Journal Article

Correspondence on ‘Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis’

Jouneau, Stephane, Lorillon, Gwenael, Bergot, Emmanuel, Haroche, Julien, Le Pavec, Jérôme, Amoura, Zahir, Gazengel, Pierre, Taieb, Dov, Pugnet, Grégory, Annesi-Maesano, Isabella, Jeny, Florence, Lhote, Raphael, Saindenberg, Nathalie, Cohen-Aubart, Fleur, Tazi, Abdellatif, Valeyre, Dominique, Hervier, Baptiste, Nunes, Hilario, Uzunhan, Yurdagul, Freymond, Nathalie, Mathian, Alexis, Justet, Aurélien, Mekinian, Arsène, Tandjaoui-Lambiotte, Yacine, Borie, Raphaël, Dhote, Robin, Belhomme, Nicolas, Chazal, Thibaud, Hié, Miguel

2022

Overview

Patients with interstitial lung disease have been considered at high risk of complications of COVID-19 because of their underlying lung disease and use of immunosuppressive agents.1 However, data on COVID-19 in patients with sarcoidosis are scarce.2–4 Several reasons for an increased risk of severe forms of COVID-19 among sarcoidosis patients have been hypothesised: the involvement of the lung in almost 90% of patients with COVID-19, some of whom have reduced pulmonary function and comorbidities such as diabetes or hypertension, which are largely associated with the use of glucocorticosteroids for treating sarcoidosis; and the use of immunosuppressive agents in a subset of these patients.5 Recently, Gyorfi et al6 described the case of a patient with sarcoidosis who experienced a symptomatic SARS-CoV-2 infection with spontaneous clinical improvement, and a virological relapse after steroids treatment. This case illustrated the fact that immunosuppression with glucocorticoids may induce relapse of COVID-19 in patients with sarcoidosis. However, we lack data on the outcomes of patients with sarcoidosis affected by COVID-19. We retrospectively collected data for all patients with sarcoidosis and SARS-CoV-2 infection seen among 15 French centres between 1 March and 20 May 2020. The inclusion criteria were a sarcoidosis diagnosis based on the American Thoracic Society/European Respiratory Society/World Association for Sarcoidosis and other granulomatous diseases criteria7 and SARS-CoV-2 infection based on at least one of the following: nasopharyngeal or tracheal swab reverse transcription (RT)-PCR positive for SARS-CoV-2; SARS-CoV-2-positive serology; or typical clinical and radiological findings.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier Limited,BMJ Publishing Group
• Subject: Comorbidity / Coronaviruses / Correspondence / COVID-19 / Diabetes mellitus / Glucocorticoids / Glucocorticoids - therapeutic use / Humans / Immunosuppression / Immunosuppressive agents / Infections / inflammation / Life Sciences / Lung diseases / Patients / Recurrence / Respiratory function / Reverse transcription / Sarcoidosis / Sarcoidosis - complications / Sarcoidosis - drug therapy / Serology / Severe acute respiratory syndrome coronavirus 2 / Steroid hormones / therapeutics / Thorax