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J Clin Med . COVID-19 in Autoinflammatory Diseases with Immunosuppressive Treatment

tetano

Editor, Senior Moderator
J Clin Med


. 2021 Feb 5;10(4):605.
doi: 10.3390/jcm10040605.
COVID-19 in Autoinflammatory Diseases with Immunosuppressive Treatment


Tatjana Welzel[SUP] 1 2 [/SUP], Samuel Dembi Samba[SUP] 1 [/SUP], Reinhild Klein[SUP] 3 [/SUP], Johannes N van den Anker[SUP] 2 4 [/SUP], Jasmin B Kuemmerle-Deschner[SUP] 1 [/SUP]



Affiliations

Abstract

COVID-19 disease increases interleukin (IL)-1β release. Anti-IL-1-treatment is effective in IL-1-mediated autoinflammatory diseases (AID). This case series presents COVID-19 in patients with IL-1-mediated and unclassified AID with immunosuppressive therapy (IT). Patient 1 is a 34-year-old woman with an unclassified AID and methotrexate. Patients 2 and 3 (14-year-old girl and 12-year-old boy, respectively) have a Cryopyrin-Associated Periodic Syndrome (NLRP3 p.Q703K heterozygous, CAPS) treated with canakinumab 150 mg/month since three and five years, respectively. Patient 4 is a 15-year-old girl who has had familial Mediterranean fever (MEFV p.M694V homozygous) for 3 years treated with canakinumab 150 mg/month and colchicine. All patients had a mild acute COVID-19 course, particularly the adolescent patients. A few weeks after COVID-19 recovery, both CAPS patients developed increased AID activity, necessitating anti-IL-1-treatment intensification in one patient. At day 100, one out of four patients (25%) showed positive antibody response to SARS-CoV-2. This is one of the first reports providing follow-up data about COVID-19 in AID. The risk for severe acute COVID-19 disease was mild/moderate, but increased AID activity post-COVID-19 was detected. Follow-up data and data combination are needed to expand understanding of COVID-19 and SARS-CoV-2 immunity in AID and the role of IT.

Keywords: CAPS; FMF; Interleukin-1; SARS-CoV-2 antibody response; autoinflammatory diseases; coronavirus.
 
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