1
|
Valeyre D, Bernaudin JF, Brauner M, Nunes H, Jeny F. Infectious Complications of Pulmonary Sarcoidosis. J Clin Med 2024; 13:342. [PMID: 38256476 PMCID: PMC10816300 DOI: 10.3390/jcm13020342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
In this review, the infectious complications observed in sarcoidosis are considered from a practical point of view to help the clinician not to overlook them in a difficult context, as pulmonary sarcoidosis makes the recognition of superinfections more difficult. An increased incidence of community-acquired pneumonia and of opportunistic pneumonia has been reported, especially in immunosuppressed patients. Pulmonary destructive lesions of advanced sarcoidosis increase the incidence of chronic pulmonary aspergillosis and infection by other agents. Screening and treatment of latent tuberculosis infection are crucial to prevent severe tuberculosis. Severity in COVID-19 appears to be increased by comorbidities rather than by sarcoidosis per se. The diagnosis of infectious complications can be challenging and should be considered as a potential differential diagnosis when the exacerbation of sarcoidosis is suspected. These complications not only increase the need for hospitalizations, but also increase the risk of death. This aspect must be carefully considered when assessing the overall health burden associated with sarcoidosis. The impact of immune dysregulation on infectious risk is unclear except in exceptional cases. In the absence of evidence-based studies on immunosuppressants in the specific context of pulmonary sarcoidosis, it is recommended to apply guidelines used in areas outside sarcoidosis. Preventive measures are essential, beginning with an appropriate use of immunosuppressants and the avoidance of unjustified treatments and doses. This approach should take into account the risk of tuberculosis, especially in highly endemic countries. Additionally, parallel emphasis should be placed on vaccinations, especially against COVID-19.
Collapse
Affiliation(s)
- Dominique Valeyre
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Service de Pneumologie, Groupe Hospitalier Paris Saint Joseph, 75014 Paris, France
| | - Jean-François Bernaudin
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Faculty of Medicine, Sorbonne University, 75013 Paris, France
| | - Michel Brauner
- Service de Radiologie, Hôpital Avicenne, 93009 Bobigny, France;
| | - Hilario Nunes
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Service de Pneumologie, Hôpital Avicenne, 93009 Bobigny, France
| | - Florence Jeny
- INSERM-UMR 1272, SMBH Université Sorbonne Paris-Nord, 93009 Bobigny, France; (D.V.); (J.-F.B.); (H.N.)
- Service de Pneumologie, Hôpital Avicenne, 93009 Bobigny, France
| |
Collapse
|
2
|
Nadeem O, Sharma A, Alaouie D, Bradley P, Ouellette D, Fadel R, Suleyman G. Outcomes in patients with sarcoidosis and COVID-19. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2023; 40:e2023055. [PMID: 38126507 DOI: 10.36141/svdld.v40i4.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/27/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIM The effect of COVID-19 in patients with sarcoidosis has not been fully explored. The aim was to conduct a retrospective cohort study investigating outcomes in patients with sarcoidosis who were hospitalized with COVID-19. METHODS We included patients who had diagnoses of sarcoidosis and COVID-19 between January 1, 2020, and February 28, 2021. Primary outcomes included development of critical COVID-19; need for supplemental oxygen, noninvasive ventilation, and invasive ventilation; and death. Association of comorbidities and immunosuppression therapy with outcomes were analyzed. Multiple logistic regression analysis was used to assess risk factors associated with critical COVID-19. RESULTS Of 1198 patients with COVID-19, 169 had sarcoidosis (14.1%) and 1029 (85.9%) did not (control group). Of the 169 patients with sarcoidosis and COVID-19, 84 (49.7%) were hospitalized (study group: mean age 62.4 years; 61.9% women; and 56.0% Black). The study group required supplemental oxygen (81% vs 62%; p = 0.001) and noninvasive ventilation (33.3% vs 6.4%; p < 0.001) more often and had lower mortality (15.5% vs. 30.4%; p = 0.004) than the control group. In patients hospitalized with COVID-19, sarcoidosis was not associated with critical COVID-19 (odds ratio, 0.77; 95% CI, 0.46-1.29; p = 0.317), but having sarcoidosis while taking immunosuppression therapy was associated with decreased risk of critical COVID-19 (odds ratio, 0.45; 95% CI, 0.31-0.65; p < 0.001). CONCLUSIONS Patients with sarcoidosis may not be at increased risk of critical illness or death from COVID-19, and immunosuppression therapy in these patients may reduce the risk of critical COVID-19.
Collapse
|
3
|
Vagts C, Sweis JJG, Sweis NWG, Ascoli C, Rottoli P, Martone FM, Wells AU, Judson MA, Sweiss NJ, Lower EE, Baughman RP. Initial behaviors and attitudes towards the COVID-19 vaccine in sarcoidosis patients: results of a self-reporting questionnaire. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2023; 40:e2023012. [PMID: 37382069 PMCID: PMC10494750 DOI: 10.36141/svdld.v40i2.14388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/09/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Individuals with self-declared sarcoidosis are at increased risk of COVID-19 related morbidity and mortality for which vaccination can be lifesaving. Despite this, vaccine hesitancy remains a large barrier to global acceptance of vaccination against COVID-19. We aimed to identify individuals with sarcoidosis who had and had not been vaccinated against COVID-19 vaccine to 1) establish a safety profile of COVID-19 vaccination in those with sarcoidosis and 2) to elucidate factors that contribute to COVID-19 vaccine hesitancy. METHODS A questionnaire inquiring about COVID-19 vaccination status, vaccination side effects, and willingness for future vaccination was distributed from December 2020 to May 2021 to individuals with sarcoidosis living in the US and European countries. Details regarding sarcoidosis manifestations and treatment were solicited. Vaccine attitudes were classified as pro or anti-COVID-19 vaccination for subgroup analysis. RESULTS At the time of questionnaire administration, 42% of respondents had already received a COVID-19 vaccination, most of whom either denied side effects or reported a local reaction only. Those off sarcoidosis therapy were more likely to report systemic side effects. Among subjects who had not yet received a COVID-19 vaccine, 27% of individuals reported they would not receive one once available. Reasons against vaccination were overwhelmingly related to the lack of confidence in vaccine safety and/or efficacy and less related to concerns associated with convenience or complacency. Black individuals, women, and younger adults were more likely to decline vaccination. CONCLUSIONS Among individuals with sarcoidosis, COVID-19 vaccination is well-accepted and well-tolerated. Subjects on sarcoidosis therapy reported significantly less vaccination side effects, and thus the correlation between side effects, vaccine type, and vaccine efficacy requires further investigation. Strategies to improve vaccination should focus on improving knowledge and education regarding vaccine safety and efficacy, as well as targeting sources of misinformation, particularly in young, black, and female subpopulations.
