COVID-19 with rheumatic diseases: a report of 5 cases

Clin Rheumatol. 2020 Jul;39(7):2025-2029. doi: 10.1007/s10067-020-05160-x. Epub 2020 May 14.

Abstract

The coronavirus disease 2019 (COVID-19), the result of an infection with the new virus, SARS-CoV-2, is rapidly spreading worldwide. It is largely unknown whether the occurrence of COVID-19 in patients with rheumatic immune diseases has some specific manifestations, or makes them more prone to rapidly progress into severe COVID-19. In this case report, we describe the clinical features of 5 rheumatic immune disease patients with the concomitant presence of COVID-19. Amongst these patients, 4 had rheumatoid arthritis (RA) and 1 had systemic sclerosis (SSc). Two patients had a history of close contact with a COVID-19 patient. The age of the patients ranged between 51 and 79 years. Fever (80%), cough (80%), dyspnea (40%), and fatigue (20%) were the most common presenting symptoms. Laboratory investigations revealed leukopenia and lymphopenia in 2 patients. In all the patients, chest computerized tomography (CT) revealed patchy ground glass opacities in the lungs. During the hospital stay, the condition of two patients remained the same (i.e., mild COVID-19), two patients progressed to the severe COVID-19, and one patient worsened to the critically ill COVID-19. These patients were treated with antiviral agents for COVID-19, antibiotics for secondary bacterial infections, and immunomodulatory agents for rheumatic immune diseases. All the patients responded well, were cured of COVID-19, and subsequently discharged.

Keywords: COVID-19; Coronavirus; Rheumatic immune disease; SARS-CoV-2.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiviral Agents / therapeutic use*
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / epidemiology
  • Arthritis, Rheumatoid* / therapy
  • Betacoronavirus / isolation & purification
  • Blood Cell Count / methods
  • COVID-19
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / immunology
  • Coronavirus Infections* / therapy
  • Critical Illness / therapy
  • Disease Progression
  • Female
  • Humans
  • Immunomodulation*
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / immunology
  • Pneumonia, Viral* / therapy
  • SARS-CoV-2
  • Scleroderma, Systemic* / diagnosis
  • Scleroderma, Systemic* / epidemiology
  • Scleroderma, Systemic* / therapy
  • Symptom Assessment / methods
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Antiviral Agents