COVID-19 pandemic and biological therapy in rheumatologic disorders: how to deal with?

  • Z. Ahmadinejad Department of Infectious Disease, Tehran University of Medical Science, Tehran, Iran; Imam Khomeini Complex Hospital, Tehran, Iran, Islamic Republic of.
  • R. Assari Rheumatology Research Center, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of.
  • N. Ayoobi Yazdi Imam Khomeini Complex Hospital, Tehran, Iran; Department of Radiology, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of.
  • S.-H. Mazloomi Imam Khomeini Complex Hospital, Tehran, Iran, Islamic Republic of.
  • P. Javanshayani Imam Khomeini Complex Hospital, Tehran, Iran, Islamic Republic of.
  • H. Khalili Afousi Department of Clinical Pharmacy, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of.
  • V. Ziaee | ziaee@tums.ac.ir Rheumatology Research Center, Tehran University of Medical Science, Tehran; Department of Pediatrics, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of. http://orcid.org/0000-0003-4648-3573

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) has involved more than 159 countries and more than 5 million people worldwide. A 40-year-old man with a history of rheumatoid arthritis treated with prednisolone, Disease-Modifying Anti-Rheumatic Drugs (DMARDs), and biologic agents was admitted with chief complaints of fever, chills, malaise, myalgia, and dyspnea. Chest computed tomography showed bilateral subsegmental atelectasis and diffuse ground-glass opacities in both lungs inducing the suspicion of COVID-19 infection. The oro-nasopharynx swab sample for COVID-19 polymerase chain reaction was positive. In addition to supportive care, lopinavir/ritonavir 400/100 mg twice daily and oseltamivir (75 mg) twice daily were started in combination with a starting dose of hydroxychloroquine (400 mg). The methotrexate dose was decreased, and the dose of prednisolone was increased to 30 mg for 10 days. Azathioprine and adalimumab were continued at previous doses. The use of biologic agents and DMARDs in rheumatic patients is a serious challenge in the COVID-19 pandemic. In conclusion, during the COVID-19 pandemic, due to the key roles of cytokines in the promotion of the disease, the rheumatic patients may benefit from continuing their previous treatment, which may have protective effects.

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Published
2020-11-19
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Section
Case Reports
Keywords:
COVID-19 pandemic, biological therapy, rheumatologic disorders.
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How to Cite
Ahmadinejad, Z., Assari, R., Ayoobi Yazdi, N., Mazloomi, S.-H., Javanshayani, P., Khalili Afousi, H., & Ziaee, V. (2020). COVID-19 pandemic and biological therapy in rheumatologic disorders: how to deal with?. Reumatismo, 72(3), 173-177. https://doi.org/10.4081/reumatismo.2020.1289