COVID-19 in familial Mediterranean fever: Clinical course and complications related to primary disease

Abstract

Objective Aim of the study is to evaluate the impact of Familial Mediterranean Fever (FMF) features on clinical course and outcomes of Coronavirus disease-19 (COVID-19) and clinical course of FMF after COVID-19. Methods Consecutive FMF patients with COVID-19 were enrolled from three referral hospitals. Clinical features of FMF and detailed COVID-19 information were obtained from patient interviews and medical records. Results Seventy-three FMF patients were included in the study. Sixty-nine patients had clinical symptoms of COVID-19, and 90.4% of patients received COVID-19 specific treatment. We found 24.7% hospitalization, %12.3 respiratory support, 4.1% ICU admission, 6.8% complication, and 1.4 % mortality rate in patients. Male gender and older age were significantly frequent in inpatients compared to outpatients (male gender 77.8 % vs 25.8%, p<0.001; median age 39.5 vs 32 years, p:0.043). FMF features were similar in both groups. The risk factors of hospitalization for respiratory support were male gender (OR: 7.167 (95% CI:1.368-37.535)), greater age (OR:1.067 (95% CI:1.016-1.121)) and non-adherence to colchicine treatment before the infection (OR:7.5 (95% CI: 1.348-41.722)). One-third of patients (33.3%) had reported attacks after COVID-19. The patterns of triggered attacks were fever, peritonitis, pleuritis, transient arthritis, chronic knee mono-arthritis, and protracted febrile myalgia. Conclusion FMF characteristics were not associated with worse outcomes of COVID-19. Colchicine non-adherence was the risk factor of hospitalization for oxygen support. The rate of FMF attacks after COVID-19 is prominently increased with some of them be protracted and destructive.

Clinical Characteristics, Outcomes, and Risk Factors for Mortality in Pregnant/Puerperal Women with COVID-19 Admitted to ICU in Turkey: A Multicenter, Retrospective Study from a Middle-Income Country

“…In previous studies in COVID-19 patients with FMF, FMF characteristics were not associated with worse outcomes in nonpregnant patients. 39 In this study, 4 pregnant women with FMF were admitted to the ICU, and 1 of them died. In previous studies, patients with selective IgA deficiency 40 and Factor V Leiden thrombophilia 41 had a higher risk of severe COVID-19 infection.…”

Covid-19 Progress in Patients With Familial Mediterranean Fever

“…The frequency and severity of SARS-CoV-2 infection in FMF are intriguing. Gunendi et al [9] and Guler et al [15] stated in their studies that FMFrelated characteristics were not associated with poor COVID-19 outcomes and were not a risk factor.…”

“…Guler et al stated that not using colchicine is a risk factor for hospitalization and oxygen support [15]. Bourguiba et al found similar incidence rates of COVID-19 in FMF patients (8%) and the general population (11%) in a French endemic region [16].…”

Post COVID recurrent fever in children with polymorphisms in the innate immunity regulator, pyrin; MEFV gene

“…A recent study reported worsening FMF symptoms after acute COVID-19 illness in 33% of patients with FMF, 7 perhaps through additive inflammasome dysregulation, which can occur both in patients with FMF 8 and in patients with acute COVID infection. 9 Given the potential for effective therapy, clinicians should obtain a thorough fever history and consider genetic testing for autoinflammatory diseases in children experiencing post-COVID recurrent fevers.…”