©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2020; 8(17): 3669-3678
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3669
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3669
Complexities of diagnosis and management of COVID-19 in autoimmune diseases: Potential benefits and detriments of immunosuppression
Tsvetoslav Georgiev, Clinic of Rheumatology, University Hospital "St. Marina", First Department of Internal Medicine, Medical University - Varna, Varna 9010, Bulgaria
Alexander Krasimirov Angelov, Clinic of Rheumatology, University Hospital "St. Ivan Rilski", Medical University - Sofia, Sofia 1612, Bulgaria
Author contributions: Georgiev T and Angelov AK contributed equally to the article by taking part in the conception and design of the study, literature search and review, and logical interpretation; Georgiev T drafted the introduction, search methodology, and diagnostic sections, while Angelov AK – the abstract, management and conclusion sections; both authors revised the manuscript critically for important intellectual content and approved the final version.
Conflict-of-interest statement: No conflict of interest to declare for both authors.
Corresponding author: Tsvetoslav Georgiev, MD, PhD, Assistant Professor, Doctor, Clinic of Rheumatology, University Hospital "St. Marina", First Department of Internal Medicine, Medical University - Varna, 1 Hristo Smirnenski str, Varna 9010, Bulgaria. tsetso@medfaculty.org
Received: May 16, 2020
Peer-review started: May 16, 2020
First decision: June 7, 2020
Revised: June 12, 2020
Accepted: August 26, 2020
Article in press: August 26, 2020
Published online: September 6, 2020
Processing time: 110 Days and 16.8 Hours
Peer-review started: May 16, 2020
First decision: June 7, 2020
Revised: June 12, 2020
Accepted: August 26, 2020
Article in press: August 26, 2020
Published online: September 6, 2020
Processing time: 110 Days and 16.8 Hours
Core Tip
Core tip: It is of utmost importance to differentiate coronavirus disease 2019 (COVID-19) manifestations from a relapse of the autoimmune disease. COVID-19 lung disease and interstitial lung disease may share similar pathological patterns. False positivity may complicate the serodiagnostics of COVID-19 in patients with autoimmune diseases. Maximum utilization of tele-medicine should be made when appropriate. Suspected COVID-19 patients should be treated by a multidisciplinary team with robust knowledge of immunosuppressive medication to carefully weigh the benefits and potential detrimental effects of the applied therapy.