Management of childhood-onset autoinflammatory diseases during the COVID-19 pandemic

Rheumatol Int. 2020 Sep;40(9):1423-1431. doi: 10.1007/s00296-020-04645-x. Epub 2020 Jul 13.

Abstract

Concerns regarding the comorbidity as a significant risk factor for Coronavirus Disease-2019 (COVID-19), gave rise to an urgent need for studies evaluating patients with chronic conditions such as autoinflammatory diseases (AIDs). We prepared a web-based survey investigating the clinical findings and contact histories among pediatric patients with AIDs. Confirmed COVID-19 cases, patients with contact history and those with symptoms which were highly suggestive of COVID-19 were called via phone or recruited to a video or face to face appointment. Data of AIDs were obtained from their medical records, retrospectively. Laboratory and screening findings were confirmed by our national health registry website. There were 404 patients (217 female) eligible for the enrollment. During pandemic, 375 (93%) were on colchicine treatment and 48 (11.8%) were receiving biologic treatment. Twenty-four out of 404 patients were admitted to hospital due to COVID-19 suspicion. Severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) was identified through rhinopharyngeal swabs in seven patients, six of whom were only on colchicine treatment. Only one patient with no finding of any severe respiratory complications was hospitalized. All of seven patients recovered completely. Among patients on biologic drugs, neither a symptom nor a positive polymerase chain reaction test for COVID 19 was detected. In conclusion, pediatric patients with AIDs, those receiving biologic treatment and/or colchicine, may not be at increased risk for neither being infected nor the severe disease course.

Keywords: Autoinflammatory diseases; Biologic drug; Colchicine; Covid-19; SARS-CoV-2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adalimumab / therapeutic use
  • Adolescent
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Betacoronavirus
  • Biological Products
  • COVID-19
  • Child
  • Child, Preschool
  • Cohort Studies
  • Colchicine / therapeutic use*
  • Coronavirus Infections / complications
  • Coronavirus Infections / physiopathology*
  • Coronavirus Infections / therapy
  • Cryopyrin-Associated Periodic Syndromes / complications
  • Cryopyrin-Associated Periodic Syndromes / drug therapy
  • Etanercept / therapeutic use
  • Familial Mediterranean Fever / complications
  • Familial Mediterranean Fever / drug therapy
  • Female
  • Hereditary Autoinflammatory Diseases / complications
  • Hereditary Autoinflammatory Diseases / drug therapy*
  • Humans
  • Infant
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use
  • Male
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / physiopathology*
  • Pneumonia, Viral / therapy
  • SARS-CoV-2
  • Tubulin Modulators / therapeutic use*
  • Tumor Necrosis Factor Inhibitors / therapeutic use*
  • Turkey
  • Young Adult

Substances

  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Interleukin 1 Receptor Antagonist Protein
  • Tubulin Modulators
  • Tumor Necrosis Factor Inhibitors
  • canakinumab
  • Adalimumab
  • tocilizumab
  • Etanercept
  • Colchicine