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No SLE patients with COVID-19? An interesting commentary in BMJ

Ann Rheum Dis. 2020 Apr 15.
SLE, hydroxychloroquine and no SLE patients with covid-19: a comment.
Joob B1, Wiwanitkit V2.
Author information
1 Medical Center, Sanitation 1 Medical Academic Center, Bangkok, Thailand beuyjoob@hotmail.com.
2 Department of Community Medicine, Dr DY Patil University, Pune, Maharastra, India.
Inter-relationship between covid-19 and rheumatic diseases is an interesting topic in clinical rheumatology. We found that article ‘Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies’ is informative. Monti et al suggested for ‘avoiding the unjustifiable preventive withdrawal of DMARDs, which could lead to an increased risk of relapses and morbidity from the chronic rheumatological condition’.1 Whether standard therapy for rheumatic diseases have any effect on clinical course of covid-19 is an interesting issue. Clinically, co-occurrence between covid-19 and other medical disorder is an interesting situation. We hereby would like to draw attention to a specific disease that is little mentioned, systemic lupus erythematosus (SLE). SLE is a common immunological disorder that is seen worldwide. There are several thousands of patients with covid-19 worldwide. Nevertheless, there is no case of SLE with covid-19. In fact, a similar unusual clinical observation is already mentioned on covid-19 and HIV infection.1 HIV‐infected patients who intake anti‐HIV drug might have lower risk to get covid-19 than general population since anti-HIV drug is proven for efficacy against the novel coronavirus.2 Regarding SLE, hydroxychloroquine is a widely used drug for treatment.3 Hydroxychloroquine is also reported for efficacy against covid-19.4
Hence, hydroxychloroquine use might be an explanation for no report on SLE patient with covid-19. This is an example that can support the suggestion of Monti et al on medication for rheumatic diseases in the present covid-19 crisis.
References
  1. Monti S, Balduzzi S, Delvino P, et al. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis 2020:annrheumdis-2020-217424.doi:10.1136/annrheumdis-2020-217424pmid:http://www.ncbi.nlm.nih.gov/pubmed/32241793PubMedGoogle Scholar
  2. Joob B, Wiwanitkit V. SARS-CoV-2 and HIV. J Med Virol 2020. doi:doi:10.1002/jmv.25782. [Epub ahead of print: 27 Mar 2020].pmid:http://www.ncbi.nlm.nih.gov/pubmed/32220066PubMedGoogle Scholar
  3. Yasri S, Wiwanitkit V. Dose prediction of lopinavir/ritonavir for 2019-novel coronavirus (2019-nCoV) infection based on mathematic modeling. Asian Pac J Trop Med 2020;13:137–8. ‐.doi:10.4103/1995-7645.277815Google Scholar
  4. Ponticelli C, Moroni G. Hydroxychloroquine in systemic lupus erythematosus (SLE). Expert Opin Drug Saf 2017;16:411–9.doi:10.1080/14740338.2017.1269168pmid:http://www.ncbi.nlm.nih.gov/pubmed/27927040PubMedGoogle Scholar
KEYWORDS:
immune complex diseases; inflammation; lupus erythematosus systemic
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