Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments

Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: To investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Method: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients along with the significant correlations with important clinical features and therapeutic regimens suggests the need to develop targeted prevention/management strategies during the current pandemic wave.

Download Full-text

Krill oil and low-dose aspirin combination mitigates experimentally induced silicosis in rats: role of NF-κB/TGF-β1/MMP-9 pathway

Environmental Science and Pollution Research ◽

10.1007/s11356-020-11921-7 ◽

2021 ◽

Author(s):

Ahmed G. Abd Elhameed

Keyword(s):

Low Dose ◽

Krill Oil ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Tgf Β1 ◽

Experimentally Induced

Download Full-text

Pih Prophylaxis—Role of Low Dose Aspirin

Hypertensive Disorders in Pregnancy ◽

10.5005/jp/books/10368_22 ◽

2007 ◽

pp. 279-279

Author(s):

Ashwini Gandhi ◽

Darade Rajesh

Keyword(s):

Low Dose ◽

Dose Aspirin ◽

Low Dose Aspirin

Download Full-text

COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series

Clinical Rheumatology ◽

10.1007/s10067-020-05334-7 ◽

2020 ◽

Vol 39 (11) ◽

pp. 3195-3204 ◽

Cited By ~ 3

Author(s):

Clodoveo Ferri ◽

◽

Dilia Giuggioli ◽

Vincenzo Raimondo ◽

Massimo L’Andolina ◽

...

Keyword(s):

Immune System ◽

General Population ◽

Connective Tissue ◽

Inflammatory Arthritis ◽

Systemic Disease ◽

Management Strategies ◽

Connective Tissue Diseases ◽

Systemic Diseases ◽

High Exposure ◽

Disease Modifying

Abstract Introduction Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune systemic diseases. We investigated the clinical-epidemiological findings of 1641 autoimmune systemic disease Italian patients during the Covid-19 pandemic. Method This observational multicenter study included 1641 unselected patients with autoimmune systemic diseases from three Italian geographical areas with different prevalence of Covid-19 [high in north (Emilia Romagna), medium in central (Tuscany), and low in south (Calabria)] by means of telephone 6-week survey. Covid-19 was classified as (1) definite diagnosis of Covid-19 disease: presence of symptomatic Covid-19 infection, confirmed by positive oral/nasopharyngeal swabs; (2) highly suspected Covid-19 disease: presence of highly suggestive symptoms, in absence of a swab test. Results A significantly higher prevalence of patients with definite diagnosis of Covid-19 disease, or with highly suspected Covid-19 disease, or both the conditions together, was observed in the whole autoimmune systemic disease series, compared to “Italian general population” (p = .030, p = .001, p = .000, respectively); and for definite + highly suspected diagnosis of Covid-19 disease, in patients with autoimmune systemic diseases of the three regions (p = .000, for all comparisons with the respective regional general population). Moreover, significantly higher prevalence of definite + highly suspected diagnosis of Covid-19 disease was found either in patients with various “connective tissue diseases” compared to “inflammatory arthritis group” (p < .000), or in patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs treatments (p = .011). Conclusions The finding of a higher prevalence of Covid-19 in patients with autoimmune systemic diseases is particularly important, suggesting the need to develop valuable prevention/management strategies, and stimulates in-depth investigations to verify the possible interactions between Covid-19 infection and impaired immune-system of autoimmune systemic diseases. Key Points• Significantly higher prevalence of Covid-19 is observed in a large series of patients with autoimmune systemic diseases compared to the Italian general population, mainly due to patients’ increased susceptibility to infections and favored by the high exposure to the virus at medical facilities before the restriction measures on individual movement.• The actual prevalence of Covid-19 in autoimmune systemic diseases may be underestimated, possibly due to the wide clinical overlapping between the two conditions, the generally mild Covid-19 disease manifestations, and the limited availability of virological testing.• Patients with “connective tissue diseases” show a significantly higher prevalence of Covid-19, possibly due to deeper immune-system impairment, with respect to “inflammatory arthritis group”.• Covid-19 is more frequent in the subgroup of autoimmune systemic diseases patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs, mainly hydroxyl-chloroquine and methotrexate, which might play some protective role against the most harmful manifestations of Covid-19.

Download Full-text

COX-1–derived thromboxane A2 plays an essential role in early B-cell development via regulation of JAK/STAT5 signaling in mouse

Blood ◽

10.1182/blood-2014-03-559658 ◽

2014 ◽

Vol 124 (10) ◽

pp. 1610-1621 ◽

Cited By ~ 12

Author(s):

Qiong Yang ◽

Maohua Shi ◽

Yujun Shen ◽

Yingjiao Cao ◽

Shengkai Zuo ◽

...

Keyword(s):

B Cell ◽

Essential Role ◽

Suppressive Effect ◽

Cell Development ◽

B Cell Development ◽

Dose Aspirin ◽

Key Points ◽

Low Dose Aspirin ◽

Cox 1

Key Points This study demonstrated an essential role of COX-1 in early B-cell development. Low-dose aspirin may have a potential suppressive effect on B-cell development in humans.

Download Full-text