Risk and management of patients with mastocytosis and MCAS in the SARS-CoV-2 (COVID-19) pandemic: Expert opinions - 05/08/20
, Cem Akin, MD, PhD b, Patrizia Bonadonna, MD c, Knut Brockow, MD d, Marek Niedoszytko, MD, PhD e, Boguslaw Nedoszytko, PhD f, Joseph H. Butterfield, MD g, Ivan Alvarez-Twose, MD, PhD h, Karl Sotlar, MD i, Juliana Schwaab, MD j, Mohamad Jawhar, MD j, Andreas Reiter, MD j, Mariana Castells, MD, PhD k, Wolfgang R. Sperr, MD a, Hanneke C. Kluin-Nelemans, MD, PhD l, Olivier Hermine, MD, PhD m, Jason Gotlib, MD, MS n, Roberta Zanotti, MD o, Sigurd Broesby-Olsen, MD p, Hans-Peter Horny, MD q, Massimo Triggiani, MD, PhD r, Frank Siebenhaar, MD s, Alberto Orfao, MD, PhD t, Dean D. Metcalfe, MD, MS u, Michel Arock, PharmD, PhD v, Karin Hartmann, MD w
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Abstract |
The coronavirus disease 2019 (COVID-19) (caused by severe acute respiratory syndrome coronavirus 2) pandemic has massively distorted our health care systems and caused catastrophic consequences in our affected communities. The number of victims continues to increase, and patients at risk can only be protected to a degree, because the virulent state may be asymptomatic. Risk factors concerning COVID-19–induced morbidity and mortality include advanced age, an impaired immune system, cardiovascular or pulmonary diseases, obesity, diabetes mellitus, and cancer treated with chemotherapy. Here, we discuss the risk and impact of COVID-19 in patients with mastocytosis and mast cell activation syndromes. Because no published data are yet available, expert opinions are, by necessity, based on case experience and reports from patients. Although the overall risk to acquire the severe acute respiratory syndrome coronavirus 2 may not be elevated in mast cell disease, certain conditions may increase the risk of infected patients to develop severe COVID-19. These factors include certain comorbidities, mast cell activation–related events affecting the cardiovascular or bronchopulmonary system, and chemotherapy or immunosuppressive drugs. Therefore, such treatments should be carefully evaluated on a case-by-case basis during a COVID-19 infection. In contrast, other therapies, such as anti–mediator-type drugs, venom immunotherapy, or vitamin D, should be continued. Overall, patients with mast cell disorders should follow the general and local guidelines in the COVID-19 pandemic and advice from their medical provider.
Le texte complet de cet article est disponible en PDF.Key words : Mast cells, mastocytosis, tryptase, KIT D816V, coronavirus, COVID-19, SARS-CoV-2, mast cell activation syndrome
Abbreviations used : CM, COVID-19, HSCT, ISM, MC, MCAS, SARS-CoV-2, SM
Plan
| P.V. was supported by the Austrian Science Fund (FWF; projects P32470-B and F4704-B20). J.G. is supported by the Charles and Ann Johnson Foundation. D.D.M. is supported by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases. |
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| Disclosure of potential conflict of interest: P. Valent received consultancy honoraria from Blueprint, Novartis, Deciphera, Celgene, and Incyte and a research grant from Pfizer. C. Akin received consultancy honoraria from Blueprint and Novartis and research grant from Blueprint and is an investigator in a clinical trial for Blueprint. M. Niedoszytko received consultancy honoraria from Novartis and AB Science and is an investigator in clinical trials for Novartis and AB Science. I. Alvarez-Twose received consultancy honoraria from Novartis and Blueprint. M. Jawhar received consultancy honoraria from Novartis. A. Reiter received consultancy honoraria from Novartis, Blueprint, and Deciphera and research support from Novartis. M. Castells is a principal investigator in a clinical trial for Blueprint. W. R. Sperr received consultancy honoraria from Thermofisher, AbbVie, Novartis, Pfizer, Incyte, Deciphera, Jazz, Teva, and Celgene. H. C. Kluin-Nelemans received consultancy honoraria from Novartis. O. Hermine received research funding from AB Science; is cofounder of AB Science; and received research funding (unrelated to this study) from Novartis, Inatherys, Celgene, BMS, and Takeda. J. Gotlib received consultancy honoraria from Novartis, Blueprint, and Deciphera and is an investigator in a clinical trial for Novartis, Blueprint, and Deciphera. R. Zanotti received consultancy (honoraria) from Novartis and Deciphera. S. Broesby-Olsen provided consultancy in a clinical trial for Blueprint and received consultancy honoraria from Novartis and ThermoFisher. H.-P. Horny received consultancy honoraria from Novartis, Deciphera, and Blueprint. M. Triggiani received consultancy honoraria from Novartis, Deciphera, and Blueprint and is an investigator in a clinical trial for Blueprint. F. Siebenhaar received consultancy honoraria and research support from Allakos, Blueprint, Novartis, and Uriach. A. Orfao received consultancy honoraria from Novartis. D. D. Metcalfe is an investigator in a clinical trial for Sanofi US Services. M. Arock received consultancy honoraria from Blueprint. K. Hartmann received consultancy honoraria from Allergopharma, ALK-Abelló, Blueprint, Deciphera, Menarini, and Novartis. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 146 - N° 2
P. 300-306 - août 2020 Retour au numéro
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