Collapse
Affiliation(s)
- Christen Vagts
- Division of Pulmonary Critical Care Sleep and Allergy, Department of Medicine, University of Illinois Chicago, Chicago IL, USA.
| | | | | | - Christian Ascoli
- Division of Pulmonary Critical Care Sleep and Allergy, Department of Medicine, University of Illinois Chicago, Chicago IL, USA.
| | - Paola Rottoli
- Specialization School of Respiratory Diseases, Department of Medical, Surgical and Neurological Sciences, Siena University, Italy.
| | | | - Athol U Wells
- Royal Brompton and Harefield National Health Service Foundation Trust, Interstitial Lung Disease Unit, London, UK.
| | - Marc A Judson
- Department of Medicine, Albany Medical College, Albany NY, USA.
| | - Nadera J Sweiss
- Division of Rheumatology and Medical Director of the Arthritis Clinic and Bernie Mac Sarcoidosis Translational Advanced Research (STAR) Center.
| | - Elyse E Lower
- University of Cincinnati Medical Center, Department of Medicine, Cincinnati, OH, USA.
| | - Robert P Baughman
- University of Cincinnati Medical Center, Department of Medicine, Cincinnati, OH, USA.
| |
Collapse
|
4
|
Sadeghi S, Mobarakeh SR, Momenzadeh M, Aria A, Heidarpour M, Ahmadi SH, Naderi Z. New-onset lung sarcoidosis, an adverse event by COVID-19 or a sign of convalescence; a case report. Clin Case Rep 2023; 11:e7339. [PMID: 37180324 PMCID: PMC10172450 DOI: 10.1002/ccr3.7339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023] Open
Abstract
Key Clinical Message Sarcoidosis is a systemic inflammatory disease able to affect any organ within the body. Sarcoidosis may be the body's secondary response to COVID-19 infection and a sign of rehabilitation. Early response to the treatments reinforces this hypothesis. The majority of sarcoidosis patients require immunosuppressive therapies, including corticosteroids. Abstract Most studies so far have focused on the management of COVID-19 in patients suffering from sarcoidosis. Nevertheless, the current report aims to present a COVID-19-induced sarcoidosis case. Sarcoidosis is a systemic inflammatory disease with granulomas. Still, its etiology is unknown. It often affects the lungs and lymph nodes. A previously healthy 47-year-old female was referred with the following chief complaints: atypical chest pain, dry cough, and dyspnea on exertion within a month after COVID-19 infection. Accordingly, a chest computed tomography revealed multiple conglomerated lymphadenopathies in the thoracic inlet, mediastinum, and hila. A core-needle biopsy from the nodes revealed non-necrotizing granulomatous inflammation, sarcoidal type. The sarcoidosis diagnosis was proposed and confirmed by a negative purified protein derivative (PPD) test. Accordingly, prednisolone was prescribed. All symptoms were relieved. A control lung HRCT was taken 6 months later, showing the lesions had disappeared. In conclusion, sarcoidosis may be the body's secondary response to COVID-19 infection and a sign of disease convalescence.
Collapse
Affiliation(s)
- Somayeh Sadeghi
- Acquired Immunodeficiency Research Center, Al‐Zahra HospitalIsfahan University of Medical SciencesIsfahanIran
- Department of Internal Medicine, Alzahra HospitalIsfahan University of Medical SciencesIsfahanIran
| | | | - Mahnaz Momenzadeh
- Department of Clinical Pharmacy and Pharmacy PracticeIsfahan University of Medical SciencesIsfahanIran
| | - Amir Aria
- Department of Internal Medicine, Alzahra HospitalIsfahan University of Medical SciencesIsfahanIran
| | - Mitra Heidarpour
- Department of PathologyIsfahan University of Medical SciencesIsfahanIran
| | - Somayeh Haji Ahmadi
- Department of Radiology, School of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Zohreh Naderi
- Acquired Immunodeficiency Research Center, Al‐Zahra HospitalIsfahan University of Medical SciencesIsfahanIran
- Department of Internal Medicine, Alzahra HospitalIsfahan University of Medical SciencesIsfahanIran
| |
Collapse
|
5
|
Sarcoidosis and COVID-19: At the Cross-Road between Immunopathology and Clinical Manifestation. Biomedicines 2022; 10:biomedicines10102525. [PMID: 36289785 PMCID: PMC9599235 DOI: 10.3390/biomedicines10102525] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 02/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been associated with dysregulation of the immune system featuring inappropriate immune responses, exacerbation of inflammatory responses, and multiple organ dysfunction syndrome in patients with severe disease. Sarcoidosis, also known as Besnier-Boeck-Schaumann disease, is an idiopathic granulomatous multisystem disease characterized by dense epithelioid non-necrotizing lesions with varying degrees of lymphocytic inflammation. These two diseases have similar clinical manifestations and may influence each other at multiple levels, eventually affecting their clinical courses and prognosis. Notably, sarcoidosis patients are at high risk of severe COVID-19 pneumonia because of the underlying lung disease and chronic immunosuppressive treatment. In this narrative review, we will discuss interactions between sarcoidosis and COVID-19 in terms of clinical manifestations, treatment, and pathogenesis, including the role of the dysregulated renin-angiotensin system, altered immune responses involving increased cytokine levels and immune system hyperactivation, and cellular death pathways.
