Rheumatological aspects of pathogenesis and treatment of COVID-19 infection
Desislava Kalinova,Rasho Rashkov +1 more
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TLDR
Treatment regimens have been developed for both patients with COVID-19 and those with symptomatic SARS-CoV infection and rheumatic disease, and the constantly new and tested concepts in the treatment of COVID testify to the growing knowledge about the virus, but also to the need for more targeted therapy.Abstract:
Contemporary rheumatology is a field dealing with the phenomena of autoimmune states and inflammation. Rheumatic diseases cover a wide spectrum of diseases of the musculoskeletal system, connective tissue and vessels. The occurrence of an immune, autoimmune and autoinflammatory response is often linked to different kinds of infections. Which aspects of the coronavirus infection relate to rheumatological therapy and practice? In order to answer this question one needs to look at the pathogenesis of the SARS-CoV-2 infection. Antimalarial drugs may block antigen presentation of the viral peptides from antigen presenting cells, as they may alter the lysosomal proteases that mediate the viral entry in the cells and have demonstrated efficacy in improving the infection. Anti-IL-6 may interfere with cytokine storm in severe cases and use of tocilizumab has had good results in a small cohort. Baricitinib not only plays a role in inhibiting the synthesis of cytokines but it also has a function in suppressing receptor-mediated endocytosis. The constantly new and tested concepts in the treatment of COVID testify to the growing knowledge about the virus, but also to the need for more targeted therapy. Treatment regimens have been developed for both patients with COVID-19 and those with symptomatic SARS-CoV infection and rheumatic disease. This article is an attempt to discuss the management of COVID-19 and coexisting rheumatic disease.read more
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Therapeutic and anti-inflammatory effects of baricitinib on mortality, ICU transfer, clinical improvement, and CRS-related laboratory parameters of hospitalized patients with moderate to severe COVID-19 pneumonia: a systematic review and meta-analysis
Sepideh Tahsini Tekantapeh,Morteza Ghojazadeh,Ali Ghamari,Aida Mohammadi,Hassan Soleimanpour +4 more
TL;DR: Baricitinib prescription is strongly recommended in moderate to severe COVID-19 and the meta-analysis result of eight included cohort studies and five Randomized Control Trials showed beneficial effects of effective antiviral and anti-inflammatory drugs used in other diseases.
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