Corpus overview


MeSH Disease

Human Phenotype


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    Severe COVID-19 is associated with elevated serum SERO IgA and antiphospholipid IgA- antibodies SERO

    Authors: Omar Hasan Ali; David Bomze; Lorenz Risch; Silvio D Brugger; Matthias Paprotny; Myriam Weber; Sarah Thiel; Lukas Kern; Werner C Albrich; Philipp Kohler; Christian R Kahlert; Pietro Vernazza; Philipp K Buehler; Reto A Schuepbach; Alejandro Gomez-Mejia; Alexandra M Popa; Andreas Bergthaler; Josef M Penninger; Lukas Flatz

    doi:10.1101/2020.07.21.20159244 Date: 2020-07-24 Source: medRxiv

    Background: While the pathogenesis of coronavirus disease MESHD 2019 (COVID-19) is becoming increasingly clear, there is little data on IgA response, the first line of bronchial immune defense. Objective: To determine, whether COVID-19 is associated with a vigorous total IgA response and whether IgA autoantibodies are associated with complications of severe illness. Since thrombotic events are frequent in severe COVID-19 and resemble hypercoagulation of antiphospholipid syndrome MESHD (APS), our approach focused on antiphospholipid antibodies SERO (aPL). Materials and methods: In this retrospective cohort study we compared clinical data and aPL from 64 patients with COVID-19 from three independent centers (two in Switzerland, one in Liechtenstein). Samples were collected from April 9, 2020 to May 1, 2020. Total IgA and aPL were measured with FDA-approved commercially available clinical diagnostic kits. Results: Clinical records of the 64 patients with COVID-19 were reviewed and divided into a cohort with mild illness (mCOVID, n=26 [41%]), a discovery cohort with severe illness (sdCOVD, n=14 [22%]) and a confirmation cohort with severe illness (scCOVID, n=24 [38%]). Severe illness was significantly associated with increased total IgA (sdCOVID, P=0.01; scCOVID, P<0.001). Total IgG levels were similar in both cohorts. Among aPL, both cohorts with severe illness significantly correlated with elevated anti-Cardiolipin IgA (sdCOVID and scCOVID, P<0.001), anti-Cardiolipin IgM (sdCOVID, P=0.003; scCOVID, P<0.001), and anti-Beta2 Glycoprotein-1 IgA (sdCOVID and scCOVID, P<0.001). Systemic lupus erythematosus MESHD Systemic lupus erythematosus HP was excluded from all patients as a potential confounder of APS. Conclusions: Higher total IgA and IgA-aPL were consistently associated with severe illness. These novel data strongly suggest that a vigorous antiviral IgA-response triggered in the bronchial mucosa induces systemic autoimmunity HP.

    Chronic treatment with hydroxychloroquine and SARS-CoV-2 infection MESHD.

    Authors: Antonio Ferreira; Antonio Oliveira-e-Silva; Paulo Bettencourt

    doi:10.1101/2020.06.26.20056507 Date: 2020-06-29 Source: medRxiv

    Background: Hydroxychloroquine sulphate (HCQ) is being scrutinized for repositioning in the treatment and prevention of SARS-Cov-2 infection MESHD. This antimalarial drug is also chronically used to treat patients with autoimmune diseases MESHD. Methods: By analyzing the Portuguese anonymized data on private and public based medical prescriptions we have identified all cases chronically receiving HCQ for the management of diseases MESHD such as systemic lupus erythematosus MESHD systemic lupus erythematosus HP, rheumatoid arthritis MESHD rheumatoid arthritis HP, and other autoimmune diseases MESHD. Additionally, we have detected all laboratory confirmed cases TRANS of SARS-CoV-2 infection and all laboratory MESHD confirmed negative cases in the Portuguese population (mandatorily registered in a centrally managed database). Cross linking the two sets of data has allowed us to compare the proportion of HCQ chronic treatment (at least 2 grams per month) in laboratory confirmed cases TRANS of SARS-CoV-2 infection with laboratory MESHD confirmed negative cases. Results: Out of 26,815 SARS-CoV-2 positive patients, 77 (0.29%) were chronically treated with HCQ, while 1,215 (0.36%) out of 333,489 negative patients were receiving it chronically (P=0.04). After adjustment for age TRANS, sex, and chronic treatment with corticosteroids and/or immunosuppressants, the odds ratio of SARS-CoV-2 infection MESHD infection for chronic HP for chronic treatment with HCQ has been 0.51 (0.37-0.70). Conclusions: Our data suggest that chronic treatment with HCQ confer protection against SARS-CoV-2 infection MESHD.