Collapse
|
6
|
Strykowski R, Patel DC, Neto MR, Hena KM, Gulati M, Maier LIA, Patterson K. Rationale and design of the SARCoidosis Outcomes in all respiratory Viral Infectious Diseases (SARCOVID) Study. BMJ Open Respir Res 2022; 9:9/1/e001254. [PMID: 35882424 PMCID: PMC9329732 DOI: 10.1136/bmjresp-2022-001254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/11/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Respiratory infections are ubiquitous. The COVID-19 pandemic has refocused our attention on how morbid and potentially fatal they can be, and how host factors have an impact on the clinical course and outcomes. Due to a range of vulnerabilities, patients with sarcoidosis may be at higher risk of poor outcomes from respiratory infections. The objective of the SARCoidosis Outcomes in all respiratory Viral Infectious Diseases (SARCOVID) Study is to determine the short-term and long-term impacts of respiratory viral illnesses (COVID-19 and non-COVID-19) in sarcoidosis. METHODS AND ANALYSIS Up to 20 clinical sites across the USA are participating in the recruitment of 2000 patients for this observational, prospective study. To ensure that the study cohort is representative of the general population with sarcoidosis, participating sites include those dedicated to reaching under-represented minorities or patients from non-urban areas. Baseline data on demographic features, comorbidities, sarcoidosis characteristics and pre-enrolment lung function will be captured at study entry. During this 3-year study, all acute respiratory infectious events (from SARS-CoV-2 and any other respiratory pathogen) will be assessed and recorded at quarterly intervals. The level of required medical care and survival outcomes determine infection severity, and the impact of infection on quality of life measures will be recorded. Post-infection lung function and imaging results will measure the long-term impact on the trajectory of sarcoidosis. Patients will be analysed according to the clinical phenotypes of cardiac and fibrotic pulmonary sarcoidosis. Control groups include non-infected patients with sarcoidosis and patients with non-sarcoidosis interstitial lung disease. ETHICS AND DISSEMINATION Each site received local institutional review board approval prior to enrolling patients, with the consent process determined by local institution standards. Data will be published in a timely manner (goal <12 months) at the conclusion of the 3-year follow-up period and will be made available upon request.
Collapse
Affiliation(s)
- Rachel Strykowski
- Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, Illinois, USA
| | - Divya C Patel
- Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, Florida, USA
| | - Manny Ribeiro Neto
- Pulmonary Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Kerry M Hena
- Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, New York University, New York, New York, USA
| | - Mridu Gulati
- Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - LIsa A Maier
- Divisions of Cardiology and Pulmonary Medicine, National Jewish Health, Denver, Colorado, USA
| | - Karen Patterson
- Medicine, Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Medicine, Brighton and Sussex Medical School, Brighton, UK
| |
Collapse
|
7
|
Affiliation(s)
- Peter V Dicpinigaitis
- Albert Einstein College of Medicine and Montefiore Medical Center/Einstein Division, 1825 Eastchester Road, Bronx, NY, 10461, USA.
| |
Collapse
|
8
|
Gupta R, Judson MA, Baughman RP. Management of Advanced Pulmonary Sarcoidosis. Am J Respir Crit Care Med 2021; 205:495-506. [PMID: 34813386 DOI: 10.1164/rccm.202106-1366ci] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The term "advanced sarcoidosis" is used for forms of sarcoidosis with a significant risk of loss of organ function or death. Advanced sarcoidosis often involves the lung and is described as "Advanced Pulmonary Sarcoidosis" (APS) which includes advanced pulmonary fibrosis, associated complications such as bronchiectasis and infections, and pulmonary hypertension. While APS affects a small proportion of patients with sarcoidosis, it is the leading cause of poor outcomes including death. Herein we review the major patterns of APS with a focus on the current management as well as potential approaches for improved outcomes for this most serious sarcoidosis phenotype.
Collapse
Affiliation(s)
- Rohit Gupta
- Temple University School of Medicine, 12314, Thoracic Medicine and Surgery, Philadelphia, Pennsylvania, United States;
| | - Marc A Judson
- Albany Medical College, 1092, Division of Pulmonary and Critical Care Medicine, Albany, New York, United States
| | - Robert P Baughman
- University of Cincinnati Medical Center, 24267, Medicine, Cincinnati, Ohio, United States
| |
Collapse
|
9
|
Chen D, Zhang S, Feng Y, Wu W, Chang C, Chen S, Zhen G, Yi L. Decreased eosinophil counts and elevated lactate dehydrogenase predict severe COVID-19 in patients with underlying chronic airway diseases. Postgrad Med J 2021; 98:906-913. [PMID: 34810271 PMCID: PMC8610616 DOI: 10.1136/postgradmedj-2021-139704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/25/2021] [Indexed: 12/11/2022]
Abstract
Background Several predictors of COVID-19 severity have been reported. However, chronic airway inflammation characterised by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19. Methods In this retrospective cohort study, we reviewed the medical records of all patients with laboratory-confirmed COVID-19 with chronic bronchitis, chronic obstructive pulmonary disease (COPD) and asthma admitted to the Sino-French New City Branch of Tongji Hospital, a large regional hospital in Wuhan, China, from 26 January to 3 April. The Tongji Hospital Ethics Committee approved this study. Results There were 59 patients with chronic bronchitis, COPD and asthma. When compared with non-severe patients, severe patients were more likely to have decreased lymphocyte counts (0.6×10⁹/L vs 1.1×10⁹/L, p<0.001), eosinopaenia (<0.02×10⁹/L; 73% vs 24%, p<0.001), increased lactate dehydrogenase (LDH) (471.0 U/L vs 230.0 U/L, p<0.001) and elevated interleukin 6 level (47.4 pg/mL vs 5.7 pg/mL, p=0.002) on admission. Eosinopaenia and elevated LDH were significantly associated with disease severity in both univariate and multivariate regression models including the above variables. Moreover, eosinophil count and LDH level tended to return to normal range over time in both groups after treatment and severe patients recovered slower than non-severe patients, especially in eosinophil count. Conclusions Eosinopaenia and elevated LDH are potential predictors of disease severity in patients with COVID-19 with underlying chronic airway diseases. In addition, they could indicate disease progression and treatment effectiveness.
