Scl-70, Jo-1, CENP-B, PM-Scl). Transbronchial biopsies as well as post mortem tissue samples were obtained from 3 and 2 cases, respectively, and subsequent histopathologic analysis with special emphasis on characterization of interstitial lung disease MESHD was performed. Results: Twelve of 22 patients (54.5%) were male TRANS and median age TRANS was 69.0 (range: 28-88). 11 (50.0%) patients had to be undergo intensive care unit (ICU) treatment. Intubation with ventilation was required in 10/22 cases (46%). Median follow-up was 26 days. Clinical and serological parameters were comparable to previous reports. Radiological and histopathological findings were highly heterogeneous including patterns reminiscent of CTD-ILD. AAB titers [≥]1:100 were detected in 10/11 (91.9%) COVID-19 patients who required ICU treatment, but in 4/11 (36.4%) patients with mild clinical course (p=0.024). Patients with AABs tended to require invasive ventilation and showed significantly more severe complications (64.3% vs. 12.5%, p=0.031). Overall COVID-19-related mortality was 18.2% among hospitalized patients at our institution. Conclusion: Our findings point out serological, radiological and histomorphological similarities between COVID-19-associated ARDS and acute exacerbation of CTD-ILD. While the exact mechanism is still unknown, we postulate that SARS-CoV-2 infection MESHD might trigger or simulate a form of organ-specific autoimmunity HP in predisposed patients. The detection of autoantibodies might identify patients who profit from immunosuppressive therapy to prevent the development of respiratory failure HP.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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