Corona Virus Disease 2019 (COVID-19) has become a pandemic affecting the entire the world.
Rheumatologists may play an important role in the management of COVID-19 cases owing to their
experiences on inflammation and macrophage activating syndrome (MAS), one of the most important
complications of COVID-19. Here, we present the applicability of pediatric rheumatology treatment
methods on COVID-19 therapy, and management of children with rheumatic diseases using immune
suppressive treatments, in this pandemic season. COVID-19 causes severe acute respiratory distress
syndrome (SARS) in about 20% of infected patients. The virus specifically recognizes the angiotensin
converting enzyme 2 (ACE2) receptor by its spike protein. In patients whose immunomodulatory capacities
are not strong enough, the virus can trigger a severe cytokine storm. The rheumatologist may play an
important role to avoid this complication with a timely treatment. In COVID-19 patients, by detecting
elevated serum ferritin levels, cytokine storm syndrome can be recognized early, and the necessary
treatments can be initiated on time. Anti-rheumatic drugs, such as hydroxychloroquine, colchicine,
interleukin-1 and interleukin-6 blockers, JAK inhibitors, TNF inhibitors are used in the treatment of
COVID-19 at different stages of the disease. Another very important issue is the management of patients
with rheumatic diseases in this pandemic season. The increased risk of infection is an important concern
in patients with rheumatic disease who are receiving immunosuppressive drugs. Various rheumatism
associations have recommended the continuation of anti-rheumatism treatments to control of chronic
inflammatory status, based on the experience so far
Frequency, characteristics and outcome of corona virus disease 2019 (COVID-19) infection in Iranian patients with rheumatic diseases
