Abstract
Amaç: Etkin COVID-19 tedavisi için çeşitli tıbbi protokoller oluşturmak adına klinik çalışmalar devam etmektedir. Kolşisin, Ailevi Akdeniz Ateşi (AAA) de dahil olmak üzere otoimmün hastalıklar için yüksek oranda kullanılan bir anti-enflamatuar ajandır. SARS-CoV-2'nin bağışıklığı bozan patogenezine dayanarak, amacımız kolşisin tedavisi gören çocukluk çağı başlangıçlı AAA hastalarında SARS-CoV-2 enfeksiyonunun klinik seyrini tanımlamaktır.
Gereç ve Yöntemler: Kolşisin ile tedavi edilen çocukluk çağı başlangıçlı AAA hastalarının temas öykülerini ve klinik tablolarını araştıran bir anket hazırlandı ve ebeveynlerini telefon görüşmeleri veya poliklinik ziyaretleri sırasında sorgulandı. Ayrıca hastane veri tabanından tıbbi kayıt geçmişi, tedavi ve ilaç geçmişi elde edildi.
Bulgular: AAA tanısı konmuş ve en az bir aydır kolşisin tedavisi altında olan, 99 (%57,9) erkek ve 72 (%42,1) kadın olmak üzere toplam 171 hasta bu çalışmaya dahil edilmiştir. Hastaların 43'ünün (%25,1) şüpheli aile üyesi teması ve 13'ünün (%7,6) aile dışı teması olmak üzere 56'sının (%32,7) doğrulanmış bir COVID-19 vakası ile teması vardı. Kolşisin ile tedavi edilen AAA hastalarının sadece 15'ine (%8,8) PCR ile COVID-19 hastalığı tanısı konmuştur; hepsinde hafif semptomlar görülmüş, hiçbiri antiviral tedavi gerektirmemiş ve hiçbiri hastaneye yatırılmamıştır. Kolşisin kullanım dozu ve süresi, COVID tanısı olan ve olmayan hastalar arasında anlamlı farklılık göstermedi (sırasıyla p=0,112 ve p=0,344).
Sonuç: Kolşisin tedavisi alan AAA'lı pediatrik hastaların SARS-CoV-2 ile enfekte olması veya bu hastalarda COVID-19'un şiddetli semptomlarının görülebilmesi açısından yüksek riskte olmadığını düşünebiliriz.
Keywords
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References
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395(10223): 507-13.
- Akpinar G, Demir MC, Sultanoglu H, Sonmez FT, Karaman K, Keskin BH, et al. The Demographic analysis of the probable COVID-19 cases in terms of RT-PCR results and age. Clin Lab 2021; 67(4).
- Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H, et al. American College of rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS–CoV‐2 and Hyperinflammation in pediatric COVID‐19: version 2. Arthritis Rheumatol 2021; 73(4): e13-e29.
- Kharouf F, Ishay Y, Kenig A, Bitan M, Ben-Chetrit E. Incidence and course of COVID-19 hospitalizations among patients with familial Mediterranean fever. Rheumatology (Oxford) 2021; 60(SI): SI85-SI9.
- Gustine JN, Jones D. Immunopathology of Hyperinflammation in COVID-19. Am J Pathol 2021; 191(1): 4-17.
- Bartoli A, Gabrielli F, Alicandro T, Nascimbeni F, Andreone P. COVID-19 treatment options: a difficult journey between failed attempts and experimental drugs. Intern Emerg Med 2021; 16(2): 281-308.
- Grailer JJ, Canning BA, Kalbitz M, Haggadone MD, Dhond RM, Andjelkovic AV, et al. Critical role for the NLRP3 inflammasome during acute lung injury. J Immunol 2014; 192(12): 5974-83.
- Mikolajewska A, Fischer AL, Piechotta V, Mueller A, Metzendorf MI, Becker M, et al. Colchicine for the treatment of COVID-19. Cochrane Database Syst Rev 2021; 10: Cd015045.
- Lien C-H, Lee M-D, Weng S-L, Lin C-H, Liu LY-M, Tai Y-L, et al. Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis. Life. 2021; 11(8): 864.
- Gasparyan AY, Ayvazyan L, Yessirkepov M, Kitas GD. Colchicine as an anti-inflammatory and cardioprotective agent. Expert Opin Drug Metab Toxicol 2015; 11(11): 1781-94.
- Kaya Akca U, Sener S, Balık Z, Gurlevik S, Oygar PD, Atalay E, et al. Clinical course of COVID-19 infection in paediatric familial Mediterranean fever patients. Mod Rheumatol. 2022; 32(2): 467-72.