    Determinants of cardiac adverse events of chloroquine and hydroxychloroquine in 20 years of drug safety surveillance reports

    Authors: Isaac V Cohen; Tigran Makunts; Talar Moumedjian; Masara Issa; Ruben Abagyan

    doi:10.1101/2020.05.19.20107227 Date: 2020-05-26 Source: medRxiv

    Chloroquine (CQ) and hydroxychloroquine (HCQ) are on the World Health Organization's List of Essential Medications for treating non-resistant malaria MESHD, rheumatoid arthritis MESHD rheumatoid arthritis HP (RA) and systemic lupus erythematosus MESHD systemic lupus erythematosus HP (SLE). In addition, both drugs are currently used off-label in hospitals worldwide and in numerous clinical trials for the treatment of SARS-CoV-2 infection MESHD. However, CQ and HCQ use has been associated with cardiac side effects, which is of concern due to the higher risk of COVID-19 complications in patients with heart related disorders, and increased mortality associated with COVID-19 cardiac complications. In this study we analyzed over thirteen million adverse event reports form the United States Food and Drug Administration Adverse Event Reporting System to confirm and quantify the association of cardiac side effects of CQ and HCQ. Additionally, we identified several confounding factors, including male TRANS sex, NSAID coadministration, advanced age TRANS, and prior diagnoses contributing to the risk of drug related cardiotoxicity MESHD. These findings may help guide therapeutic decision making and ethical trial design for COVID-19 treatment.

    Prevalence SERO of Hospital PCR Confirmed Covid-19 Cases in Patients with Chronic Inflammatory and Autoimmune Rheumatic Diseases MESHD

    Authors: José L. Pablos; Lydia Abasolo-Alcázar; José M. Álvaro-Gracia; Francisco J. Blanco; Ricardo Blanco; Isabel Castrejón; David Fernández-Fernández; Benjamín Fernández-Gutierrez; María Galindo; Miguel A. González-Gay; Sara Manrique-Arija; Natalia Mena-Vázquez; Antonio Mera-Varela; Miriam Retuerto; Álvaro Seijas-Lopez; - RIER investigators group

    doi:10.1101/2020.05.11.20097808 Date: 2020-05-14 Source: medRxiv

    ABSTRACT Background. The susceptibility of patients with rheumatic diseases MESHD, and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown. Methods. We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with SARS-CoV-2 positive PCR tests performed in the hospital to the same reference populations. Incidences of PCR+ confirmed COVID-19 were compared among groups. Results. Patients with chronic inflammatory diseases MESHD had 1.32-fold higher prevalence SERO of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Systemic autoimmune or immune mediated diseases MESHD (AI/IMID) patients showed a significant increase, whereas inflammatory arthritis MESHD arthritis HP (IA) or systemic lupus erythematosus MESHD systemic lupus erythematosus HP (SLE) patients did not. COVID-19 cases in some but not all diagnostic groups had older ages TRANS than cases in the reference population. IA patients on targeted-synthetic or biological disease MESHD-modifying antirheumatic drugs (ts/bDMARD), but not those on conventional-synthetic (csDMARD), had a greater prevalence SERO despite a similar age TRANS distribution. Conclusion. Patients with AI/IMID show a variable risk of hospital diagnosed COVID-19. Interplay of aging, therapies, and disease MESHD specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyze the specific factors involved in COVID-19 susceptibility.

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MeSH Disease
Human Phenotype

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