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COVID-19 in Autoinflammatory Diseases with Immunosuppressive Treatment

Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen (arcT), University Children’s Hospital Tuebingen, 72076 Tuebingen, Germany
Pediatric Pharmacology and Pharmacometrics, University Children‘s Hospital Basel (UKBB), University of Basel, 4056 Basel, Switzerland
Department of Internal Medicine II, Immunopathological Laboratory, 72076 Tuebingen, Germany
Divison of Clinical Pharmacology, Children’s National Hospital, 111 Michigan Avenue, NW, Washington, DC 20010, USA
Author to whom correspondence should be addressed.
The authors contributed equally.
Academic Editor: Eugen Feist; Eugen Feist; Erkan Demirkaya
J. Clin. Med. 2021, 10(4), 605;
Received: 27 November 2020 / Revised: 19 January 2021 / Accepted: 2 February 2021 / Published: 5 February 2021
(This article belongs to the Special Issue Systemic Autoinflammatory Diseases—Clinical Rheumatic Challenges)
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. View Full-Text
Keywords: Interleukin-1; autoinflammatory diseases; CAPS; FMF; coronavirus; SARS-CoV-2 antibody response Interleukin-1; autoinflammatory diseases; CAPS; FMF; coronavirus; SARS-CoV-2 antibody response
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MDPI and ACS Style

Welzel, T.; Samba, S.D.; Klein, R.; van den Anker, J.N.; Kuemmerle-Deschner, J.B. COVID-19 in Autoinflammatory Diseases with Immunosuppressive Treatment. J. Clin. Med. 2021, 10, 605.

AMA Style

Welzel T, Samba SD, Klein R, van den Anker JN, Kuemmerle-Deschner JB. COVID-19 in Autoinflammatory Diseases with Immunosuppressive Treatment. Journal of Clinical Medicine. 2021; 10(4):605.

Chicago/Turabian Style

Welzel, Tatjana, Samuel D. Samba, Reinhild Klein, Johannes N. van den Anker, and Jasmin B. Kuemmerle-Deschner 2021. "COVID-19 in Autoinflammatory Diseases with Immunosuppressive Treatment" Journal of Clinical Medicine 10, no. 4: 605.

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