COVID-19 outcomes in patients with familial Mediterranean fever: a retrospective cohort study

Abstract

Aim of this study is to investigate the course of coronavirus disease 2019 (COVID-19), in our cohort of familial Mediterranean fever (FMF) patients in means of mortality, admission to hospital and/or intensive care unit and length of hospital stay.A retrospective cohort was formed from patients who have previously been followed with a diagnosis of FMF. Patients of this cohort were retrospectively evaluated for a positive severe acute respiratory syndrome-coronavirus 2 (SARS-CoV 2) polymerized chain reaction (PCR) test result and information regarding hospitalisation, intensive care unit admission and mortality were collected from medical records.Out of a total 496 FMF patients, 34 were detected to have a positive SARS-CoV 2 PCR test. Eighty-five point three percent of these patients were under colchicine treatment and 17.6% were under interleukin (IL)—1 inhibitor treatment. Eight of the 34 patients (23.9%) were found to be hospitalized, one of them was admitted to the intensive care unit and died thereafter (2.9%). An increasing trend in the frequency of comorbid diseases (presence of at least one comorbidity 64.7% in all patients vs 75.0% in hospitalized patients) and IL-1 inhibitor usage (17.6% in all patients vs 50.0% in hospitalized patients) was observed in hospitalized patients.Rates of comorbid diseases and IL-1 inhibitor use for FMF were observed to be increased in FMF patients hospitalized for COVID-19.

Immunologic Dysregulation and Hypercoagulability as a Pathophysiologic Background in COVID-19 Infection and the Immunomodulating Role of Colchicine

“…The small number of patients and the observational study design with no controls are the major limitations of this study. Similarly, Güven et al retrospectively examined data from 34 FMF patients diagnosed with SARS-COV-2 between March and December 2020 in Turkey and their findings were in accordance with the above-mentioned study [ 74 ]. In addition, Gendelman et al retrospectively investigated 14,520 subjects from the Maccabi Health Services database in Israel (from 23 February 2020 to 31 March 2020) and found no difference in the rate of COVID-19 infection between colchicine users and non-users [ 75 ].…”

Coronavirus disease 2019 in patients with inborn errors of immunity: lessons learned

“…Autoinflammatory disorders were present in 54 patients infected with SARS-CoV-2 (8%), 39 with familial Mediterranean fever (FMF, 72%) [ 5 ▪ , 12 , 13 , 20 ]. The rate of ICU admission was 4% and CFR 6% ( n = 3) for the entire group, while both ICU admission rate and CFR were 3% ( n = 1) for FMF patients.…”

“…Despite this, CFR among APS-1 patients is like the whole group of immune dysregulation disorders, indicating that immune dysregulation diseases arising from distinct genetic causes can predispose to severe COVID-19. On the other hand, patients affected by autoinflammatory disorders do not seem to have a specifically higher risk of severe COVID-19 and have mostly a mild course [ 5 ▪ , 10 , 20 ]. One prediction would be that elevated production or action of type I interferon, as one of the inflammatory mechanisms, provides effective innate host defense against SARS-CoV-2 infection, thereby minimizing disease severity.…”

The impact of COVID-19 on familial Mediterranean fever: a nationwide study

“…Two papers from Turkey were published recently [ 28 , 29 ]. First paper reported three FMF patients with mild COVID-19.…”

“…Second paper is a retrospective cohort study from a single center. It was found that comorbidities and disease severity were numerically high in hospitalized COVID-19 patients with FMF [ 29 ]. However, without statistical analysis, no estimation could be made in terms of factors associated with poor COVID-19 outcomes in patients with FMF.…”