Collapse
Affiliation(s)
- Dian Chen
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Respiratory Diseases, National Health Commission of People's Republic of China, Wuhan, China
| | - Shuchen Zhang
- Department of Allergy, Huazhong University of Science and Technology, Wuhan, China
| | - Yuchen Feng
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Respiratory Diseases, National Health Commission of People's Republic of China, Wuhan, China
| | - Wenliang Wu
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Respiratory Diseases, National Health Commission of People's Republic of China, Wuhan, China
| | - Chenli Chang
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Respiratory Diseases, National Health Commission of People's Republic of China, Wuhan, China
| | - Shengchong Chen
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Respiratory Diseases, National Health Commission of People's Republic of China, Wuhan, China
| | - Guohua Zhen
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Respiratory Diseases, National Health Commission of People's Republic of China, Wuhan, China
| | - Lingling Yi
- Department of Internal Medicine, Huazhong University of Science and Technology, Wuhan, China .,Key Laboratory of Respiratory Diseases, National Health Commission of People's Republic of China, Wuhan, China
| |
Collapse
|
10
|
George LJ, Philip AM, John KJ, George AA, Nayar J, Mishra AK, Lal A. A review of the presentation and outcome of sarcoidosis in coronavirus disease 2019. J Clin Transl Res 2021; 7:657-665. [PMID: 34778596 PMCID: PMC8580525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/18/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In the setting of the current pandemic, concerns have arisen regarding the multisystemic involvement of sarcoidosis and the possible exacerbations in response to the exposure to severe acute respiratory syndrome coronavirus 2. AIM This study aims to compare the differences in clinical presentation, management, and outcome of coronavirus disease 2019 (COVID-19) between patients with sarcoidosis and those in the general population. METHODS A literature search was conducted by reviewing original research articles such as case reports, case series, observational studies, and questionnaire-based surveys published in PubMed/Medline, Web of Science, and Google scholar. Data from individual patients in case series and case reports have been pooled to create a data set that was compared with larger such cohorts obtained from several other observational studies. RESULTS Twenty-seven patients were identified from 14 original articles. No significant differences were found in the clinical manifestations of patients with sarcoidosis presenting with COVID-19 as compared to the general population. The rate of hospitalization in our study was found to be 48.1%. The overall mortality in our study was 7.4%, which is higher than the global average of 2.1%. CONCLUSION Our observations have reinforced the hypothesis that the presence of additional medical comorbidities is associated with a higher risk of intensive care unit admission. Furthermore, the presence of moderate to a severe limitation in pulmonary functions is an additional risk factor associated with increased hospital admissions and mortality in sarcoidosis. However, neither the diagnosis of sarcoidosis nor ongoing treatment with steroids, methotrexate, or other immunosuppressants was associated with a poorer prognosis in patients with sarcoidosis. RELEVANCE FOR PATIENTS Patients with sarcoidosis must take added precautions to mitigate the risk of acquiring COVID-19 infection in view of the COVID-19-related mortality rate in this group of patients. Specifically, immunocompromised patients (on immunomodulator drugs and high dose steroids) have been found to have an increased risk of contracting COVID-19. Overall impact on prognostication and outcome in cases requiring hospitalization remains yet to be determined.
Collapse
Affiliation(s)
- Lina James George
- Department of Pulmonary Medicine, DR KM Cherian Institute of Medical Sciences, Kallissery, Kerala, India
| | - Anil Mathew Philip
- Department of Medicine, St. Thomas Mission Hospital, Kattanam, Kerala, India
| | - Kevin John John
- Department of Critical Care, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Anu Anna George
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, United States
| | - Jemimah Nayar
- Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ajay Kumar Mishra
- Department of Internal Medicine, Division of Cardiology, Saint Vincent Hospital, Worcester, Massachusetts, United States
| | - Amos Lal
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, United States
| |
Collapse
|
11
|
Ouyang L, Gong J, Yu M. Pre-existing interstitial lung disease in patients with coronavirus disease 2019: A meta-analysis. Int Immunopharmacol 2021; 100:108145. [PMID: 34547678 PMCID: PMC8450148 DOI: 10.1016/j.intimp.2021.108145] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 01/15/2023]
Abstract
Background The impact of pre-existing interstitial lung disease (ILD) on the severity and mortality of COVID-19 remains largely unknown. The purpose of this meta-analysis was to investigate the prevalence of ILD among patients with COVID-19 and figure out the relationship between ILD and the poor clinical outcomes of COVID-19. Methods A systematic literature search was conducted in the PubMed, EMBASE, Web of Science and MedRxiv Database from 1 January 2020 to 26 May 2021. Results 15 studies with 135,263 COVID-19 patients were included for analysis of ILD prevalence. The pooled prevalence of comorbid ILD in patients with COVID-19 was 1.4% (95% CI, 1.1%-1.8%, I2 = 91%) with significant between-study heterogeneity. Moreover, the prevalence of ILD in non-survival patients with COVID-19 was 2.728-folds higher than that in corresponding survival patients (RR = 2.728, 95% CI 1.162–6.408, I2 = 54%, p = 0.021). Additionally, 2–3 studies were included for comparison analysis of clinical outcome between COVID-19 patients with and without ILD. The results showed that the mortality of COVID-19 patients with ILD was remarkably elevated compared with patients without ILD (RR = 2.454, 95% CI 1.111–5.421, I2 = 87%, p = 0.026). Meanwhile, the pooled RR of ICU admission for ILD vs. non-ILD cases with COVID-19 was 3.064 (95% CI 1.889–4.972, I2 = 0, p < 0.0001). No significant difference in utilizing rate of mechanical ventilation was observed between COVID-19 patients with and without ILD. Conclusions There is great variability in ILD prevalence among patients with COVID-19 across the globe. Pre-existing ILD is associated with higher severity and mortality of COVID-19.
