How to handle patients with autoimmune rheumatic and inflammatory bowel diseases in the COVID-19 era: An expert opinion

Piercarlo Sarzi-Puttini; Daniela Marotto; Marco Antivalle; Fausto Salaffi; Fabiola Atzeni; Giovanni Maconi; Giovanni Monteleone; Giuliano Rizzardini; Spinello Antinori; Massimo Galli; Sandro Ardizzone

doi:10.1016/j.autrev.2020.102574

How to handle patients with autoimmune rheumatic and inflammatory bowel diseases in the COVID-19 era: An expert opinion

Autoimmun Rev. 2020 Jul;19(7):102574. doi: 10.1016/j.autrev.2020.102574. Epub 2020 May 5.

Affiliations

¹ Rheumatology Unit, ASST Fatebenefratelli-Sacco, L. Sacco Department of Biochemical and Clinical Sciences, University of Milan, Milan, Italy. Electronic address: piercarlo.sarziputtini@gmail.com.
² Rheumatology Unit, ASST Fatebenefratelli-Sacco, L. Sacco Department of Biochemical and Clinical Sciences, University of Milan, Milan, Italy.
³ Rheumatological Clinic, Ospedale Carlo Urbani, Università Politecnica delle Marche, Jesi, Ancona, Italy.
⁴ Rheumatology Unit, University of Messina, Messina, Italy.
⁵ Gastroenterology Unit, ASST Fatebenefratelli-Sacco, Milan L. Sacco Department of Biochemical and Clinical Sciences, University of Milan, Milan, Italy.
⁶ Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
⁷ Department of Infectious Diseases, I Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
⁸ Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, L. Sacco Hospital, Milan, Italy.

Abstract

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A correct patient risk stratification is of paramount importance for the proper management of economic and human resources.
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Clinical trials are crucial to assessing immunosuppressant prophylaxis and treatment to avoid overuse and treatment shortage.
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Controlled studies may highlight a potential preventive role of immunosuppressant in the development of Covid-19 severe forms
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Despite the risk of infection in rheumatic and gastroenterological diseases a conclusive link with COV-19 remains questionable

Keywords: COVID-19; DMARDs; Flow-chart; Infection; Inflammatory bowel disease; Prevention; Rheumatic disease; Small molecules; Treatment; bDMARDs.

Publication types

Review

MeSH terms

Antirheumatic Agents / therapeutic use
Autoimmune Diseases / complications
Autoimmune Diseases / drug therapy*
Betacoronavirus
COVID-19
Coronavirus Infections / complications*
Humans
Immunosuppressive Agents / therapeutic use*
Inflammatory Bowel Diseases / complications
Inflammatory Bowel Diseases / drug therapy*
Pandemics
Pneumonia, Viral / complications*
Rheumatic Diseases / drug therapy*
Risk Factors
SARS-CoV-2

Substances

Antirheumatic Agents
Immunosuppressive Agents