- Hedrich CM. COVID-19–Considerations for the paediatric rheumatologist. Clin Immunol 2020;214:108420.
- Golpour M, Mousavi T, Alimohammadi M, Mosayebian A, Shiran M, Alizadeh Navaei R, et al. The effectiveness of Colchicine as an anti-inflammatory drug in the treatment of coronavirus disease 2019: Meta-analysis. Int J Immunopathol Pharmacol 2021; 35: 20587384211031763.
- D'Antiga L. Coronaviruses and immunosuppressed patients: the facts during the third epidemic. Liver Transpl 2020; 26(6): 832-4.
- Haslak F, Yildiz M, Adrovic A, Sahin S, Koker O, Aliyeva A, et al. Management of childhood-onset autoinflammatory diseases during the COVID-19 pandemic. Rheumatol Int 2020; 40(9): 1423-31.
- Seo MR, Kim J-W, Park E-J, Jung SM, Sung Y-K, Kim H, et al. Recommendations for the management of patients with systemic rheumatic diseases during the coronavirus disease pandemic. Korean J Intern Med 2020; 35(6): 1317-32.
- Güven SC, Erden A, Karakaş Ö, Armağan B, Usul E, Omma A, et al. COVID-19 outcomes in patients with familial Mediterranean fever: a retrospective cohort study. Rheumatol Int 2021; 41(4): 715-9.
- Connelly JA, Chong H, Esbenshade AJ, Frame D, Failing C, Secord E, et al. Impact of COVID-19 on pediatric immunocompromised patients. Pediatr Clin North Am 2021; 68(5): 1029-54.
- Rojas-Villarraga A, Parra-Medina R, Gómez-López A. Colchicine treatment in COVID-19: the remaining unsolved question. Lancet Respir Med 2021; 9(12): 1351-3.
- Nas K, Eryilmaz N, Geyik MF, Altaş A. COVID-19 in patients with familial Mediterranean fever treated with colchicine: case based review. Rheumatol Int 2021; 41(4): 811-7.
- RECOVERY Collaborative Group. Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet Respir Med 2021; 9(12): 1419-26.
- Günendi Z, Yurdakul FG, Bodur H, Cengiz AK, Uçar Ü, Çay HF, et al. The impact of COVID-19 on familial Mediterranean fever: a nationwide study. Rheumatol Int 2021; 41(8): 1447-55.
- Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med 2020; 27(2): taaa020.
- Erden A, Karakas O, Armagan B, C. Guven, B. Ozdemir, E. Atalar, et al. COVID-19 outcomes in patients with antiphospholipid syndrome: a retrospective cohort study. Bratisl Med J 2022; 123(2): 120-4.
Abstract
Aim: Clinical trials continue for several medical protocols for COVID-19. Colchicine is an anti-inflammatory agent that is highly used medicament for autoimmune disorders, including Familial Mediterranean Fever (FMF). Based on immunity disrupting the pathogenesis of SARS-CoV-2, we aimed to describe the clinical course of SARS-CoV-2 infection in patients with childhood-onset FMF on colchicine treatment.
Material and Methods: We prepared a survey investigating contact histories, and clinical presentation of childhood-onset FMF patients treated with colchicine and questioned their parents via phone calls or during outpatient visits. In addition, medical record history, treatment, and medication history were obtained from the hospital database.
Results: A total of 171 patients, 99 (57.9%) male and 72 (42.1%) female, diagnosed with FMF and who have been under colchicine treatment for at least one month were included in the study. Among patients, 56 (32.7%) have contact with a confirmed COVID-19 case; 43 (25.1%) have suspected family member contact and 13 (7.6%) have non-family contact. Only 15 (8.8%) FMF patients treated with colchicine were PCR diagnosed with COVID-19 disease; all had mild symptoms, none required antiviral treatment, and none were hospitalized. The dose and duration of colchicine use did not significantly differ between the patients with confirmed COVID or not (p=0.112, and p=0.344, respectively).
Conclusion: We concluded that pediatric patients with FMF receiving colchicine treatment may not be at increased risk for being infected with SARS-CoV-2 or the severe symptoms of COVID-19.
Project Number
yok
References
- Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395(10223): 507-13.
- Akpinar G, Demir MC, Sultanoglu H, Sonmez FT, Karaman K, Keskin BH, et al. The Demographic analysis of the probable COVID-19 cases in terms of RT-PCR results and age. Clin Lab 2021; 67(4).
- Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H, et al. American College of rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS–CoV‐2 and Hyperinflammation in pediatric COVID‐19: version 2. Arthritis Rheumatol 2021; 73(4): e13-e29.
