Rheumatologists: On the COVID-19 Front Line
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Get authentic, real-time news that helps you fight COVID-19 better.
Install PlexusMD App for doctors. It's free.
Rheumatologists may be in a unique position to consult and help in the management of patients with severe disease caused by COVID-19, said experts. Some of the drugs that appear promising for patients who are severely ill with COVID-19 are those in which rheumatologists have extensive experience, such as hydroxychloroquine or tocilizumab [Actemra].

It appears that in patients who are having the worst outcomes with COVID-19 infections, the immune system itself may be the culprit, with developments similar to hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), Muskardin explained. In these conditions, the immune system becomes overactive with excessive production of T cells and macrophages, resulting in a "cytokine storm" with a variety of proinflammatory cytokines such as interleukins (IL)-1, 6, 12, and 18 being released. Fatalities are not uncommon.

Patients with certain rheumatic diseases, particularly those with systemic juvenile idiopathic arthritis or adult-onset Still's disease, are most often affected by those potentially catastrophic events. Accordingly, many rheumatologists are experienced in diagnosing and managing HLH and MAS, according to Muskardin, who is a pediatric and adult rheumatologist.

"There is a role for us in educating our colleagues on recognizing impending secondary HLH or MAS and helping to select patients who may benefit by immunologic treatments," she told.

"This is an opportunity for us to have conversations with our intensivists and people on the front lines of caring for these patients and to educate them on recognizing the subset of patients who may have impending HLH or MAS and those in whom we should be intervening," she said.

Source: https://www.medpagetoday.com/infectiousdisease/covid19/85545
S S and 5 others like this2 shares
Like
Comment
Share
M●●●T L●●●●●L
M●●●T L●●●●●L General Medicine
I think its half half we r not sure
Mar 26, 2020Like
M●●●T L●●●●●L
M●●●T L●●●●●L General Medicine
I think its half half we r not sure
Mar 26, 2020Like
M●●●T L●●●●●L
M●●●T L●●●●●L General Medicine
I think its half half we r not sure
Mar 26, 2020Like