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You are here: Home / Articles / 2 Patients on Different DMARDs Experience Different COVID-19 Disease Courses

2 Patients on Different DMARDs Experience Different COVID-19 Disease Courses

April 13, 2020 • By Luis A. Marcos, MD, MPH, Saika Sharmeen, DO, Jaime Gonzalez, MD, Qingping Yao, MD, PhD, Bettina Fries, MD, & Jack Fuhrer, MD

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May 2020

These two cases highlight the disparate clinical courses that may be experienced by patients with rheumatic disease who are infected by SARS-CoV2. The immunologic mechanisms underpinning the more severe manifestations of COVID-19 have not yet been elucidated, and observations such as these may begin to provide some clarity.

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It is important, however, to acknowledge limitations in interpreting these cases. In particular, the clinical course of COVID -19 may be highly heterogeneous, even among patients with otherwise similar characteristics. The relative contribution of other potential risk-factors (e.g., gender, genetic milieu and concomitant medications) is impossible to differentiate from the impact of the biologic agents used for each patient.

That said, these cases raise intriguing questions regarding the pathogenesis of COVID-19. The potential risks and benefits of specific immunosuppressive agents for patients with COVID-19 and the potential role of biologic agents for the management of severe COVID-19 warrant further study.

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Dr. Marcos

Luis A. Marcos, MD, MPH, is an infectious diseases physician, Associate Professor, Department of Medicine, Stony Brook University Renaissance School of Medicine, N.Y.

Dr. Sharmeen

Saika Sharmeen, DO, is a rheumatologist and an assistant professor in the Department of Medicine, Division of Rheumatology, Allergy and Immunology, Stony Brook University Renaissance School of Medicine, N.Y.

Dr. Gonzalez

Jaime Gonzalez, MD, is an infectious diseases fellow, Department of Medicine, Stony Brook University Renaissance School of Medicine, N.Y.

Dr. Yao

Qingping Yao, MD, PhD, is a rheumatologist, Professor, Department of Medicine, Chief, Division of Rheumatology, Allergy and Immunology, Stony Brook University Renaissance School of Medicine.

Dr. Fries

Bettina Fries, MD, is an infectious diseases physician, professor and chief of the Division of Infectious Diseases, Department of Medicine, Stony Brook University Renaissance School of Medicine, N.Y.

Dr. Fuhrer

Jack Fuhrer, MD, is an associate professor of medicine and faculty member of the Division of Infectious Diseases. He is also the director of the HIV Treatment Center, and associate dean for admissions for the Renaissance School of Medicine at Stony Brook University, N.Y.

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Updated and revised April 13, 2020.

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Filed Under: Conditions Tagged With: COVID-19Issue: May 2020

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