Collapse
Affiliation(s)
- Lichen Ouyang
- Department of Immunology, School of Medicine, Jianghan University, Wuhan, China.
| | - Jie Gong
- Department of Anesthesiology, Union Hospital, Tongji Medical College, HuazhongUniversity of Science and Technology, Wuhan, China; The Clinical Skill Center, The First Clinical College, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Muqing Yu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
12
|
Autophagy and Mitophagy-Related Pathways at the Crossroads of Genetic Pathways Involved in Familial Sarcoidosis and Host-Pathogen Interactions Induced by Coronaviruses. Cells 2021; 10:cells10081995. [PMID: 34440765 PMCID: PMC8393644 DOI: 10.3390/cells10081995] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/16/2021] [Accepted: 07/29/2021] [Indexed: 12/12/2022] Open
Abstract
Sarcoidosis is a multisystem disease characterized by the development and accumulation of granulomas, the hallmark of an inflammatory process induced by environmental and/or infectious and or genetic factors. This auto-inflammatory disease mainly affects the lungs, the gateway to environmental aggressions and viral infections. We have shown previously that genetic predisposition to sarcoidosis occurring in familial cases is related to a large spectrum of pathogenic variants with, however, a clustering around mTOR (mammalian Target Of Rapamycin)-related pathways and autophagy regulation. The context of the COVID-19 pandemic led us to evaluate whether such genetic defects may increase the risk of a severe course of SARS-CoV2 infection in patients with sarcoidosis. We extended a whole exome screening to 13 families predisposed to sarcoidosis and crossed the genes sharing mutations with the list of genes involved in the SARS-CoV2 host-pathogen protein-protein interactome. A similar analysis protocol was applied to a series of 100 healthy individuals. Using ENRICH.R, a comprehensive gene set enrichment web server, we identified the functional pathways represented in the set of genes carrying deleterious mutations and confirmed the overrepresentation of autophagy- and mitophagy-related functions in familial cases of sarcoidosis. The same protocol was applied to the set of genes common to sarcoidosis and the SARS-CoV2-host interactome and found a significant enrichment of genes related to mitochondrial factors involved in autophagy, mitophagy, and RIG-I-like (Retinoic Acid Inducible Gene 1) Receptor antiviral response signaling. From these results, we discuss the hypothesis according to which sarcoidosis is a model for studying genetic abnormalities associated with host response to viral infections as a consequence of defects in autophagy and mitophagy processes.
Collapse
|
13
|
Baughman RP, Lower EE. COVID-19 infections in sarcoidosis: a prospective single center study of 886 sarcoidosis patients. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2021; 38:e2021029. [PMID: 34316261 PMCID: PMC8288208 DOI: 10.36141/svdld.v38i2.11646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/10/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Robert P Baughman
- Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Elyse E Lower
- Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| |
Collapse
|
14
|
Kondle S, Hou T, Manansala M, Ascoli C, Novak RM, Sweiss N. Treatment of COVID-19 in Patients With Sarcoidosis. Front Med (Lausanne) 2021; 8:689539. [PMID: 34336892 PMCID: PMC8322657 DOI: 10.3389/fmed.2021.689539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/17/2021] [Indexed: 01/16/2023] Open
Abstract
Recent case reports and studies on treating COVID-19 in patients with chronic sarcoidosis describe different treatment modalities ranging from glucocorticoids to biologic medications. This review article summarizes seven case series and reports totaling 46 patients. While one case report suggested that sarcoidosis medications such as glucocorticoids may lengthen the COVID-19 disease course, another study with a larger registry suggests they do not. More studies are needed to elucidate an improvement in outcomes. It is possible that addition of TNF-alpha inhibitors at COVID-19 diagnosis decreases hospitalization rate. Overall, it is difficult to make firm conclusions regarding treatment given the heterogeneity of treatment modalities in the current literature. Our summarized findings are outlined with the opinions of sarcoidosis, pulmonary, and infectious disease experts in a flow chart that provides clinicians with our proposed management algorithm for sarcoidosis patients who develop COVID-19. We emphasize a need for exchange of information regarding management of COVID-19 in the setting of sarcoidosis to further improve treatment in this vulnerable population of patients.
Collapse
Affiliation(s)
- Shreya Kondle
- Department of Medicine, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Titus Hou
- Department of Medicine, University of Illinois College of Medicine at Rockford, Rockford, IL, United States
| | - Michael Manansala
- Department of Medicine, University of Illinois College of Medicine at Chicago, Chicago, IL, United States
| | - Christian Ascoli
- Department of Medicine, University of Illinois College of Medicine at Chicago, Chicago, IL, United States
| | - Richard M Novak
- Department of Medicine, University of Illinois College of Medicine at Chicago, Chicago, IL, United States
| | - Nadera Sweiss
- Department of Medicine, University of Illinois College of Medicine at Chicago, Chicago, IL, United States
| |
Collapse
|
15
|
Kahlmann V, Manansala M, Moor CC, Shahrara S, Wijsenbeek MS, Sweiss NJ. COVID-19 infection in patients with sarcoidosis: susceptibility and clinical outcomes. Curr Opin Pulm Med 2021; 27:463-471. [PMID: 34397613 DOI: 10.1097/mcp.0000000000000812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Patients with sarcoidosis may be at higher risk of coronavirus disease-19 (COVID-19) as over 90% of the patients have pulmonary involvement and many are treated with immunosuppressive agents. This review will summarize the current literature regarding sarcoidosis and COVID-19, with a particular focus on susceptibility, clinical outcomes, management, and approach to vaccination. RECENT FINDINGS Data about COVID-19 and sarcoidosis include a number of case series and reports, cohort studies, and registries. Literature is not conclusive whether patients with sarcoidosis have increased susceptibility to COVID-19. Patients with moderate to severe impaired pulmonary function may be at increased risk of adverse outcomes and mortality. Whether immunosuppressive medication increases risk of COVID-19 severity or affects vaccination response is not yet clear. Novel approaches, such as telemedicine and home monitoring programs, are promising to ensure continuity of care for patients with sarcoidosis during the COVID-19 pandemic. SUMMARY Current evidence about the risk and clinical outcomes of COVID-19 infection in patient with sarcoidosis, is mainly extrapolated from other immune-mediated diseases. Hence, further research that focuses on the sarcoidosis population is warranted.
