Systemic immunosuppression in times of COVID-19: do we need to rethink our standards?

The current SARS-CoV-2 pandemic particularly endangers older people with pre-existing cardiopulmonary and metabolic conditions. However, it is also currently under discussion whether patients under immunosuppressive therapy also have a higher risk of suffering a severe course of the COVID-19 disease...

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Main Authors: Grabbe, Stephan (Author) , Beissert, Stefan (Author) , Enk, Alexander (Author)
Format: Article (Journal)
Language:English
Published: 21 August 2020
In: Journal der Deutschen Dermatologischen Gesellschaft
Year: 2020, Volume: 18, Issue: 8, Pages: 810-813
ISSN:1610-0387
DOI:10.1111/ddg.14194
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1111/ddg.14194
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/ddg.14194
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Author Notes:Stephan Grabbe, Stefan Beissert, Alexander Enk

MARC

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520 |a The current SARS-CoV-2 pandemic particularly endangers older people with pre-existing cardiopulmonary and metabolic conditions. However, it is also currently under discussion whether patients under immunosuppressive therapy also have a higher risk of suffering a severe course of the COVID-19 disease. In principle though, there is currently no data available for a general reduction or pause of immunosuppression in patients with autoimmune diseases because of the SARS-CoV-2 pandemic. However, since there is currently neither an effective therapy nor corresponding vaccination protection, the indication for a prolonged immunosuppressive therapy should be made with special care. In particular, immunotherapeutic agents that produce long-term effects (e.g., rituximab) should be used with special caution. In contrast, immunomodulating substances that do not suppress antiviral immunity (e.g. systemic immunoglobulins, doxycycline), or that have intrinsic effects on SARS-CoV-2 (calcineurin inhibitors, chloroquine, hydroxychloroquine) may be useful alternatives. 
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