Recommendations on the management of adult patients with rheumatic diseases in the context of SARS-CoV-2/COVID-19 infection. Colombian Association of Rheumatology
Reumatol Clin (Engl Ed). 2020 Nov-Dec;16(6):437-446.
doi: 10.1016/j.reuma.2020.06.011.
Epub 2020 Jul 28.
[Article in
English,
Spanish]
Authors
Lina María Saldarriaga Rivera
1
, Daniel Fernández Ávila
2
, Wilson Bautista Molano
3
, Daniel Jaramillo Arroyave
4
, Alain Jasaf Bautista Ramírez
5
, Adriana Díaz Maldonado
6
, Jorge Hernán Izquierdo
7
, Edwin Jáuregui
8
, María Constanza Latorre Muñoz
9
, Juan Pablo Restrepo
10
, Juan Sebastián Segura Charry
11
Affiliations
- 1 Departamento de Medicina Interna, Unidad de Reumatología, Facultad de Medicina, Universidad Tecnológica de Pereira. Hospital Universitario San Jorge, Clínica Los Rosales, Pereira, Colombia. Electronic address: vasculitisreumato@gmail.com.
- 2 Departamento de Medicina Interna, Unidad de Reumatología, Facultad de Medicina, Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Bogotá, Colombia.
- 3 Sección de Reumatología, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad el Bosque, Bogotá, Colombia.
- 4 Servicio de Reumatología, IPS Universitaria de Antioquia, Universidad CES, Medellín, Colombia.
- 5 Departamento de Medicina Interna, Unidad de Reumatología, Hospital Santa Sofía, Manizales, Colombia.
- 6 Unidad de Reumatología Pediátrica, Care for Kids, Fundación HOMI, Instituto Roosevelt, Bogotá, Colombia.
- 7 Unidad de Reumatología, Clínica de Occidente S.A., Cali, Colombia.
- 8 Unidad de Reumatología, Epidemiología Clínica, Riesgo de Fractura S.A-CAYRE IPS, Bogotá, Colombia.
- 9 Unidad de Reumatología, Country Medical Center, Bogotá, Colombia.
- 10 Consultorio privado Clínica Central del Quindío, Armenia, Colombia.
- 11 Unidad de Reumatología, Clínica Medilaser, Neiva, Colombia.
Abstract
Objective:
To produce recommendations for patients with rheumatological diseases receiving immunomodulatory and immunosuppressive therapies (conventional drugs, biologicals, and small molecules) during the COVID-19 pandemic.
Materials and methods:
The recommendations were determined using the Delphi method as an agreement tool. A panel of experts was formed, with academic backgrounds and research experience in rheumatology. A literature search was conducted and 42 questions were generated. The level of agreement was made with 80% of approval by the participants.
Results:
A group of eleven rheumatologists from 7 cities in the country participated. The response rate was 100% for the three consultation rounds. In the first round, agreement was reached on 35 questions, on 37 in the second round, and on 42 questions in the third round.
Conclusion:
The recommendation for the majority of the pharmacological treatments used in rheumatology is to continue with immunomodulatory or immunosuppressive therapies in patients who do not have the infection, and to suspend it in patients with a diagnosis of SARS-CoV-2/COVID-19.
Keywords:
Immunomodulation; Immunosuppression; Inmunomodulación; Inmunosupresión; SARS-CoV-2/COVID-19; Tratamiento; Treatment.
Copyright © 2020 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.
Publication types
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Consensus Development Conference
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Practice Guideline
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Review
MeSH terms
-
Adult
-
Anti-Inflammatory Agents, Non-Steroidal / adverse effects
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / therapeutic use
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Antimalarials / adverse effects
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Antimalarials / therapeutic use
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Antirheumatic Agents / adverse effects
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Antirheumatic Agents / therapeutic use*
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Betacoronavirus*
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Biological Products / adverse effects
-
Biological Products / therapeutic use
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COVID-19
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COVID-19 Drug Treatment
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Clinical Trials as Topic
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Colombia
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Coronavirus Infections / complications*
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Coronavirus Infections / drug therapy
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Delphi Technique
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Drug Interactions
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Drug Repositioning
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Glucocorticoids / adverse effects
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Glucocorticoids / therapeutic use
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Humans
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Immunoglobulins, Intravenous / therapeutic use
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Immunologic Factors / adverse effects
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Immunologic Factors / therapeutic use
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Immunosuppressive Agents / adverse effects
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Immunosuppressive Agents / therapeutic use
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Multicenter Studies as Topic
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Pandemics*
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Pneumonia, Viral / complications*
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Pneumonia, Viral / drug therapy
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Rheumatic Diseases / complications*
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Rheumatic Diseases / drug therapy
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SARS-CoV-2
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Antibodies, Monoclonal
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Antimalarials
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Antirheumatic Agents
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Biological Products
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Glucocorticoids
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Immunoglobulins, Intravenous
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Immunologic Factors
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Immunosuppressive Agents