Collapse
Affiliation(s)
- Vivienne Kahlmann
- Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Catharina C Moor
- Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Shiva Shahrara
- Division of Rheumatology, Department of Medicine, University of Illinois at Chicago.,Jesse Brown VA Medical Center, Chicago, Illinois, USA
| | - Marlies S Wijsenbeek
- Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nadera J Sweiss
- Division of Rheumatology, Department of Medicine, University of Illinois at Chicago
| |
Collapse
|
16
|
Zhu J, Long Q, Mao H, Ran W. Effects of respiratory training on pulmonary function, bad mood, and quality of life in patients with COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26154. [PMID: 34114998 PMCID: PMC8202561 DOI: 10.1097/md.0000000000026154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND At present, whether respiratory training can improve the lung function, quality of life, and mental health of patients with Coronavirus Disease 2019 (COVID-19) is still controversial. Therefore, in order to provide new evidence-based medicine for clinical treatment, we conducted a systematic review and meta-analysis to evaluate the effects of respiratory training in improving lung function, quality of life, and mental health of patients with COVID-19. METHODS Relevant publications were searched from clinical trials. Computer was used to retrieve Cochrane Central Register of Controlled Trials Repositories, PubMed, Embase, and Web of Science databases. The retrieval time limit was from the establishment of the database to April 2021. Two researchers independently carried out data extraction and literature quality evaluation on the quality and meta-analysis of the included literature was performed with Revman 5.3 software. RESULTS The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This study will provide reliable evidence-based evidence on the effects of breathing training on lung function, bad mood, and quality of life in patients with COVID-19. ETHICS AND DISSEMINATION Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/ZQTGY.
Collapse
|
17
|
Characterization and Outcomes of SARS-CoV-2 Infection in Patients with Sarcoidosis. Viruses 2021; 13:v13061000. [PMID: 34071924 PMCID: PMC8228115 DOI: 10.3390/v13061000] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023] Open
Abstract
To analyze the clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with sarcoidosis from a large multicenter cohort from Southern Europe and to identify the risk factors associated with a more complicated infection. We searched for patients with sarcoidosis presenting with SARS-CoV-2 infection (defined according to the European Centre for Disease Prevention and Control guidelines) among those included in the SarcoGEAS Registry, a nationwide, multicenter registry of patients fulfilling the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders 1999 classification criteria for sarcoidosis. A 2:1 age-sex-matched subset of patients with sarcoidosis without SARS-CoV-2 infection was selected as control population. Forty-five patients with SARS-CoV-2 infection were identified (28 women, mean age 55 years). Thirty-six patients presented a symptomatic SARS-CoV-2 infection and 14 were hospitalized (12 required supplemental oxygen, 2 intensive care unit admission and 1 mechanical ventilation). Four patients died due to progressive respiratory failure. Patients who required hospital admission had an older mean age (64.9 vs. 51.0 years, p = 0.006), a higher frequency of baseline comorbidities including cardiovascular disease (64% vs. 23%, p = 0.016), diabetes mellitus (43% vs. 13%, p = 0.049) and chronic liver/kidney diseases (36% vs. 0%, p = 0.002) and presented more frequently fever (79% vs. 35%, p = 0.011) and dyspnea (50% vs. 3%, p = 0.001) in comparison with patients managed at home. Age- and sex-adjusted multivariate analysis identified the age at diagnosis of SARS-Cov-2 infection as the only independent variable associated with hospitalization (adjusted odds ratio 1.18, 95% conficence interval 1.04-1.35). A baseline moderate/severe pulmonary impairment in function tests was associated with a higher rate of hospitalization but the difference was not statistically significant (50% vs. 23%, p = 0.219). A close monitoring of SARS-CoV-2 infection in elderly patients with sarcoidosis, especially in those with baseline cardiopulmonary diseases and chronic liver or renal failure, is recommended. The low frequency of severe pulmonary involvement in patients with sarcoidosis from Southern Europe may explain the weak prognostic role of baseline lung impairment in our study, in contrast to studies from other geographical areas.
Collapse
|
18
|
Manansala M, Chopra A, Baughman RP, Novak R, Lower EE, Culver DA, Korsten P, Drake WP, Judson MA, Sweiss N. COVID-19 and Sarcoidosis, Readiness for Vaccination: Challenges and Opportunities. Front Med (Lausanne) 2021; 8:672028. [PMID: 33996868 PMCID: PMC8119656 DOI: 10.3389/fmed.2021.672028] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/06/2021] [Indexed: 12/19/2022] Open
Abstract
Sarcoidosis is an immune mediated chronic inflammatory disorder that is best characterized by non-caseating granulomas found in one or more affected organs. The COVID-19 pandemic poses a challenge for clinicians caring for sarcoidosis patients who may be at increased risk of infection compared to the general population. With the recent availability of COVID-19 vaccines, it is expected that clinicians raise questions regarding efficacy and safety in sarcoidosis. However, studies examining safety and efficacy of vaccines in sarcoidosis are lacking. In this review, we examine the current literature regarding vaccination in immunocompromised populations and apply them to sarcoidosis patients. The available literature suggests that vaccines are safe and effective in patients with autoimmune disorders and in those taking immunosuppressive medications. We strongly recommend the administration of COVID-19 vaccines in patients with sarcoidosis. We also present a clinical decision algorithm to provide guidance on vaccination of sarcoidosis patients against COVID-19.
Collapse
Affiliation(s)
- Michael Manansala
- Department of Medicine, Academic Internal Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Amit Chopra
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Albany Medical College, Albany, NY, United States
| | - Robert P Baughman
- Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, United States
| | - Richard Novak
- Division of Infectious Disease, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Elyse E Lower
- Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, United States
| | - Daniel A Culver
- Cleveland Clinic, Department of Pulmonary Medicine, Cleveland, OH, United States
| | - Peter Korsten
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Wonder P Drake
- Division of Infectious Disease, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Marc A Judson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Albany Medical College, Albany, NY, United States
| | - Nadera Sweiss
- Division of Rheumatology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| |
Collapse
|
19
|
Ferretti F, Cannatelli R, Benucci M, Carmagnola S, Clementi E, Danelli P, Dilillo D, Fiorina P, Galli M, Gallieni M, Genovese G, Giorgi V, Invernizzi A, Maconi G, Maier JA, Marzano AV, Morpurgo PS, Nebuloni M, Radovanovic D, Riva A, Rizzardini G, Sabiu G, Santus P, Staurenghi G, Zuccotti G, Sarzi-Puttini PC, Ardizzone S. How to Manage COVID-19 Vaccination in Immune-Mediated Inflammatory Diseases: An Expert Opinion by IMIDs Study Group. Front Immunol 2021; 12:656362. [PMID: 33936084 PMCID: PMC8082137 DOI: 10.3389/fimmu.2021.656362] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022] Open
Abstract
Since March 2020, the outbreak of Sars-CoV-2 pandemic has changed medical practice and daily routine around the world. Huge efforts from pharmacological industries have led to the development of COVID-19 vaccines. In particular two mRNA vaccines, namely the BNT162b2 (Pfizer-BioNTech) and the mRNA-1273 (Moderna), and a viral-vectored vaccine, i.e. ChAdOx1 nCoV-19 (AstraZeneca), have recently been approved in Europe. Clinical trials on these vaccines have been published on the general population showing a high efficacy with minor adverse events. However, specific data about the efficacy and safety of these vaccines in patients with immune-mediated inflammatory diseases (IMIDs) are still lacking. Moreover, the limited availability of these vaccines requires prioritizing some vulnerable categories of patients compared to others. In this position paper, we propose the point of view about the management of COVID-19 vaccination from Italian experts on IMIDs and the identification of high-risk groups according to the different diseases and their chronic therapy.