- Kharouf F, Ishay Y, Kenig A, Bitan M, Ben-Chetrit E. Incidence and course of COVID-19 hospitalizations among patients with familial Mediterranean fever. Rheumatology (Oxford) 2021; 60(SI): SI85-SI9.
- Gustine JN, Jones D. Immunopathology of Hyperinflammation in COVID-19. Am J Pathol 2021; 191(1): 4-17.
- Bartoli A, Gabrielli F, Alicandro T, Nascimbeni F, Andreone P. COVID-19 treatment options: a difficult journey between failed attempts and experimental drugs. Intern Emerg Med 2021; 16(2): 281-308.
- Grailer JJ, Canning BA, Kalbitz M, Haggadone MD, Dhond RM, Andjelkovic AV, et al. Critical role for the NLRP3 inflammasome during acute lung injury. J Immunol 2014; 192(12): 5974-83.
- Mikolajewska A, Fischer AL, Piechotta V, Mueller A, Metzendorf MI, Becker M, et al. Colchicine for the treatment of COVID-19. Cochrane Database Syst Rev 2021; 10: Cd015045.
- Lien C-H, Lee M-D, Weng S-L, Lin C-H, Liu LY-M, Tai Y-L, et al. Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis. Life. 2021; 11(8): 864.
- Gasparyan AY, Ayvazyan L, Yessirkepov M, Kitas GD. Colchicine as an anti-inflammatory and cardioprotective agent. Expert Opin Drug Metab Toxicol 2015; 11(11): 1781-94.
- Kaya Akca U, Sener S, Balık Z, Gurlevik S, Oygar PD, Atalay E, et al. Clinical course of COVID-19 infection in paediatric familial Mediterranean fever patients. Mod Rheumatol. 2022; 32(2): 467-72.
- Hedrich CM. COVID-19–Considerations for the paediatric rheumatologist. Clin Immunol 2020;214:108420.
- Golpour M, Mousavi T, Alimohammadi M, Mosayebian A, Shiran M, Alizadeh Navaei R, et al. The effectiveness of Colchicine as an anti-inflammatory drug in the treatment of coronavirus disease 2019: Meta-analysis. Int J Immunopathol Pharmacol 2021; 35: 20587384211031763.
- D'Antiga L. Coronaviruses and immunosuppressed patients: the facts during the third epidemic. Liver Transpl 2020; 26(6): 832-4.
- Haslak F, Yildiz M, Adrovic A, Sahin S, Koker O, Aliyeva A, et al. Management of childhood-onset autoinflammatory diseases during the COVID-19 pandemic. Rheumatol Int 2020; 40(9): 1423-31.
- Seo MR, Kim J-W, Park E-J, Jung SM, Sung Y-K, Kim H, et al. Recommendations for the management of patients with systemic rheumatic diseases during the coronavirus disease pandemic. Korean J Intern Med 2020; 35(6): 1317-32.
- Güven SC, Erden A, Karakaş Ö, Armağan B, Usul E, Omma A, et al. COVID-19 outcomes in patients with familial Mediterranean fever: a retrospective cohort study. Rheumatol Int 2021; 41(4): 715-9.
- Connelly JA, Chong H, Esbenshade AJ, Frame D, Failing C, Secord E, et al. Impact of COVID-19 on pediatric immunocompromised patients. Pediatr Clin North Am 2021; 68(5): 1029-54.
- Rojas-Villarraga A, Parra-Medina R, Gómez-López A. Colchicine treatment in COVID-19: the remaining unsolved question. Lancet Respir Med 2021; 9(12): 1351-3.
- Nas K, Eryilmaz N, Geyik MF, Altaş A. COVID-19 in patients with familial Mediterranean fever treated with colchicine: case based review. Rheumatol Int 2021; 41(4): 811-7.
- RECOVERY Collaborative Group. Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet Respir Med 2021; 9(12): 1419-26.
- Günendi Z, Yurdakul FG, Bodur H, Cengiz AK, Uçar Ü, Çay HF, et al. The impact of COVID-19 on familial Mediterranean fever: a nationwide study. Rheumatol Int 2021; 41(8): 1447-55.
- Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med 2020; 27(2): taaa020.
- Erden A, Karakas O, Armagan B, C. Guven, B. Ozdemir, E. Atalar, et al. COVID-19 outcomes in patients with antiphospholipid syndrome: a retrospective cohort study. Bratisl Med J 2022; 123(2): 120-4.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Research Articles |
| Authors | |
| Project Number | yok |
| Publication Date | January 16, 2024 |
| Submission Date | August 14, 2023 |
| Published in Issue | Year 2024 Volume: 14 Issue: 1 |
