Juvenile Dermatomyositis Triggered by SARS-CoV-2

Abstract

Please cite this article as: RRH: Juvenile Dermatomyositis triggered by SARS-CoV2 This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Anti-MDA5 Antibody Linking COVID-19, Type I Interferon, and Autoimmunity: A Case Report and Systematic Literature Review

“…In nine patients, new-onset inflammatory myositis followed SARS-CoV-2 infection; two cases of disease relapse following COVID-19 have been reported: one at pediatric age ( 22 ) (in a child who experienced a skin-only relapse of juvenile DM) and one in the adult setting ( 20 ) (in a patient positive for both anti-Mi-2 and anti-PM/Scl antibodies). Three out of eleven cases were juvenile DM ( 22 , 26 ), in the other 8 adult cases the median age was 58 (interquartile range – IQR 50-64) years; a strong female predominance was observed (8/11 cases). In 9/11 reports, the severity of COVID-19 is described: 3/9 patients developed overt pneumonia, one of them succumbing to the infection ( 20 ); a flu-like illness was experienced in 4/9 cases, whereas two patients ( 22 , 26 ) were completely asymptomatic.…”

“…Three out of eleven cases were juvenile DM ( 22 , 26 ), in the other 8 adult cases the median age was 58 (interquartile range – IQR 50-64) years; a strong female predominance was observed (8/11 cases). In 9/11 reports, the severity of COVID-19 is described: 3/9 patients developed overt pneumonia, one of them succumbing to the infection ( 20 ); a flu-like illness was experienced in 4/9 cases, whereas two patients ( 22 , 26 ) were completely asymptomatic. Apart from the case described by Gokhale ( 20 ) et al., none of the patients required specific therapies, oxygen supplementation nor mechanical ventilation for COVID-19.…”

“…Apart from the case described by Gokhale ( 20 ) et al., none of the patients required specific therapies, oxygen supplementation nor mechanical ventilation for COVID-19. Time from the diagnosis of SARS-CoV-2 infection to the onset of inflammatory myositis was less than two months, and in four patients ( 20 , 24 , 26 ) rheumatologic manifestations were concomitant with the diagnosis of the infection. DM-related skin involvement was present in all the patients, being the only manifestation in one case of relapsed juvenile DM ( 22 ).…”

“…Eleven cases of inflammatory myositis temporally related to COVID-19 have been reported (20)(21)(22)(23)(24)(25)(26)(27); the main features are illustrated in Table 1. In nine patients, new-onset inflammatory myositis followed SARS-CoV-2 infection; two cases of disease relapse following COVID-19 have been reported: one at pediatric age (22) (in a child who experienced a skin-only relapse of juvenile DM) and one in the adult setting (20) (in a patient positive for both anti-Mi-2 and anti-PM/Scl antibodies).…”

“…Eight out of eleven patients experienced favorable outcome regarding both inflammatory myositis and COVID-19. One case of juvenile DM required mechanical ventilation due to respiratory deterioration, but gradual improvement followed thereafter ( 26 ). As already stated, two deaths were observed: one following macrophage activation syndrome ( 23 ), the other attributable to severe SARS-CoV-2 pneumonia ( 20 ); both patients had tested positive for anti-MDA5 autoantibodies.…”