Collapse
Affiliation(s)
- Francesca Ferretti
- Gastroenterology Unit, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Rosanna Cannatelli
- Gastroenterology Unit, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Benucci
- Rheumatology Unit, S. Giovanni di Dio Hospital, Azienda USL-Toscana Centro, Florence, Italy
| | - Stefania Carmagnola
- Gastroenterology Unit, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Emilio Clementi
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy.,Scientific Institute IRCCS E. Medea, Lecco, Italy
| | - Piergiorgio Danelli
- Surgery Unit, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Dario Dilillo
- Pediatric Department, Ospedale dei Bambini, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Paolo Fiorina
- Division of Endocrinology, ASST Fatebenefratelli - Sacco, Milan, Italy.,International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi di Milano, Milan, Italy.,Nephrology Division, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, III Infectious Diseases unit, University Hospital "Luigi Sacco", Milan, Italy
| | - Maurizio Gallieni
- Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy.,Nephrology and Dialysis Unit, "L. Sacco" Hospital, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Giovanni Genovese
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Valeria Giorgi
- Rheumatology Unit, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Sciences Luigi Sacco, Università degli Studi di Milano, Milan, Italy.,The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, NSW, Australia
| | - Giovanni Maconi
- Gastroenterology Unit, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Jeanette A Maier
- Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Angelo V Marzano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Paola S Morpurgo
- Division of Endocrinology, ASST Fatebenefratelli - Sacco, Milan, Italy
| | - Manuela Nebuloni
- Pathology Unit, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Dejan Radovanovic
- Division of Respiratory Diseases, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Agostino Riva
- Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Università degli Studi di Milano, Milan, Italy.,School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Gianmarco Sabiu
- Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy.,Nephrology and Dialysis Unit, "L. Sacco" Hospital, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy.,Division of Respiratory Diseases, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Sciences Luigi Sacco, Università degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Ospedale dei Bambini, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Pier Carlo Sarzi-Puttini
- Rheumatology Unit, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Sandro Ardizzone
- Gastroenterology Unit, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
20
|
Abstract
In people recovering from COVID-19, there is concern regarding potential long-term pulmonary sequelae and associated impairment of functional capacity. Data published thus far indicate that spirometric indices appear to be generally well preserved, but that a defect in diffusing capacity (DLco) is a prevalent abnormality identified on follow-up lung function; present in 20-30% of those with mild to moderate disease and 60% in those with severe disease. Reductions in total lung capacity were commonly reported. Functional capacity is also often impaired, with data now starting to emerge detailing walk test and cardiopulmonary exercise test outcome at follow-up. In this review, we evaluate the published evidence in this area, to summarise the impact of COVID-19 infection on pulmonary function and relate this to the clinico-radiological findings and disease severity.
Collapse
Affiliation(s)
- Max Thomas
- Birmingham Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK
| | - Oliver J Price
- Clinical Exercise and Respiratory Physiology Research Group, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,Leeds Institute of Medical Research at St. James's, University of Leeds, UK
| | - James H Hull
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK.,Institute of Sport, Exercise and Health (ISEH), University College London (UCL), London, UK
| |
Collapse
|
21
|
Affiliation(s)
- Peter V. Dicpinigaitis
- Albert Einstein College of Medicine and Montefiore Medical Center, 1825 Eastchester Road, Bronx, NY 10461 USA
| |
Collapse
|
22
|
Yang H, Xu J, Liang X, Shi L, Wang Y. Autoimmune diseases are independently associated with COVID-19 severity: Evidence based on adjusted effect estimates. J Infect 2020; 82:e23-e26. [PMID: 33383087 PMCID: PMC7833739 DOI: 10.1016/j.jinf.2020.12.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 01/11/2023]
Affiliation(s)
- Haiyan Yang
- Department of Epidemiology, School of Public Heath, Zhengzhou University, No. 100 of Science avenue, Zhengzhou 450001, China.
