SARS‐CoV‐2 asymptomatic infection in a patient under treatment with dupilumab

Caroppo, Francesca; Biolo, Giulia; Fortina, Anna Belloni

doi:10.1111/jdv.16619

Cited by 23 publications

(27 citation statements)

References 8 publications

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“…[1][2][3] Recently, few papers describe chilblain-like lesions (CLL) as a possible skin clue of COVID-19 among young patients and children, mostly in the absence of systemic symptoms and with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab negativity. [4][5][6][7][8] This observation is consistent with the atypical outbreak of CLL reported in high endemic COVID-19 Italian regions among paediatric and dermatological networks. 6 We hereby report a case of an adolescent boy with a reverse transcriptase (RT)-PCR-confirmed COVID-19 who developed long-lasting CLL.…”

Section: Histologic Features Of Longlasting Chilblain-like Lesions Insupporting

confidence: 87%

“…Our case reflects the prototype reported in the literature: an adolescent in good health with occasional history of systemic symptoms preceding cutaneous lesions. [4][5][6][7][8] Interestingly, we observed in our patient long-lasting skin lesions several weeks after the first showings of the symptoms, concurrently with the positivity of the nasopharyngeal swab.…”

Section: Histologic Features Of Longlasting Chilblain-like Lesions Insupporting

confidence: 53%

“…adalimumab, infliximab, ustekinumab, secukinumab and guselkumab), does not worsen the condition of patients infected by SARS-CoV-2 or increase the risk of infection by SARS-CoV-2, 2-7 possibly because these antibodies neutralize individual mediators of the inflammation cascade rather than leading to broad immunosuppression. 8 However, of course, more robust clinical data are needed in order to evaluate the safety of dupilumab and of other biologics in patients infected by SARS-CoV-2.…”

Section: Histologic Features Of Longlasting Chilblain-like Lesions Inmentioning

confidence: 99%

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Histologic features of long‐lasting chilblain‐like lesions in a paediatric COVID‐19 patient

Locatelli

Test

Vezzoli

et al. 2020

Acad Dermatol Venereol

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Section: Histologic Features Of Longlasting Chilblain-like Lesions Insupporting

confidence: 87%

Section: Histologic Features Of Longlasting Chilblain-like Lesions Insupporting

confidence: 53%

Section: Histologic Features Of Longlasting Chilblain-like Lesions Inmentioning

confidence: 99%

See 1 more Smart Citation

Histologic features of long‐lasting chilblain‐like lesions in a paediatric COVID‐19 patient

Locatelli

Test

Vezzoli

et al. 2020

Acad Dermatol Venereol

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“…We also observed lower plasma levels of the macrophage activation marker sCD163, although macrophages infiltrating the lungs of COVID-19 patients expressed may also be counteracted with monoclonal antibodies. For instance, dupilumab, a monoclonal antibody against IL-4, has been safely used in patients with atopic dermatitis and COVID-19, without increased risk of severe complications of the infection, and even some patients receiving dupilumab that later acquired the infection with SARS-CoV-2 did not show respiratory symptoms (64)(65)(66). Finally, TSLP could be another target to inhibit Th2 responses in COVID-19 patients, as this molecule promotes allergic inflammation (36), and indeed, high levels of TSLP were observed in our cohort of COVID-19 but not influenza subjects.…”

Section: Discussionmentioning

confidence: 99%

Clinical and immunological factors that distinguish COVID-19 from pandemic influenza A(H1N1)

Choreño-Parra

Jiménez-Álvarez

Cruz‐Lagunas

et al. 2020

Preprint

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), is a global health threat with the potential to cause severe disease manifestations in the lungs. Although clinical descriptions of COVID-19 are currently available, the factors distinguishing SARS-CoV-2 from other respiratory viruses are unknown. Here, we compared the clinical, histopathological, and immunological characteristics of patients with COVID-19 and pandemic influenza A(H1N1). We observed a higher frequency of respiratory symptoms, increased tissue injury markers, a histological pattern of alveolar pneumonia, and higher levels of IL-1RA, TNF-α, CCL3, G-CSF, APRIL, sTNF-R1, sTNF-R2, sCD30, and sCD163 in influenza patients. Conversely, dry cough, gastrointestinal symptoms, interstitial lung pathology, increased Th1 (IL-12, IFN-γ) and Th2 (IL-4, IL-5, IL-10, IL-13) cytokine levels, along with IL-1β, IL-6, CCL11, VEGF, TWEAK, TSLP, MMP-1, and MMP-3, were observed in COVID-19 cases. We demonstrated the diagnostic potential of some clinical and immune factors to differentiate COVID-19 from pandemic influenza A(H1N1). Our data suggest that SARS-CoV-2 induces a dysbalanced polyfunctional inflammatory response that is different from the immune response against influenza. These findings might be relevant for the upcoming 2020-2021 influenza season, which is projected to be historically unique due to its convergence with COVID-19.

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“…A pooled analysis of two phase III RCTs demonstrated safety of dupilumab, where URTIs, nasopharyngitis, and severe infection rates were comparable to the placebo group 41 . Recently, several case reports demonstrated no evidence of increased risk for COVID‐19 infection in patients treated with dupilumab 42‐45 …”

Section: Introductionmentioning

confidence: 99%

Infection risk of dermatologic therapeutics during the COVID‐19 pandemic: an evidence‐based recalibration

et al. 2020

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Recommendations were made recently to limit or stop the use of oral and systemic immunotherapies for skin diseases due to potential risks to the patients during the current severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) COVID‐19 pandemic. Herein, we attempt to identify potentially safe immunotherapies that may be used in the treatment of cutaneous diseases during the current COVID‐19 pandemic. We performed a literature review to approximate the risk of SARS‐CoV‐2 infection, including available data on the roles of relevant cytokines, cell subsets, and their mediators in eliciting an optimal immune response against respiratory viruses in murine gene deletion models and humans with congenital deficiencies were reviewed for viral infections risk and if possible coronaviruses specifically. Furthermore, reported risk of infections of biologic and non‐biologic therapeutics for skin diseases from clinical trials and drug data registries were evaluated. Many of the immunotherapies used in dermatology have data to support their safe use during the COVID‐19 pandemic including the biologics that target IgE, IL‐4/13, TNF‐α, IL‐17, IL‐12, and IL‐23. Furthermore, we provide evidence to show that oral immunosuppressive medications such as methotrexate and cyclosporine do not significantly increase the risk to patients. Most biologic and conventional immunotherapies, based on doses and indications in dermatology, do not appear to increase risk of viral susceptibility and are most likely safe for use during the COVID‐19 pandemic. The limitation of this study is availability of data on COVID‐19.

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SARS‐CoV‐2 asymptomatic infection in a patient under treatment with dupilumab

Abstract: Since the new fatal pneumonia was identified in December 2019 in Wuhan, China, the WHO declared the infection a health emergency of international concern.

Cited by 23 publications

References 8 publications

Histologic features of long‐lasting chilblain‐like lesions in a paediatric COVID‐19 patient

Histologic features of long‐lasting chilblain‐like lesions in a paediatric COVID‐19 patient

Clinical and immunological factors that distinguish COVID-19 from pandemic influenza A(H1N1)

Infection risk of dermatologic therapeutics during the COVID‐19 pandemic: an evidence‐based recalibration

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