COVID-19 IgG-related autoimmune inflammatory necrotizing myositis

Veyseh, Maedeh; Koyoda, Sai; Ayesha, Bibi

doi:10.1136/bcr-2020-239457

Cited by 19 publications

(15 citation statements)

References 20 publications

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“…Therefore, 9 cases from 8 articles were included in this review. Six cases fulfilled the 2017 EULAR/ACR classification criteria for adult and juvenile IIM and 3 patients were classified as possible polymyositis according to the Bohan and Peter criteria for DM and PM [ 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 ] ( Supplementary file ). Four cases were reports from Europe, 3 from America, and 2 from Asia.…”

Section: Resultsmentioning

confidence: 99%

New Onset of Autoimmune Diseases Following COVID-19 Diagnosis

Gracia‐Ramos

Martín‐Nares

Hernández-Molina

2021

Cells

203

158

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There is growing evidence that coronavirus disease 2019 (COVID-19) can lead to a dysregulation of the immune system with the development of autoimmune phenomena. The consequence of this immune dysregulation ranges from the production of autoantibodies to the onset of rheumatic autoimmune disease. In this context, we conducted a systematic review to analyze the current data regarding the new-onset systemic and rheumatic autoimmune diseases in COVID-19 patients. A literature search in PubMed and Scopus databases from December 2019 to September 2021 identified 99 patients that fulfilled the specific diagnostic/classification criteria and/or nomenclature for each rheumatic autoimmune disease. The main diseases reported were vasculitis and arthritis. Idiopathic inflammatory myopathies, systemic lupus erythematosus, and sarcoidosis were also reported in a limited number of patients, as well as isolated cases of systemic sclerosis and adult-onset Still’s disease. These findings highlight the potential spectrum of systemic and rheumatic autoimmune diseases that could be precipitated by SARS-CoV-2 infection. Complementary studies are needed to discern the link between the SARS-CoV-2 and new onset-rheumatic diseases so that this knowledge can be used in early diagnosis and the most suitable management.

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Section: Resultsmentioning

confidence: 99%

New Onset of Autoimmune Diseases Following COVID-19 Diagnosis

Gracia‐Ramos

Martín‐Nares

Hernández-Molina

2021

Cells

203

158

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“…SARS‐CoV‐2 infection‐associated myopathy may be an immune‐mediated necrotizing myopathy, unspecified necrotizing myopathy or myositis. 12 , 13 , 14 SARS‐CoV immunostaining of skeletal muscle was performed in 2 recently reported autopsy studies, and negative possibly due to postmortem changes with a postmortem interval of up to 6 days, 13 , 14 although positive SARS‐CoV‐2 testing by reverse transcription quantitative PCR (RT‐qPCR) was found in at least 16% (7/41) of quadriceps and 5% (2/42) of deltoid muscles. 14 Our present study (with the muscle biopsy tissue processed in 0.5 day) is the first to demonstrate SARS‐CoV+ myofibers with granular staining and EM finding of virus‐like particles consistent with SARS‐CoV‐2, which suggests direct viral infection of the muscle in some patients with COVID‐19.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19‐Associated Critical Illness Myopathy with Direct Viral Effects

Dodig

Tarnopolsky

Margeta

et al. 2022

Annals of Neurology

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Coronavirus disease 2019 (COVID-19) severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2 infection) can lead to intensive care unit (ICU) admission and critical illness myopathy (CIM). We examined 3 ICU patients with COVID-19 who required mechanical ventilation for pneumonia and developed CIM. Pathological examination of the skeletal muscle biopsies revealed myopathic changes consistent with CIM, variable inflammation with autophagic vacuoles, SARS-CoV immunostaining + fibers/granules, and electron microscopy findings of mitochondrial abnormalities and coronaviruslike particles. Although mitochondrial dysfunction with compromised energy production is a critical pathogenic mechanism of non-COVID-19-associated CIM, in our series of COVID-19-associated CIM, myopathic changes including prominent mitochondrial damage suggest a similar mechanism and association with direct SARS-CoV-2 muscle infection.

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“…A diagnosis of necrotizing myositis was established after muscle biopsy [ 3 ]. Another similar study reported a case in which the patient presented with worsening dyspnea and elevated CK 1 month after COVID-19 infection, but the lower extremity weakness started after 3 months [ 26 ]. These studies are all similar to our report, in which the patient presented with increased CK and acute lower extremity weakness weeks after the initial COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing autoimmune myositis following coronavirus disease 2019 infection: a case report

et al. 2022

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Background Severe acute respiratory syndrome coronavirus 2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis; however, the exact underlying pathogenesis of severe acute respiratory syndrome coronavirus 2-induced myositis is still unclear. Case Presentation Herein, we report a rare case of necrotizing autoimmune myositis in a 67-year-old middle eastern male following coronavirus disease 2019 infection, who presented with muscle weakness. The patient had positive anti-NXP2. The diagnosis of necrotizing autoimmune myositis was made according to muscle weakness, increased liver enzymes, electromyography and nerve conduction velocity results, and muscle biopsy. The patient underwent a full malignancy evaluation, which was unremarkable, and was discharged in relatively well condition with a daily dose of 1 mg/kg prednisolone and azathioprine 150 mg (2 mg/kg). Conclusion Our report highlights the already known possible protracted sequence of coronavirus disease 2019 infection and the potential for delayed-onset necrotizing myositis.

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COVID-19 IgG-related autoimmune inflammatory necrotizing myositis

Cited by 19 publications

References 20 publications

New Onset of Autoimmune Diseases Following COVID-19 Diagnosis

New Onset of Autoimmune Diseases Following COVID-19 Diagnosis

COVID‐19‐Associated Critical Illness Myopathy with Direct Viral Effects

Necrotizing autoimmune myositis following coronavirus disease 2019 infection: a case report

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