| | - Jie Xu
- Department of Epidemiology, School of Public Heath, Zhengzhou University, No. 100 of Science avenue, Zhengzhou 450001, China
| | - Xuan Liang
- Department of Epidemiology, School of Public Heath, Zhengzhou University, No. 100 of Science avenue, Zhengzhou 450001, China
| | - Li Shi
- Department of Epidemiology, School of Public Heath, Zhengzhou University, No. 100 of Science avenue, Zhengzhou 450001, China
| | - Yadong Wang
- Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China
| |
Collapse
|
23
|
Baughman RP, Lower EE, Buchanan M, Rottoli P, Drent M, Sellares J, Terwiel M, Elfferich M, Francesqui J, Barriuso Cabrerizo MR, Sweiss N, Martone F, Al-Hakim T, Judson MA. Risk and outcome of COVID-19 infection in sarcoidosis patients: results of a self-reporting questionnaire. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2020; 37:e2020009. [PMID: 33597796 PMCID: PMC7883514 DOI: 10.36141/svdld.v37i4.10726] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/29/2020] [Indexed: 01/02/2023]
Abstract
Background: It has been suggested that sarcoidosis patients, especially those on immunosuppressive medications, are at increased risk for COVID-19 infection and more severe disease. Methods: A questionnaire was developed in four languages (English, Dutch, Italian, and Spanish). The questionnaire queried whether patients had been infected with COVID-19 and outcome of the infection. Risk factors for COVID-19 infection were collected. Results: A total of 5200 sarcoidosis patients completed the questionnaire with 116 (2.23%) reporting infection and 18 (15.8%) required hospitalization. Increased hazard ratio (HR) for COVID-19 infection were seen for those with a COVID-19 infected roommate (HR=27.44, p<0.0001), health care provider (HR=2.4, p=0.0001), pulmonary sarcoidosis (HR=2.48, p=0.001), neurosarcoidosis (HR=2.02, p<0.01), or rituximab treatment (HR=5.40, p<0.0001). A higher rate of hospitalization was found for those with underlying heart disease (HR=3.19 (1.297-7.855), p<0.02). No other feature including race, other immunosuppressive agent, age, or underlying condition was associated with a significant increased risk for infection or more severe disease. Conclusion: The overall rate of COVID-19 was 2.23%, suggesting an increased rate of COVID-19 infection. However, when an analysis of the questionnaires of sarcoidosis and non-sarcoidosis patients was performed in one localized area over this time period, the rate of COVID-19 infection was similar in both groups. Sarcoidosis patients who cohabitated with COVID-19 infected individuals, worked in health care, had pulmonary or neurologic sarcoidosis, or were treated with rituximab had an increased risk for COVID-19 infection. No significant increased risk for hospitalization could be identified based on age, race, gender or any specific immunosuppressive treatment. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (4): e2020009)
Collapse
Affiliation(s)
- Robert P Baughman
- University of Cincinnati Medical Center, Department of Medicine, Cincinnati, OH, USA
| | - Elyse E Lower
- University of Cincinnati Medical Center, Department of Medicine, Cincinnati, OH, USA
| | | | - Paola Rottoli
- Specialization School of Respiratory Diseases, Dept of Medical, Surgical and Neurological Sciences, Siena University, Italy
| | - Marjolein Drent
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands.,Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht, the Netherlands.,ild care foundation research team, Ede, the Netherlands
| | - Jacobo Sellares
- Servei de Pneumologia, Respiratory Institute, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomedica en Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Spain.,Interstitial Lung Diseases Core member, European Reference Network for Rare Diseases of the Respiratory System (ERN-LUNG), Spain
| | - Michelle Terwiel
- ILD Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Marjon Elfferich
- ild care foundation research team, Ede, the Netherlands.,Hospital Gelderse Vallei, Ede, the Netherlands
| | - Joel Francesqui
- Servei de Pneumologia, Respiratory Institute, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | | | - Nadera Sweiss
- Division of Rheumatology and Medical Director of the Arthritis Clinic and Bernie Mac Sarcoidosis Translational Advanced Research Center (STAR), University of Illinois Chicago, Chicago IL, USA
| | | | | | - Marc A Judson
- Department of Medicine, Albany Medical College, Albany NY, USA
| |
Collapse
|
24
|
Lommatzsch M, Rabe KF, Taube C, Joest M, Kreuter M, Wirtz H, Blum TG, Kolditz M, Geerdes-Fenge H, Otto-Knapp R, Häcker B, Schaberg T, Ringshausen FC, Vogelmeier CF, Reinmuth N, Reck M, Gottlieb J, Konstantinides S, Meyer FJ, Worth H, Windisch W, Welte T, Bauer T. [Risk Assessment for Patients with Chronic Respiratory and Pulmonary Conditions in the Context of the SARS-CoV-2 Pandemic - Statement of the German Respiratory Society (DGP) with the Support of the German Association of Respiratory Physicians (BdP)]. Pneumologie 2020; 75:19-30. [PMID: 33242887 DOI: 10.1055/a-1321-3400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- M Lommatzsch
- Zentrum für Innere Medizin, Abteilung Pneumologie, Universitätsmedizin Rostock, Rostock
| | - K F Rabe
- LungenClinic Großhansdorf, Großhansdorf.,Deutsches Zentrum für Lungenforschung
| | - C Taube
- Klinik für Pneumologie, Universitätsmedizin Essen-Ruhrlandklinik, Westdeutsches Lungenzentrum, Essen
| | - M Joest
- Lungen- und Allergiezentrum Bonn, Bonn
| | - M Kreuter
- Zentrum für interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.,Deutsches Zentrum für Lungenforschung
| | - H Wirtz
- Abt. Pneumologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - T G Blum
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| | - M Kolditz
- Medizinische Klinik 1, Bereich Pneumologie, Universitätsklinikum Carl Gustav Carus, Dresden
| | - H Geerdes-Fenge
- Universitätsmedizin Rostock, Zentrum für Innere Medizin, Abteilung für Infektionskrankheiten und Tropenmedizin, Rostock
| | - R Otto-Knapp
- Dtsch. Zentralkomitee zur Bekämpfung der Tuberkulose, DZK, Berlin
| | - B Häcker
- Dtsch. Zentralkomitee zur Bekämpfung der Tuberkulose, DZK, Berlin
| | | | - F C Ringshausen
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover.,Deutsches Zentrum für Lungenforschung
| | - C F Vogelmeier
- Klinik für Pneumologie, Universitätsklinikum Marburg, Marburg.,Deutsches Zentrum für Lungenforschung
| | - N Reinmuth
- Asklepios Fachkliniken München-Gauting, Thorakale Onkologie, Gauting.,Deutsches Zentrum für Lungenforschung
| | - M Reck
- LungenClinic Großhansdorf, Großhansdorf.,Deutsches Zentrum für Lungenforschung
| | - J Gottlieb
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover.,Deutsches Zentrum für Lungenforschung
| | - S Konstantinides
- Centrum für Thrombose und Hämostase (CTH), Universitätsmedizin Mainz, Mainz
| | - F J Meyer
- Lungenzentrum München (Bogenhausen-Harlaching), München Klinik, München
| | | | - W Windisch
- Lungenklinik, Kliniken der Stadt Köln GmbH, Lehrstuhl für Pneumologie der Universität Witten-Herdecke
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover.,Deutsches Zentrum für Lungenforschung
| | - T Bauer
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| |
Collapse
|